Pelvic pain during pregnancy is common, but that doesn't mean you simply have to put up with it until your baby arrives.
Pregnancy-related pelvic girdle pain (PGP) describes pain experienced around the joints and structures of the pelvis during pregnancy. It may be felt around the pubic bone, hips, groin, buttocks, sacrum or lower back and can sometimes make everyday movements uncomfortable.
Symptoms can vary considerably between people. Understanding where your pain is coming from, what movements aggravate it and how your body is adapting during pregnancy can help guide appropriate management.
Pelvic Girdle Pain in Pregnancy: Why Does My Pelvis Hurt?
Pelvic girdle pain can be experienced in different areas and may affect one or both sides of the pelvis.
You may notice:
Pain around the pubic bone
Groin or inner thigh pain
Pain around the buttocks or sacrum
Lower back pain
Hip pain
Pain when walking
Pain going up or down stairs
Difficulty standing on one leg
Pain getting dressed
Discomfort getting in or out of the car
Pain rolling over or changing position in bed
Pain with some types of exercise
Symptoms may remain relatively localised or be felt across several areas of the pelvis.
What Does Pelvic Girdle Pain Feel Like?
You may have heard pregnancy-related pelvic pain referred to as SPD or symphysis pubis dysfunction.
The pubic symphysis is the joint at the front of your pelvis. Pain around this area can form part of pregnancy-related pelvic girdle pain.
Some people experience very localised pubic pain, while others have symptoms involving both the front and back of the pelvis.
The term pelvic girdle pain is now generally used because pregnancy-related pelvic pain can involve more than the pubic symphysis alone.
What Is SPD in Pregnancy?
There isn't usually one single cause.
Pregnancy involves significant changes in the way your body moves and manages load. Factors that may influence pelvic girdle pain include changes in:
Load through the pelvis
Muscle function and coordination
Movement patterns
Abdominal wall function
Pelvic floor function
Previous injuries or musculoskeletal concerns
Physical demands at work or home
Hormonal changes occur during pregnancy too, but pelvic pain shouldn't automatically be explained as simply being caused by “loose ligaments” or relaxin.
PGP is generally considered a multifactorial musculoskeletal pain presentation.
Why Does Pelvic Girdle Pain Happen During Pregnancy?
Pelvic discomfort is common during pregnancy, particularly as your body changes and the physical demands placed on it increase.
However, common and normal aren't necessarily the same thing.
If pelvic pain is making it difficult to walk, sleep, work, exercise, roll in bed or complete everyday activities, you don't need to wait until after birth to seek advice.
Assessment can help determine what may be contributing and identify strategies to make movement and daily activities more manageable.
Is Pelvic Pain Normal During Pregnancy?
Walking requires your pelvis, hips and surrounding muscles to repeatedly transfer load from one side of your body to the other.
For someone experiencing pelvic girdle pain, this can sometimes aggravate symptoms — particularly with longer walks, faster walking, hills or when symptoms are already irritated.
This doesn't necessarily mean you need to stop walking altogether.
Adjusting your walking distance, pace or frequency and gradually building activity according to your symptoms may be more appropriate than simply avoiding movement.
Why Does My Pelvis Hurt When I Walk?
Rolling in bed is a surprisingly common aggravating movement for people experiencing pregnancy-related pelvic girdle pain.
Changing position requires coordinated movement through the pelvis, hips and trunk, which can become uncomfortable when the area is sensitive.
Your practitioner may discuss different movement strategies or positioning options to help make getting in and out of bed and rolling overnight more comfortable.
Why Does Rolling Over in Bed Hurt During Pregnancy?
You don't necessarily need to completely avoid these movements.
However, activities that place more load through one side of the pelvis can be uncomfortable during a flare of pelvic girdle pain.
This may include:
Stairs
Getting dressed while standing
Getting in or out of a car
Carrying a child on one hip
Lunges
Some single-leg exercises
Temporarily modifying aggravating activities can sometimes help settle symptoms while you work on gradually improving your capacity.
Should I Avoid Stairs or Standing on One Leg?
For many people, yes.
Experiencing pelvic girdle pain doesn't automatically mean you need to stop exercising for the remainder of your pregnancy.
The type and amount of exercise that's appropriate will depend on your symptoms, pregnancy, previous activity levels and individual circumstances.
Exercise may need to be modified temporarily, with gradual progression as tolerated.
The goal is generally to find movement your body can comfortably manage, rather than becoming fearful of movement altogether.
Can I Exercise With Pelvic Girdle Pain During Pregnancy?
Not necessarily.
Terms such as “pelvic instability” are commonly used to describe pregnancy-related pelvic pain, but pain does not automatically mean that your pelvis is unstable, damaged or moving out of place.
The pelvis is a strong structure designed to manage significant loads.
For many people, thinking about PGP in terms of sensitivity, load tolerance, movement and muscular support can be more helpful than believing their pelvis needs to be repeatedly “put back into alignment”.
Does Pelvic Girdle Pain Mean My Pelvis Is Unstable?
Many people experience improvement in pregnancy-related pelvic girdle pain following birth, although recovery time can vary.
For some people, symptoms may continue into the postpartum period and require further rehabilitation.
If pain persists after birth, a postpartum assessment can consider your pelvic floor, abdominal wall, pelvis, hips, lower back, movement and return to activity.
Will Pelvic Girdle Pain Go Away After Birth?
An osteopathic assessment can consider your symptoms, movement and musculoskeletal function to identify factors that may be contributing to your pain.
Depending on your presentation, management may include:
Hands-on osteopathic treatment where appropriate
Exercise and rehabilitation
Movement and activity modification
Strength and mobility strategies
Advice for aggravating everyday movements
Breathing and pressure-management strategies
Pelvic floor assessment where appropriate
Education and self-management strategies
Your management is adapted throughout pregnancy according to your symptoms, stage of pregnancy and individual goals.
How Can Osteopathy Support Pelvic Girdle Pain During Pregnancy?
When Should I Seek Medical Advice for Pelvic Pain During Pregnancy?
Not all pelvic or abdominal pain during pregnancy is musculoskeletal.
Seek medical or maternity advice for new or severe pain, vaginal bleeding, fever, feeling significantly unwell, contractions or concerns about your pregnancy or baby's movements.
If you're unsure whether your symptoms are musculoskeletal, discussing them with your GP, midwife or obstetric team.
Pregnancy Osteopathy in Healesville & the Yarra Valley
At Yarra Valley Women's Health, our osteopaths provide individualised pregnancy care for pelvic girdle pain and other pregnancy-related musculoskeletal concerns.
Our aim is to help you better understand what's happening, adapt movement where needed and provide you with the knowledge and strategies to feel confident staying active throughout your pregnancy where appropriate.