The mechanical effect of a pelvic belt in patients with pregnancy-related pelvic pain

Jan M.A. Mens, Léonie Damen, Chris J. Snijders and henk J. Stam

Clinical Biomechanics

October 2005

Renowned researchers from The Netherlands have examined the effect of wearing a pelvic belt on Sacro Iliac joint laxity. Because of hormonal changes that lead to ligament laxity and the widening of the pelvis in preparation for childbirth, Sacro Iliac joint pain is common in pregnant women. Conventional lower back and SI joint supports are not feasible to wear due to the developing 'bump', so Pelvic belts are a common physical treatment.

The theory behind the use of a pelvic belt is that the articular surfaces of the SI joint will be pressed together and/or that the SI joint will be placed in an extreme position to provide stability but, prior to this research, there was no proof of this mechanical effect. Anecdotally, there is quite a lot of evidence to suggest that the use of a pelvic belt is effective in relieving symptoms, as the treatment is extremely common in pregnant women.

Twenty five patients were selected from the outpatient clinic of a rehabilitation centre, which specializes in the treatment of pregnancy-related low back pain. Women who had low back pain prior to pregnancy were excluded from the study.

The authors used a method called Doppler Imaging of Vibrations (DIV) to detect SI joint laxity changes. Vibrations were applied to the pelvis at a set frequency and intensity. This can then be interpreted using a form of ultrasound scan. In a stiff joint, there is a small or imperceptible difference in vibration amplitude between both sides. In a lax joint there is a large difference between the DIV measures of both sides of the SI joint.

The SI joint laxity values were measured without a pelvic belt, with a pelvic belt in low position and with a pelvic belt in high position. SI joint laxity values showed a significant decrease with the application of a pelvic belt in low and high position, compared to the condition without a belt. The application of a pelvic belt in high position was found to decrease SI joint laxity to a significantly greater degree than the application of a belt in low position.

Although the authors acknowledge that there is no definitive evidence that the DIV method is a true indicator of SI joint laxity, the findings indicate that pelvic belts can be beneficial to women with pregnancy related SI joint pain. The exact mechanism through which a pelvic belt works is still unknown.

The authors postulate that a pelvic belt in high position may simulate the action of the transversus abdominis muscle (corset muscle around the tummy) and the action of the multifidus (stabilizing muscle of the spine) while approximation of the pelvic belt at the level of the pubic bone may simulate the action of the pelvic floor muscles.

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