Do you have an positioning advice for pregnant woman who are having pelvic pain and/or lateral hip pain at night?
Answer
Some women have significant hip pain when they are sleeping and cannot tolerate being on one side all night long. We may want to teach her how to use the semi-side-lying sleep position. This is the same position that we need to teach if we are concerned that she might have supine hypotensive syndrome. Supine hypotensive syndrome, just to remind you, is when the pregnant uterus compresses the vena cava and leads to a reduction in cardiac output. During our examination and in these resting positions, all we have to do is place a pillow under the right side of the body and tilt that uterus off of the vena cava just a little bit. Then it will restore the blood flow and allow cardiac output to the return to normal. To sleep in this position, we do the same thing. We put a pillow under the right side of the body, but then what we might also do is put a couple of pillows under the knees. Then the patient is in a semi-supine or a semi-side-lying sleep position. This can be a great relief for women who are having hip pain, lateral hip pain, low back pain, and pelvic girdle pain during their pregnancy that is interrupting their sleep.
Cynthia Neville, PT, DPT, WCS, BCB-PMD
Dr. Cynthia (Cindy) Neville, PT, DPT, WCS is Assistant Professor of Physical Therapy, Mayo Clinic Alix College of Medicine, in Jacksonville, Florida. She is a Women’s Health Certified Specialist (WCS), board certified by the American Board of Physical Therapy Specialties. She serves on the faculty of the Mayo Clinic Florida Orthopedic Physical Therapy Residency Program, and advises multiple medical specialty programs at Mayo Clinic Florida. Her outpatient clinical practice at Mayo Clinic Florida serves women and men with pelvic floor disorders. Dr. Neville has authored and co-authored several research articles and book chapters on the topics of pelvic health rehabilitation, pelvic pain, and urinary incontinence. She has presented her research and provided rehabilitation and medical education nationally and internationally. She has developed successful Pelvic and Women’s Health Rehabilitation Programs at premier healthcare organizations including the Rehabilitation Institute of Chicago (now the Shirley Ryan Ability Lab) and Mayo Clinic Florida. At Brooks Rehabilitation in Jacksonville, Dr. Neville developed the first institutional pelvic health rehabilitation program across all levels of care, and the first credentialed physical therapy women’s health residency program in the state of Florida. She has trained more than a thousand physical therapists, occupational therapists, physical therapist assistants, and physicians in pelvic floor examination and pelvic health rehabilitation.
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