Pelvic girdle pain is one of the most common pregnancy complaints and one of the most under-treated, largely because it is frequently dismissed as an inevitable part of pregnancy rather than something that responds well to the right treatment. It does not have to be endured, and most people improve significantly with appropriate physiotherapy.
This guide covers what pelvic girdle pain is, why it happens, what genuinely helps, and when to seek assessment.
What pelvic girdle pain actually is
Pelvic girdle pain, sometimes still referred to by the older term symphysis pubis dysfunction, describes pain arising from the joints of the pelvis: the pubic symphysis at the front, and the sacroiliac joints at the back.
These joints move only a small amount in normal circumstances, but during pregnancy the hormone relaxin increases ligament laxity throughout the body, including here, to allow the pelvis to adapt for birth. Combined with the changing distribution of weight and altered movement patterns as pregnancy progresses, this can result in the joints becoming irritated, uneven in their loading, or moving with less control than usual.
Common symptoms include pain in the pubic area, lower back, hips or across the buttocks, often worse with walking, climbing stairs, turning over in bed, standing on one leg to dress, or getting in and out of a car. A clicking or grinding sensation in the pelvis is also commonly reported.
Why it is not simply something to endure
Pelvic girdle pain is common, affecting a substantial proportion of pregnant people to some degree, but common does not mean untreatable, and severity varies enormously. Some experience mild discomfort; others experience pain that significantly limits daily function.
Physiotherapy is the recommended first-line treatment, and the evidence supports it: targeted exercise and manual therapy, delivered appropriately for pregnancy, meaningfully reduce pain and improve function for most people. Waiting it out or assuming nothing can be done until after birth is not the recommended approach, and earlier treatment is generally more effective than treatment started once symptoms have become severe.
What helps
Physiotherapy assessment
Establishes which structures are involved, how the pelvis is loading asymmetrically, and what movement patterns are contributing. Treatment is built around these findings rather than a generic exercise sheet, since pelvic girdle pain varies considerably between individuals.
Manual therapy
Gentle, pregnancy-appropriate hands-on techniques can reduce pain and improve joint mechanics, particularly where one side of the pelvis is more restricted or more mobile than the other.
Targeted exercise
Rather than general pregnancy exercise, specific work on the deep core, glutes and pelvic floor, aimed at improving how load is shared across the pelvis. This is usually low intensity and controlled rather than strenuous.
Movement modification
Practical adjustments that reduce provocation day to day: keeping the knees together when turning over in bed, sitting to get dressed rather than standing on one leg, taking stairs one at a time, avoiding activities that involve standing on one leg or straddling movements where possible.
A pelvic support belt
Can reduce pain for some people by providing external support to the pelvis, though it works best alongside active treatment rather than as a substitute for it, and is not universally helpful.
Pacing activity
Breaking up walking and standing rather than pushing through, and resting before pain escalates rather than after, tends to keep symptoms more manageable through the day.
What tends to make it worse
- Asymmetrical positions, such as standing on one leg, sitting cross-legged, or straddling movements
- Wide-legged movements, including some yoga positions and getting out of a car without keeping the knees together
- Prolonged standing or walking without breaks
- High heels or unsupportive footwear
- Twisting movements, particularly under load
What about birth?
Pelvic girdle pain does not usually prevent a vaginal birth, and most people continue to have choices about their birth plan. It is worth discussing with your midwife or obstetrician in advance so positions and movements during labour can be planned around what your pelvis tolerates. A physiotherapist experienced in pelvic girdle pain can also advise on positioning for labour.
Does it resolve after birth?
For most people, yes, pain improves significantly in the weeks after birth as hormone levels change and load through the pelvis normalises. For some, symptoms persist longer, and postnatal physiotherapy is recommended if pain has not settled within a few months, since the same principles of assessment and targeted treatment apply.
When to seek assessment
Physiotherapy assessment is worth seeking as soon as pelvic pain becomes noticeable, rather than waiting for it to become severe. Earlier treatment is generally more effective, and there is no benefit to delaying.
Contact your midwife or GP promptly if pain is severe, comes on suddenly, is accompanied by fever, or if you have any bleeding or reduced fetal movement alongside it, since these need separate medical assessment.
Frequently asked questions
Is pelvic girdle pain the same for every pregnancy?
Not necessarily. Some people experience it in one pregnancy and not another, and severity can vary between pregnancies.
Can I still exercise?
Generally yes, and appropriate exercise is part of treatment. High-impact activity, wide-legged movements and asymmetrical loading are usually modified or avoided while symptoms are present.
Will physiotherapy definitely fix it?
Most people see meaningful improvement with appropriate treatment, though the degree of improvement varies. Assessment early gives the best chance of good management through the remainder of pregnancy.
Is it safe to have manual therapy while pregnant?
Yes, when delivered by a practitioner experienced in treating pregnancy, using techniques and positioning appropriate for each stage.
Should I stop working?
Depends on the nature of your work and severity of symptoms. Many people continue working with activity modifications; some require adjustments or a change in duties, which is worth discussing with your employer and midwife.
Pregnancy physiotherapy in Chiswick
Pelvic girdle pain and other pregnancy-related musculoskeletal concerns are assessed and treated at Omnia Lifestyle in Chiswick, W4, close to Gunnersbury station. Assessment and treatment are tailored to each stage of pregnancy.
Read more about pregnancy and postnatal care, explore physiotherapy, or book an assessment.
This article is general information, not medical advice. Always discuss new symptoms in pregnancy with your midwife or doctor.
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