Pelvic girdle pain (PGP), sometimes still called symphysis pubis dysfunction, is pain around your pelvic joints during pregnancy caused by the combination of hormonal ligament softening and the growing mechanical load of pregnancy. It affects roughly 1 in 5 pregnant women to some degree, and while it can feel alarming, it is not a sign that anything is wrong with your baby. It is common, it is manageable, and for most women it responds well to the right treatment.
The underlying cause is usually a combination of two things happening at once: the hormone relaxin loosens the ligaments around your pelvis to prepare for birth, and your changing posture and growing bump shift how load passes through the pelvic joints. When one side of the pelvis moves slightly out of sync with the other under load, typically during walking, turning over in bed, or getting out of the car, that’s when the sharp, catching pain shows up.
If you’re experiencing this, the first practical step is a simple movement self-check (below) to understand your pattern, followed by an assessment from a physiotherapist or osteopath experienced in pregnancy care, ideally sooner rather than later, since early treatment tends to produce faster, better results than waiting. The rest of this article covers exactly what’s happening in your pelvis, a practical self-check and symptom-easing strategies, what the research actually shows about what helps, and the specific signs that mean you should contact your midwife or GP rather than waiting for a routine appointment.
What’s actually happening in your pelvis
Your pelvis is made up of three main joints: the two sacroiliac joints at the back, either side of your spine, and the symphysis pubis at the front. In a non-pregnant body these joints barely move. During pregnancy, the hormone relaxin (alongside oestrogen and progesterone) increases the laxity of the ligaments holding these joints together, which is a normal and necessary adaptation to allow the pelvis some give during labour.
The problem is that “more movement” in these joints doesn’t automatically mean “well-controlled movement”. The muscles that normally stabilise the pelvis, deep abdominal muscles, the pelvic floor, and the muscles around the hip, have to work harder to control that extra laxity. As your bump grows, your centre of gravity shifts forward, your lower back curve typically increases, and the load through the pelvic joints changes shape and direction. If the stabilising muscles can’t quite keep pace with the increased ligament laxity and the changing load, the joints move slightly asymmetrically under stress, which irritates the joint capsule and surrounding ligaments. That’s the sharp or grinding pain you feel with specific movements, rather than a constant ache.
This is also why PGP is typically movement-specific rather than constant: certain tasks (getting out of a low car, climbing stairs one leg at a time, standing on one leg to dress) load the pelvis asymmetrically and provoke symptoms, while symmetrical, supported movement often feels fine.
Self-check and symptom-easing steps
This helps you understand your pattern and what to try before your first appointment. It is not a substitute for assessment.
- Notice which movements provoke it. Getting out of bed, turning over, climbing stairs, getting out of a car, or standing on one leg are the classic triggers. Write down which two or three provoke it most.
- Check where the pain is. Central, low, at the front (symphysis pubis) or on one or both sides at the back (sacroiliac joints)? This helps your practitioner target assessment.
- Try keeping your knees together during triggering movements (rolling in bed with a pillow between your knees, getting out of the car with knees together and pivoting as one unit). If this noticeably reduces the sharp catch, it strongly supports a PGP diagnosis and confirms the mechanism.
- Avoid standing on one leg for dressing, and avoid activities that push your legs wide apart (deep squats, breaststroke, straddle positions) until you’ve been assessed, as these load the pelvis asymmetrically.
If keeping movements symmetrical clearly helps, book an assessment. If pain is severe, constant regardless of movement, or accompanied by any of the red flags below, don’t wait, see your midwife or GP first.
What the evidence actually says
A NICE evidence review of physiotherapy-delivered exercise for pregnancy-related pelvic girdle pain found that structured exercise advice from a physiotherapist reduced pain intensity and functional disability compared with standard care, though the review noted the certainty of the underlying trial evidence was limited. The same evidence review found that a non-rigid lumbopelvic support belt was cost-effective compared with information alone or exercise alone, with an estimated cost of £1,900 to £2,930 per quality-adjusted life year, a genuinely useful, low-risk option many women aren’t told about.
Clinical guidance published by the Pelvic, Obstetric and Gynaecological Physiotherapy (POGP) professional body for health professionals is consistent with this and goes further on timing: it cites research (Stuge et al., 2004, and Elden et al., 2005) showing that targeted stabilising exercise and, separately, acupuncture, both improved outcomes for women with persistent PGP, and notes that many women see meaningful improvement within one or two treatment sessions when care starts early. Crucially, the same guidance references research (Albert et al., 2001) indicating that untreated PGP can persist well beyond two years in a minority of cases, which is the clearest argument in the evidence for not “waiting it out” if pain is affecting your daily function.
