Pelvic girdle pain in pregnancy: what helps, what hurts, who to see

If getting out of the car, climbing the stairs or rolling over in bed has started to bring a sharp or aching pain around your pelvis, you are far from alone. Pelvic girdle pain is a common part of pregnancy, and many people assume it's simply something to put up with. It isn't. There is a lot you can do, and help is available.

What is pelvic girdle pain in pregnancy?

Your pelvis is a ring of bones joined by three joints: two sacroiliac joints at the back, where the pelvis meets the base of the spine, and the symphysis pubis at the front. The RCOG describes PGP as pain in the front and/or back of the pelvis that can also spread to the hips or thighs, and notes it used to be called symphysis pubis dysfunction, or SPD.^[5] European guidelines define it as pain between the top of the back of the pelvis and the fold of the buttocks, particularly near the sacroiliac joints; it can also be felt at the pubic joint, together with the back pain or on its own.^[1][3]

It is common. The European guidelines put the share of pregnant people with PGP at any given time at about 20%,^[1] and both the NHS and the RCOG describe it as affecting around one in five pregnancies.^[4][5] The IOC expert group estimates that 20 to 25% of pregnant people have PGP severe enough to need medical help.^[3]

Nobody fully understands why it happens. The joints normally move slightly and in balance; PGP is thought to arise when they move unevenly, and the growing weight of the baby and changes in posture add strain.^[5] You may be more likely to develop it if you've had back or pelvic pain before, an injury to your pelvis, or PGP in a previous pregnancy.^[1][4]

It's worth saying clearly: PGP is not harmful to your baby.^[4] It is, however, real pain that deserves real care.

What does pelvic girdle pain feel like?

The NHS and the RCOG describe a similar picture. Pain may be felt over the pubic bone at the front, across one or both sides of the lower back, in the perineum, or spreading to the hips, groin, thighs or knees. Some people feel or hear clicking or grinding in the pelvis.^[4][5]

The pattern of what makes it worse is often the clearest clue. Common triggers include walking (especially on uneven ground or for long distances), going up or down stairs, standing on one leg while dressing, turning over in bed, and moving your knees apart, as when getting out of a car.^[4][5]

PGP is different from the more familiar lower back pain of pregnancy, although the two can occur together. A systematic review proposed separating them for exactly this reason, finding that roughly half of people with pregnancy-related lumbopelvic pain have PGP, a third have lower back pain, and about a sixth have both.^[2] The IOC expert group notes that PGP tends to cause more disability than lower back pain.^[3] A physiotherapist can tell them apart with specific tests.

Which movements make pelvic girdle pain worse?

The RCOG's list of things to avoid includes lifting anything heavy, going up and down stairs too often, stooping, bending or twisting to lift or carry a toddler on one hip, sitting on the floor or sitting twisted, sitting or standing for long periods, and standing on one leg or crossing your legs.^[5] The NHS gives similar advice.^[4]

Applied to exercise, the same principles suggest pausing or modifying anything that loads one leg, spreads the legs wide, or twists the pelvis under load. Here is how everyday and gym movements compare:

Eggsports uses the same logic. When you tell the app your pelvis or back feels sore, that day's session leaves out inner-thigh exercises and single-leg standing work, and favours seated and side-lying movements instead.

Which exercises can help pelvic girdle pain?

The evidence here is honest about its limits. A large meta-analysis found that exercise during pregnancy did not reduce the chances of developing lower back or pelvic girdle pain, but it did lower the severity of pain during pregnancy and early after.^[6] Another meta-analysis found exercise slightly lowered the risk of lower back pain, but had no clear protective effect on PGP itself.^[7]

Treatment is where exercise earns its place. The European guidelines recommend individualised exercises for pregnant people with PGP, along with clear information and reassurance.^[1] The NHS describes physiotherapy for PGP as including exercises to strengthen the pelvic floor, stomach, back and hip muscles, plus equipment such as a pelvic support belt or crutches if needed.^[4] A systematic review of physiotherapy treatments found strong evidence for pelvic belts and acupuncture, and lower-quality evidence for exercise in general and specific stabilising exercises.^[9]

While you wait for a physiotherapy appointment, these principles tend to help:

• Keep active, and rest often. The RCOG recommends staying active while also getting plenty of rest.^[5]
• Change position regularly. Try not to sit for more than 30 minutes at a time.^[5]
• Keep movements symmetrical and small. Squats with your feet hip-width apart, seated marching, gentle pelvic tilts while sitting on a ball, and wall push-ups usually suit a sore pelvis better than single-leg work.
• Walk on even ground, in shorter bouts. Long distances and rough ground can make PGP worse.^[5]
• Train your pelvic floor and deep core. The RCOG notes that strengthening your abdominal and pelvic floor muscles can improve your balance and posture and make your spine more stable.^[5] Our pelvic floor exercise timer guides you through them, and our guide to core training in pregnancy shows how they fit together.
• Use your breath. Pain often comes with tension. A few minutes with our breathing timer can help you settle.

If you lift weights, the trimester swaps in our guide to lifting weights while pregnant also suit a sensitive pelvis.

When should you see a physiotherapist for pelvic pain?

The NHS advises contacting your midwife or GP if you have pelvic pain and find it hard to move around, it hurts to get out of a car or turn over in bed, or stairs are painful. It notes that early diagnosis can help keep pain to a minimum and avoid long-term discomfort, and that you may be referred to a physiotherapist who specialises in pelvic joint problems in pregnancy.^[4] The RCOG is clear that PGP is not something you just have to put up with until the end of pregnancy, and that treatment is safe at any stage.^[5]

A physiotherapist will usually look at your posture and your back and hip movements, and rule out other causes of pelvic pain.^[5] Treatment may include advice on positions and pacing, exercises, hands-on treatment to help the joints move normally, heat or ice, and a support belt or crutches.^[5]

Pelvic pain that comes with vaginal bleeding, fluid leaking, regular painful contractions, a fever or feeling unwell is not typical PGP. Contact your doctor or midwife promptly. Our guide to warning signs to stop exercising lists the signs to act on. And if the pain is causing you a lot of distress, the NHS encourages you to tell your GP or midwife, as you may need extra treatment and support.^[4]

How can you make daily life easier with PGP?

The RCOG and the NHS suggest a set of simple measures:^[5][4]

• Stand tall with your weight spread evenly across both legs.
• Sit down to get dressed and undressed.
• Keep your knees together when getting in and out of the car and when turning over in bed.
• Lie on the less painful side, with a pillow under your bump and between your legs.
• Wear supportive shoes.
• Avoid carrying a toddler on one hip, and get help with heavy shopping.

PGP usually improves once pregnancy is over, although the RCOG notes that around one in ten people have ongoing pain, and that it's important to continue treatment if so.^[5]

For the bigger picture on staying active through these months, see our guide to exercise in the second and third trimester and our complete guide to exercise during pregnancy.