Day Thirty-five: off topic - pelvic girdle pain

Apparently, some studies show that intermittent fasting boosts brain power. I'm not entirely convinced today, as I'm struggling to write a particularly troublesome report for work. I'm putting my difficulty with concentrating partly down to having to deal with fairly constant pain in my hip. So this post isn't about fasting, but brings together various themes which are related to my journey, namely health, gender, pain and weight.

Just over 5 years ago I had a baby, my second child, another beloved daughter. The pregnancy and delivery were pretty much a nightmare from beginning to end, and the consequences of the experience are still with me today. I could point at various mistakes and oversights made in my health care during that time and continuing since then, but I don't think there is any positive reason to do so. The reality is that I have to deal with where I am now.

Since the end of that pregnancy I have suffered intermittent intense pain in my groin. This ranges from an unpleasant ache to agonising stabbing pain, the feeling that my pelvis is coming apart, and shooting pains down my legs. Turning or moving my leg in a particular way can leave me literally gasping for breath and unable to move. I can go months without any symptoms at all, and then something will trigger a flare up and I'm back on walking sticks. Triggers tend to be any kind of exercise more rigorous than a gentle stroll to the end of the road and back. As a result I have done next to no exercise over this time - each attempt has ended in more pain.

I have asked for, and been referred for various types of treatment over the years. Some have been covered on the NHS or my health insurance, others I have paid for myself. I have worn support belts, I have had obstetric physiotherapy, osteopathy and chiropractic. As I can avoid pain by basically being a couch potato, I'm not considered an urgent case. The last time I asked my GP for help following a particularly acute episode this summer, I was told there was no point getting treatment unless I lost weight. As it turns out, this was the kick I needed to get started on 5:2, for which I am grateful. However, now being in the middle of another flare up, I find I am no longer prepared to wait until I reach some arbitrary desired weight before attempting to seek treatment again.

I've tried Googling many times before to see if there is any advice or treatment I could research, but most of the information I found was related to how to manage the problem during pregnancy, which didn't really help me. Part of the problem was not knowing what the problem was called, or if it even had a name. While I was pregnant I was told it was called "Symphysis Pubis Dysfunction", or SPD. It was then renamed "Pelvic Pain in Pregnancy", or PPP. Again, this didn't help given that I am no longer pregnant, so none of the information was relevant. I finally found that the current term used is Pelvic Girdle Pain or PGP, and hey presto, I found all sorts of useful information, including acknowledgement and treatment of this as a long-term problem.

My new friend is the Pelvic Partnership - http://www.pelvicpartnership.org.uk/

Here is what I have learned. Pelvic girdle pain is usually caused by an asymmetry or change of normal movement or alignment in the pelvic joints – a mechanical joint problem. Frequently in PGP one of the three joints in the pelvis, often one of the SI joints at the back, becomes slightly stuck and the joints start to move asymmetrically. This then puts extra strain on the other joints which start to move differently and can become irritated and inflamed, leading to PGP.

In pregnant women this is usually triggered by abnormal pressures on the pelvis, by the loosening of the ligaments that hold the pelvis together due to the hormone relaxin, and in some cases by childbirth itself. Women are often told that their pelvic pain is due to:

• round ligament pain
• hormones
• sciatica
• trapped nerve
• normal aches and pains of pregnancy
• low back pain
• nerve irritation; 

and that it is not treatable and will get better on its own, or as soon as the baby is born. Many women have discovered later that it was pelvic girdle pain and could have been treated as soon as symptoms occurred. PGP also occurs in sportsmen, such as rugby players, and they are treated quickly and effectively with the same range of techniques as those used for pregnancy-related PGP.

This all gives me some hope, but also slightly depresses me. I have definitely been in the camp of thinking that this was just something I was going to have to live with, as a woman and a mother, and as a person who is obese. It has limited my lifestyle choices drastically over the last 5 years, ranging from not being able to exercise, to sometimes not being able to participate in normal family activities like playing with my children. Maybe I should have shouted louder, but all the professional feedback I have had is that it's too vague and too difficult and I should take care of it myself by doing Pilates and stop complaining.

I'm going to see a new GP this evening and am hopeful that armed with my new knowledge I can start down the road to recovery. If my GP is not helpful at least I know where to look for better information and support.