What is pelvic girdle pain in pregnancy?

• Pelvic girdle pain (PGP) in pregnancy affects around 1 in 5 women and is a common source of discomfort, but it does not harm your baby. 
• Symptoms of PGP include pain and stiffness in the lower back, hips, pelvis, groin, and thighs, which can make everyday activities like walking, climbing stairs, or getting dressed challenging. 
• Managing pelvic girdle pain is possible with posture tips, gentle pregnancy-safe exercises, pacing, and pain relief strategies, with most women improving after birth. 

Pregnancy comes with many symptoms, some of which are easier to manage than others. 

Pelvic girdle pain (PGP) is a common symptom that one in five people experience during pregnancy.  

Although PGP can be painful and distressing for you, rest assured that it will not harm your baby. 

What is pelvic girdle pain? 

Pregnancy-related pelvic girdle pain describes the aches and pains felt around the pelvis during pregnancy.  

Areas affected can include: 

• Lower back 

• Symphysis pubis joint (the front of the pelvis) 

• Sacroiliac joint (the joint that links the pelvis and lower spine) 

• Groin 

• Front/back of thighs 

• Hip/outer thighs 

• Pelvic floor/perineum 

What does pelvic girdle pain feel like? 

Pelvic girdle pain symptoms can range from mild to more severe. You might have difficulty with activities such as:  

• Walking (for prolonged periods) 
• Climbing stairs 
• Turning when lying down 
• Putting on socks/shoes/trousers 
• Getting in and out of the car and driving 
• Sex 

You may also feel clicking or grinding when moving or feel that your pelvic joints are loose. It is important to remember that the pelvis is extremely strong and stable, and the pain is not from damage.

Pelvic girdle pain can start at any stage of pregnancy, but it most commonly begins in the second or third trimester as your baby and bump grow. 

Many things can contribute to PGP. You are more likely to experience it or feel it earlier if: 

• You have had back pain before your pregnancy 
• You have had PGP in a previous pregnancy 
• You start your pregnancy being overweight 

Hormonal changes 

Hormone changes in pregnancy cause the ligaments in the pelvis to be more flexible so you can grow your baby. This makes you more mobile; however, research has not found a direct link between joint mobility and the level of pelvic pain experienced. 

Hormones can also affect your sensitivity to pain, meaning you may experience more pain during pregnancy. 

Postural changes 

During pregnancy, your posture may change to help support your growing body. Lots of women find that the curve in their lower back may become more pronounced as their bump grows, which can cause stiffness and pain.  

Activity level 

It’s normal to gain weight in pregnancy, and your pelvis has to support this and your growing bump. This means extra pressure is placed on your joints, even when you’re following your usual routine or activities. 

Emotional factors  

Factors such as stress, depression, anxiety, and fatigue can impact the sensitivity of our nervous system, meaning you may feel pain more. 

How to help pelvic girdle pain 

When it comes to pelvic girdle pain treatment, it’s important to remember the four Ps: 

• Posture 
• Pain relief 
• Pacing 
• Physical exercise 

Posture 

Change your position regularly to prevent stiffness. If you need to sit in one position for a long time, you can use a cushion to support your lower back. 

To keep your back moving, you can gently rock your pelvis back and forth or try sitting on a gym ball sometimes. 

It may also be helpful to adjust how to do everyday tasks, such as getting dressed sitting down or making sure to stand evenly on both feet instead of leaning. 

At night, you can place a pillow between your knees and ankles when lying on your side to squeeze when you turn for extra support. 

When getting out of bed, you may find it easier to roll onto your side first and keep your legs together. 

Pain relief 

The NHS confirms that it is safe to take regular paracetamol during your pregnancy. You can speak to your GP to discuss this further or if you need advice on stronger pain relief. 

Other pain relief strategies for pelvic girdle pain include: 

• Hot water bottles/heat packs or a towel-wrapped cold pack/frozen peas - don’t apply directly to your bump 
• A maternity support belt or supportive clothing during walking  
• Having a massage in a chair or side-lying 
• TENS (transcutaneous electrical nerve stimulation) machines from 37 weeks  
• Controlled breathwork by breathing slowly and deeply to help ease muscle tension 

Pacing 

Pacing yourself can help manage aches and pains as it gives your body time to rest.  

Split up activities into shorter sections, plan breaks, and spread out your tasks so you don’t overdo it in one day. 

It’s also important to ask for and accept help to relieve the pressure on you. 

Physical exercise 

Keeping active can feel difficult when you’re in pain, but it can help you stay mobile and motivated. 

If you are experiencing pelvic girdle pain, more gentle exercise may feel better – such as walking, swimming, or antenatal yoga. 

Read out blog about exercising in pregnancy here.

Remember: 

• Do not do physical activity in excessive heat and high humidity 
• Keep exercise to a ‘moderate’ level to avoid raising your heart rate too much 
• Drink plenty of water to avoid dehydration 
• Avoid activities that might risk bumping or putting extra pressure on your bump 
• It is recommended that you don’t exercise lying on your back from 16 weeks 
• Listen to your body and pace yourself 

For most women, the pain quickly improves after giving birth. For some, the pain can take a little longer to settle down and may last longer than the initial post-natal period.