The role of physiotherapy in managing pregnancy related pelvic girdle pain

Pregnancy related pelvic girdle pain (PPGP) is a common musculoskeletal condition with a prevalence ranging from 23% to 33% in New Zealand and Australia (Ashby & Johnson, 2015, Pierce, Homer, Dahlen, & King, 2012). Most women with PPGP report moderate to severe pain (Pierce et al., 2012). In addition, the ability to perform everyday activities such as getting up from a chair, bending and walking is affected (Elden, Ladfors, Olsen, Ostgaard, & Hagberg, 2005). Furthermore, a significant proportion of women report a persistence of symptoms following childbirth suggesting that the condition is not self-resolving (Elden, Gutke, Kjellby-Wendt, Fagevik-Olsen, & Ostgaard, 2016). With the pain and functional restrictions during and following pregnancy, PPGP is now considered a major public health issue (Elden, Lundgren, & Robertson, 2014). Generally, women with PPGP report beneficial effects following physiotherapy management (Chang, Jensen, & Lai, 2015, Fishburn & Cooper, 2015, Pierce et al., 2012). For example, an Australian study reported that 75% of women had improvement in symptoms following physiotherapy (Pierce et al., 2012). Similarly, a recent clinical trial found a statistically significant and clinically meaningful effect on pain and function following a single physiotherapy treatment session (Ceprnja & Gupta, submitted for publication). In this study, pain reduced from an average (SD) of 5.6 (2.7) before treatment to 2.8 (2.2) after physiotherapy when measured using a visual analogue scale (Ceprnja & Gupta, submitted for publication). Importantly, no adverse events have been reported following physiotherapy management indicating that physiotherapy is a very safe treatment option for PPGP (Gutke, Betten, Degerskär, Pousette, & Olsen, 2015).