Pelvic girdle pain in pregnancy: what helps

What pelvic girdle pain is

The pelvis is a ring of bones joined by the sacroiliac joints at the back and the symphysis pubis joint at the front. During pregnancy, hormonal changes, a growing bump, changes in posture and the way the muscles around the pelvis work can all make these joints and the tissues around them sensitive. Pelvic girdle pain is the term for pain arising from this area during or after pregnancy.

You may hear it called symphysis pubis dysfunction (SPD) when the pain is mainly at the front. PGP is the broader, more accurate term. It can start at any point in pregnancy, it varies a lot in severity, and it is common, so if you have it, you are far from alone.

Who gets it

Any pregnant woman can develop PGP. It is more likely if you had it in a previous pregnancy, have had back or pelvic pain before, have had an injury to the pelvis, or have a physically demanding job. Being active before pregnancy does not guarantee you will avoid it, and having it does not mean you did anything wrong.

Many women who train, including those who lift and do conditioning classes, continue to exercise through pregnancy with some changes. PGP often means adjusting certain movements rather than stopping altogether.

Typical symptoms

• Pain over the pubic bone at the front, across one or both sides of the lower back, or in the buttocks
• Pain spreading into the groin, inner thighs or back of the thighs
• Pain walking, climbing stairs or standing on one leg, for example to put trousers on
• Pain turning over in bed or getting in and out of a car
• Pain when moving your legs apart
• A clicking or grinding feeling in the pelvis

Pain often builds through the day and with more activity. Some women find it mild and manageable; others find walking any distance difficult. Both are within the range of PGP, and both are worth getting help for early.

What a physio assessment looks at

A physio experienced in pregnancy and women's health will ask about your pregnancy, symptoms and daily routine, and check for other causes of pain. They will assess how you move, the strength and control of the muscles around the pelvis, hips and trunk, and which activities provoke pain. They will also consider your pelvic floor and ask about bladder and bowel function, which is routine and nothing to be embarrassed about.

You can often self-refer to NHS maternity physiotherapy, and your midwife or GP can refer you. Telling your midwife about PGP also helps with planning comfortable positions for labour.

What usually helps

Treatment is tailored to you, but usually includes advice on everyday activities, exercises to strengthen and improve control of the tummy, back, pelvic floor and hip muscles, and manual therapy to ease pain and improve movement where appropriate. Some women find a pelvic support belt helpful, and crutches can be useful for a period if walking is very painful.

Staying active is good for both you and your baby. The UK Chief Medical Officers' guidance for pregnancy supports around 150 minutes of moderate activity a week plus some strength work, adjusted to how you feel. With PGP, that usually means choosing lower-impact options and avoiding the movements that provoke pain. Our guide to strength training for women has more on training around life stages.

Everyday tips and exercises to start with

• Keep your knees together when getting in and out of the car, and swivel on the seat.
• Turn over in bed with your knees together and bent, and sleep with a pillow between your knees.
• Sit down to put on trousers, socks and shoes.
• Take stairs one step at a time, leading with the less painful leg going up.
• Avoid carrying heavy loads on one side, and ask for help with heavy shopping.
• Rest before pain builds rather than waiting until you have to stop.

1. Pelvic floor exercises: gently squeeze and lift, hold for up to 10 seconds, and also practise quick squeezes, several times a day.
2. Gentle tummy tightening in sitting or on all fours, 10 slow reps.
3. Glute bridges early in pregnancy, or supported variations later, 2 to 3 sets of 10.
4. Sit to stand with knees together, 2 to 3 sets of 10.

In the gym, wide-stance squats, lunges, split squats, single-leg work and heavy carries are the most common aggravators. Swapping them for symmetrical, narrower-stance movements often keeps you training comfortably. Our guide to core training has gentler options. Check with your midwife about exercise if you have any pregnancy complications.

Recovery and when to get urgent help

For most women, PGP improves after the baby is born, often within weeks to a few months, although some need ongoing physio. The on-site physio at Lycan Strength treats women's health conditions, and members get 20% off; you can book a physio appointment online.

• Contact your maternity unit immediately for vaginal bleeding, fluid leaking, regular painful contractions before 37 weeks, severe or constant tummy pain, or reduced baby movements.
• Contact your maternity unit or call NHS 111 urgently for a severe headache, vision problems or sudden swelling of the face, hands or feet.
• Call 999 for chest pain or sudden breathlessness. Contact your maternity unit or NHS 111 urgently for a swollen, warm, painful calf.
• Call 999 or go to A&E for numbness around the genitals or buttocks, new bladder or bowel problems, or weakness in both legs.
• Contact your GP or maternity unit for back pain with fever, pain passing urine or feeling unwell.

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