Women’s Rehabilitation Medicine for Pelvic and Sacroiliac Joint Pain
Pelvic pain and sacroiliac joint pain in women are frequently misdiagnosed as originating from spinal structures or abdominal or pelvic organs.
The physiatrists at the Department of Physical Medicine and Rehabilitation (PM&R) diagnose and treat these difficult musculoskeletal conditions using a holistic, multidisciplinary approach.
What Is Pelvic Pain?
Pelvic pain is common during pregnancy and postpartum. You may experience pelvic pain in your lower abdomen, though sometimes it spreads to the back and upper thighs. Pelvic pain can range from mild to severe, often varying in consistency.
In many cases, pelvic pain arises due to an underlying issue in the pelvic muscles or your urinary, digestive, or reproductive system. Various causes of pelvic pain include:
Your physiatrist will help determine the cause of your pelvic pain by performing a comprehensive evaluation that may include other tests such an ultrasound, abdominal x-ray, urine sample, and blood tests.
When gynecologic dysfunction has been ruled out, myofascial pain, or chronic and severe pelvic pain, can often be attributed to sacroiliac dysfunction. Learn more about treatment for pelvic pain and other women's health issues at the UPMC Centers for Rehab Services.
What Is Sacroiliac Joint Pain?
The sacroiliac joint lies next to the bottom of the spine and acts as a shock-absorbing structure. It may cause pain and dysfunction in cases where the symphysis pubis joint separates after delivery. Your symphysis pubis joint refers to ligaments that help keep your pelvic bone in place, especially important during pregnancy.
Sacroiliac joint pain causes
Sacroiliac joint dysfunction occurs due to:
- A change in your typical gait or joint motion
- Trauma or injury to your lower back area
- Pregnancy and childbirth complications
- Cartilage degeneration over the bone (degenerative arthritis)
Sacroiliac joint pain symptoms
Symptoms of sacroiliac pain commonly include pain in your lower back, made worse by movement directly affecting the area such as sitting or standing for long periods of time. Similar to pelvic pain, sacroiliac joint pain can spread to other areas of the body and increase in intensity.
Sacroiliac dysfunction and pain are often misdiagnosed as they imitate other conditions, including underlying causes of pelvic pain.
A few reasons it is important to accurately diagnose and treat sacroiliac pain include:
- Misdiagnosis frequently results in unnecessary surgery.
- Left untreated, symptoms of myofascial pain can lead to persistent impairment and disability.
- Early referral can prevent dysfunction and chronic pain.
Treating Pelvic and Sacroiliac Joint Pain
Once the cause of pain has been determined, our physiatrists will work with you to effectively manage your type of pain. Treatment for both pelvic pain and sacroiliac joint dysfunction include similar types of rehabilitation.
Physical therapy exercises and other forms of treatment for these muscular imbalances include:
- Bracing, in the form of a wide belt (specific to sacroiliac dysfunction)
- Medications to treat both pain and inflammation
- Joint manipulation, including properly directed muscle energy techniques and strengthening
Joint injections, such as cortisone shots which reduce inflammation and provide pain relief, may be necessary for some patients to reduce severe pain levels before beginning other treatment.
Those suffering specifically from pelvic pain may benefit from pelvic floor therapy. Your pelvic floor includes the muscles and nerves near your lower back and abdomen, especially those with reproductive function. Pelvic floor physical therapy treats the pain through techniques such as deep tissue massage, and exercises to tighten and relax specific muscles.
Physiatrists at the Department of Physical Medicine and Rehabilitation are specifically trained in areas relating to women's health and wellness, including the ability to:
- Address biomechanical issues
- Treat pain
- Perform interventional procedures, when indicated
- Coordinate care with physical therapists and other professionals to address contributing factors, like mood disturbances and life situations
For more information about conditions associated with pregnancy and postpartum care, visit Magee-Women's Hospital of UPMC.