Pregnancy-Related Back and Pelvic Girdle Pain

Overview

Back and pelvic pain are very common in pregnancy. Lower back pain is felt above the pelvis, around the waist. Pelvic girdle pain (PGP) is felt over the joints of the pelvis: at the front over the pubic bone (symphysis pubis dysfunction, or SPD), at the back over one or both sacroiliac joints, or both. It can make walking, climbing stairs, turning in bed, standing on one leg or getting in and out of a car painful, and some people notice clicking or grinding at the front of the pelvis.

These problems usually reflect the normal changes of pregnancy: hormones that soften the ligaments, a growing bump that shifts your centre of gravity, and extra load on the pelvis. They can start at any stage and may continue after birth. With the right advice and treatment, many people find their pain becomes more manageable, and for most it eases after delivery, although outcomes vary.

This page is general information. Always check with your midwife or GP/obstetrician about any new pain in pregnancy, and let them know you are seeing us. We work around their advice and adapt treatment positions to each trimester. Sacroiliac joint pain outside pregnancy is covered on its own page.

Causes and risk factors

• Pregnancy hormones that increase ligament laxity around the pelvis
• The growing bump changing your posture and centre of gravity
• Previous back or pelvic pain, including in an earlier pregnancy
• A physically demanding job, or lifting and carrying young children
• Long periods of standing, or sitting without breaks
• Uneven loading such as standing on one leg or carrying a child on one hip
• Reduced strength in the deep abdominal, gluteal and pelvic floor muscles

How we may be able to help

We start with a careful assessment of your pregnancy so far, how many weeks you are, any advice from your midwife or obstetrician, and which movements bring on pain. We examine your lower back, sacroiliac joints, pubic joint and hips, and screen for symptoms that need maternity care rather than physiotherapy. Treatment positions are adapted to each trimester, using side-lying, sitting or supported positions and avoiding lying flat on your back for long periods later in pregnancy.

Physiotherapy may include gentle manual therapy, exercises for the deep abdominal, gluteal and pelvic floor muscles, and practical advice on getting in and out of bed and the car, stairs, sleeping positions and pelvic support belts. Our chiropractor may use gentle techniques adapted for pregnancy, such as low-force mobilisation of the lower back and pelvis, which many people find eases stiffness. Kinesiology taping can offer comfortable support for the back or bump.

We keep treatment conservative and pregnancy-appropriate. We do not use shockwave, electrotherapy, ultrasound therapy, needling, cupping or injections during pregnancy. After birth, we can continue to help with postnatal back and pelvic pain.

What you can do at home

• Keep your knees together when turning in bed or getting in and out of the car
• Sit down to put on trousers, socks and shoes rather than standing on one leg
• Take stairs one step at a time, leading with the less painful leg
• Sleep on your side with a pillow between your knees and under your bump
• Stay active within comfort; many people find swimming and shorter walks helpful
• Ask us or your midwife about a pelvic support belt for longer walks