Tommy’s and the Pelvic Partnership charities, which support pregnant women with PGP, both echo this early-intervention message in their patient guidance. What this means in practice: this is one of the better-evidenced areas of pregnancy musculoskeletal care. Exercise, manual therapy and a support belt where appropriate are not just “worth trying”, they have real evidence behind them, and starting early is linked to better outcomes than waiting.
When to worry: red flags that need same-day attention
Most PGP is uncomfortable but not dangerous, and treatable. Contact your midwife or GP the same day, or go to A&E if severe, if you notice:
- Severe pain that stops you weight-bearing on one or both legs at all.
- Numbness, tingling or weakness in your legs, or loss of bladder or bowel control (this needs emergency assessment to rule out cauda equina syndrome, which is rare but serious).
- Pain accompanied by fever, or pain that comes on suddenly and severely without a clear mechanical trigger.
- Any reduction in your baby’s movements alongside your pain, this should always be checked regardless of the pelvic symptoms.
- Pain that wakes you from sleep and is not eased by any position change.
If none of these apply, pelvic girdle pain is a safe and appropriate condition to bring to an osteopathic assessment.
How we approach pelvic girdle pain at our Maidstone and Rainham clinics
Every patient starts with a full case history and a holistic, whole-body assessment, not just a look at the pelvis in isolation, because how your hips, lower back and even your ribcage are moving all affects how well your pelvis tolerates the extra laxity of pregnancy. In our clinic, the most common pattern we see is a combination of one-sided sacroiliac irritation and reduced hip mobility on the same side, often in women who spend a lot of the day sitting for work.
We use gentle, pregnancy-appropriate hands-on techniques to improve joint mobility and reduce muscular guarding, combined with a realistic, small home exercise plan and practical daily-life advice (car transfers, sleeping positions, work adaptations). Sessions typically run 30 to 45 minutes, and treatment is adapted throughout your pregnancy as your bump and symptoms change. If you’re unsure whether this is straightforward PGP or something that needs your midwife first, our free 15-minute phone consultation is a good starting point to talk it through before booking.
Common questions
Is pelvic girdle pain dangerous for my baby?
No. PGP is a musculoskeletal condition affecting your ligaments and joints; it does not affect your baby directly. It can, however, significantly affect your comfort and mobility, which is why treating it matters for your wellbeing during pregnancy.
How is pelvic girdle pain different from sciatica in pregnancy?
PGP is joint and ligament pain around the pelvis itself, typically sharp and triggered by specific asymmetrical movements. Sciatica involves nerve pain that radiates down the back of the leg, often with tingling or numbness, and has a different underlying mechanism. An assessment can distinguish between the two, and it’s possible to have elements of both.
Can I still exercise with pelvic girdle pain?
Usually yes, but the type matters. Symmetrical, low-impact movement like walking within a comfortable range and swimming with a symmetrical stroke (avoiding breaststroke) is often well tolerated. Activities that push your legs wide apart or load one side more than the other tend to aggravate symptoms and are best avoided until you’ve been assessed.
Will pelvic girdle pain go away after I give birth?
For most women, yes, symptoms ease significantly once relaxin levels fall and the mechanical load of pregnancy resolves, though this can take some weeks. A minority of women have symptoms that persist longer, particularly if PGP wasn’t actively managed during pregnancy, which is part of why earlier treatment tends to produce better outcomes.
Is it safe to have osteopathic treatment during pregnancy?
Yes. Osteopaths are trained to adapt technique and positioning throughout pregnancy, and gentle, targeted treatment for PGP is a well-established and safe approach. We’ll always take a full history, including your due date and any pregnancy complications, before treatment.
Should I use a support belt?
A support belt can help some women, particularly for standing and walking tasks, and evidence suggests it can be a cost-effective option alongside exercise. It works best as part of a wider plan rather than as a stand-alone fix, so it’s worth discussing fit and use as part of your assessment.
About the author
Tim Wood is a registered osteopath (GOsC) and the founder of Tim Wood Healthcare, qualified in 2007 with a BSc (Hons) in Osteopathy and a background in sports science. He has spent over 15 years treating patients across Rainham and Maidstone, working within a team with 40+ years of combined practitioner experience. Find out more about our osteopathic care.
Ready to get to the bottom of your pelvic pain?
If you’re ready to get to the bottom of your pelvic pain, our osteopaths at Tim Wood Healthcare are here to help. Book an appointment at our Maidstone or Rainham clinic, or take advantage of our free 15-minute phone consultation to have your questions answered before your first visit.
