Abstract
Pelvic girdle pain (PGP) refers specifically to musculoskeletal pain localised to the pelvic ring and can be present at its anterior and/or posterior aspects. Causes such as trauma, infection and pregnancy have been well-established, while patients with hypermobile joints are at greater risk of developing PGP. Research exploring this association is limited and of varying quality. In the present study we report on the incidence, pathophysiology, diagnostic and treatment modalities for PGP in patients suffering from Hypermobility Spectrum Disorder (HSD) and Hypermobility-Type Ehlers-Danlos Syndrome (hEDS). Recommendations are made for clinical practice by elaborating on screening, diagnosis and management of such patients to provide a holistic approach to their care. It appears that this cohort of patients are at greater risk particularly of mental health issues. Moreover over, they may require a multidisciplinary approach for their management. Ongoing research is still required to expand our understanding of the relationship between PGP, HSD and hEDS by appropriately diagnosing patients using the latest updated terminologies and by conducting randomised control trials to compare outcomes of interventions using standardised patient reported outcome measures.
Highlights
Pelvic girdle pain (PGP) refers to musculoskeletal pain localised to the level of the posterior iliac crest and the gluteal fold, and occasionally over the anterior and posterior elements of the bony pelvis [1]
Ongoing literature would benefit from authors using the most recent and appropriate terminology and classifications for the diagnosis of PGP, hypermobility spectrum disorder (HSD) and Hypermobility-Type Ehlers-Danlos Syndrome (hEDS)
Patients presenting with PGP should formally be assessed for hypermobile joints, with support from connective tissue specialist colleagues for a formal diagnosis of HSD or hEDS
Summary
Pelvic girdle pain (PGP) refers to musculoskeletal pain localised to the level of the posterior iliac crest and the gluteal fold, and occasionally over the anterior and posterior elements of the bony pelvis [1]. There are many causes of pelvic pain overall, including trauma, infections of soft tissue, bone or underlying viscera, lower-back pain syndromes, pregnancy, joint hypermobility and disorders of connective tissues [1,2]. Joint hypermobility (JH) places a great level of strain on an affected individual’s musculoskeletal system. JH occurs secondary to increased elasticity of the soft tissues that support a joint, tendons and ligaments, which allows a greater range of motion [3]. Previous research has highlighted that there may be a link between JH and development of osteoarthritis secondary to the increased stress placed on joints, studies
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