Pelvic Girdle Pain in Pregnancy: Causes, Tips and Treatment

Q: When should you tell your midwife or GP about pelvic pain in pregnancy?

As soon as symptoms start. An early referral to a physiotherapist gives treatment more time to take effect before your due date. You do not need to wait until the pain becomes severe.

Q: Is pelvic girdle pain the same as SPD?

Symphysis pubis dysfunction (SPD) is an older term for pain specifically at the front of the pelvis. Pelvic girdle pain (PGP) is the preferred term now because it covers the full range of pelvic joint pain, including pain at the back of the pelvis and into the hips and thighs.

Q: Can you still exercise with pelvic girdle pain in pregnancy?

Staying gently active is usually encouraged, as long as the activity does not increase your pain. The movement changes and specific exercises a physiotherapist suggests tend to help more than either complete rest or pushing through painful activity.

Q: Will pelvic girdle pain go away after the baby is born?

For most people, the pain eases a lot after giving birth. Around 1 in 10 find symptoms continue after delivery. If you have ongoing pain once your baby arrives, mention it at your postnatal appointment so you can be referred for more support.

A tired stressed pregnant woman resting at home.

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When walking to the kitchen or rolling over in bed starts to cause significant pain, pelvic girdle pain in pregnancy could be behind it. The ache can sit deep in the front of your pelvis, spread across your lower back, or run down into your thighs. You might also notice a clicking or grinding feeling in the area. These are all signs of pelvic girdle pain (PGP), a condition once known as symphysis pubis dysfunction (SPD). It affects about 1 in 5 pregnant women, and it is not something you have to push through on your own.²

PGP is not simply a normal part of pregnancy, and it can be managed well. The sooner you mention your symptoms to your midwife or GP, the sooner the right help can be in place.³

What helps day to day

Small changes to how you move through the day can make a real difference to how much pain you feel.

For example, when you get dressed, sit down to pull on trousers or shoes rather than balancing on one leg. When you are standing, try to spread your weight evenly across both feet. Try not to sit for longer than about 30 minutes at a stretch, since staying in one position too long can worsen your pain. Little bits of movement throughout the day, as well as spending time in different positions, for example, sitting, standing or lying can help as well. ⁴

In bed, keeping your knees together as you turn over can take some load off the pelvic joints. A pillow between your legs and another under your bump can ease the pressure while you sleep. The same idea helps when you get out of a car: swing both legs out together rather than stepping out one foot at a time.⁵

Movements that tend to make pelvic girdle pain worse

Some movements put uneven or increased load on the pelvic joints, so they are worth being mindful of where you can. These include standing on one leg, crossing your legs, heavy lifting, going up and down stairs often, and twisting or bending, especially if you are carrying a child on one hip at the same time.⁶

Pain when you walk, climb stairs, turn in bed, or move your legs apart is common with PGP. If a particular movement reliably brings on pain, that is a useful signal to find a gentler way of doing it rather than pushing through.⁷

How a physiotherapist can help with pelvic girdle pain in pregnancy

A physiotherapist who specialises in pregnancy care is the main route to structured treatment for PGP, and your midwife or GP can refer you. A first appointment usually involves the physiotherapist looking at your pelvis, back and hips, as well as your movement patterns and any aggravating factors you report, so they can understand the pattern of your pain.⁸

From there, treatment can include hands-on work on the muscles and joints around your pelvis, exercises to build strength in your core and pelvic muscles, and practical guidance on pacing your activity across the day. You might also be fitted with a pelvic support belt, which wraps around your hips and pelvis to give the joints a little more support, or given crutches to take the load off when you walk.⁹

What causes pelvic girdle pain?

The cause of PGP is often multifactorial and personal to the individual experiencing it. It may be influenced by the muscles around the pelvis, their strength and overall function, and your movement patterns. These factors, alongside the increased weight of your growing bump, and increased sensitivity of your nervous system and tissues around the pelvis, can all contribute to your experience of PGP. It is not simply down to pregnancy hormones, as was once thought.¹

You may be more likely to develop PGP if you have had lower back or pelvic pain before, had a previous pelvic injury, experienced PGP in an earlier pregnancy, or have a physically demanding job. Having one or more of these does not mean PGP is inevitable, and having none of them does not rule it out.¹⁰

PGP, birth, and recovery

PGP is not harmful to your baby, and most people with the condition are still able to have a vaginal birth. It is worth talking your birth plan through with your maternity team so your midwives know about your PGP and can help with positioning during labour.¹¹

For most people, the pain eases a lot after giving birth. For about 1 in 10, symptoms carry on after delivery and may need ongoing physiotherapy and support. If your pain continues after birth, raise it at your postnatal appointment so a referral can be made.¹²

Frequently Asked Questions

When should you tell your midwife or GP about pelvic pain in pregnancy?

Is pelvic girdle pain the same as SPD?

Can you still exercise with pelvic girdle pain in pregnancy?

Will pelvic girdle pain go away after the baby is born?

Does pelvic girdle pain affect how your baby is born?

Sources

[1] Pelvic Girdle Pain and other common conditions in pregnancy

The causes of PGP is often multifactorial and personal to the individual experiencing it.
[2] Pelvic girdle pain and pregnancy

Some people describe a clicking or grinding sensation in the pelvic area.
[3] Pelvic girdle pain and pregnancy

PGP is not considered a normal part of pregnancy and effective management is possible.
[4] Pelvic pain in pregnancy

When getting dressed, sit down rather than standing on one leg. Keep your weight spread evenly across both feet. Avoid sitting for longer than about 30 minutes at a stretch.
[5] Pelvic pain in pregnancy

Keep your knees together when turning in bed. A pillow between your legs and another under your bump can take pressure off while you sleep. When getting out of a car, swing both legs out together.
[6] Pelvic girdle pain and pregnancy

Movements to avoid include standing on one leg, crossing your legs, heavy lifting, using stairs frequently, and twisting or bending, particularly while carrying a child on one hip.
[7] Pelvic girdle pain and pregnancy

Pain when walking, climbing stairs, turning in bed, or moving your legs apart are all common with PGP.
[8] Pelvic girdle pain and pregnancy

Physiotherapy for PGP aims to relieve pain and improve pelvic joint stability. An initial assessment involves examining posture and the movement of the hips and back.
[9] Pelvic girdle pain and pregnancy

Physiotherapy treatments for PGP may include hands-on therapy for the muscles and joints, exercises to strengthen core and pelvic muscles, advice on activity pacing, and supportive equipment like a pelvic belt or crutches.
[10] Pelvic girdle pain and pregnancy

Risk factors for PGP include a history of lower back or pelvic pain, a previous pelvic injury, having had PGP in an earlier pregnancy, or having a physically demanding job.
[11] Pelvic girdle pain and pregnancy

PGP is not harmful to your baby, and most women with the condition are able to have a vaginal birth.
[12] Pelvic girdle pain and pregnancy

For most women, pain improves significantly after giving birth. For about 1 in 10 women, symptoms can persist after delivery and may need ongoing physiotherapy and management.