Pelvic girdle pain (PGP), sometimes called symphysis pubis dysfunction or SPD, is a common cause of pain at the front or back of the pelvis during pregnancy. It is treatable at any stage, and the sooner it is recognised, the sooner you can ease it. Tell your midwife or doctor, change the movements that provoke it, and ask for a referral to a physiotherapy service that treats pregnancy pelvic problems. This guide explains what PGP feels like, why it happens, what helps day to day and at night, and how hands-on care can sit alongside your NHS maternity team.
TL;DR
- PGP is estimated to affect up to 1 in 5 pregnant women. It is common, but it is not something you simply have to put up with.
- Typical signs are pain over the pubic bone, across the lower back or into the thighs, often worse on stairs, when rolling over in bed or when standing on one leg.
- Tell your midwife or doctor early. Pacing your day, a pillow between your knees at night and supportive shoes all help.
- Treatment usually means specialist physiotherapy, targeted exercises and sometimes a support belt or crutches. Hands-on care from a chiropractor can be part of your plan, once you have checked in with your midwife.
- Pain usually improves after birth, though around 1 in 10 women still have pain, and that is worth getting assessed.
Table of Contents
- What pelvic girdle pain feels like
- Why it happens
- When to tell your midwife or doctor
- Everyday ways to ease pelvic girdle pain
- Night pain and the final months
- Treatment for SPD and PGP in pregnancy
- Our perspective: why a thorough assessment matters
- Booking an assessment at Elaris
- After the birth: what to expect
- Planning another pregnancy
- FAQ
- Sources
What pelvic girdle pain feels like
Your pelvis is a ring of bones joined at the front by the pubic joint and at the back by the two sacroiliac joints. In pregnancy these joints need to move a little, and they need to move together. PGP is a collection of symptoms linked to stiffness of the pelvic joints or the joints moving unevenly.
The NHS describes pain that can be felt:
- over the pubic bone at the front, in the middle
- across one or both sides of the lower back
- in the area between the vagina and anus (the perineum)
- spreading into the thighs
Some women also notice a clicking or grinding sensation in the pelvis. Pain is rarely constant. It tends to appear with particular movements and then settle, which is why many women describe good mornings and difficult afternoons.
The movements that most often set it off are walking, climbing or descending stairs, standing on one leg (think pulling on trousers), rolling over in bed and moving the legs apart, according to the NHS. If you recognise two or three of those, PGP is a likely explanation, but only an assessment can confirm it.
SPD or PGP: is there a difference?
The two terms are used for overlapping problems. SPD refers to the pubic joint at the front, while PGP is the wider term covering pain around the pelvis, including the back joints. Many clinicians now prefer PGP because pain often involves more than one joint. If you searched for SPD treatment, everything in this guide applies to you.
Why it happens
Nobody can point to a single cause. The NHS says PGP is thought to be linked to previous damage to the pelvis, joints moving unevenly, and the weight or position of the baby. A 2026 review in The BMJ describes a mix of hormonal and biomechanical factors, and adds that the exact part played by hormones such as relaxin is still unclear. So the popular explanation, “your ligaments have gone loose”, is only part of a more complicated picture.
What matters for you is the practical side. As the baby grows, your centre of gravity shifts, your posture adapts and your pelvic joints take load in new ways. If one side of the pelvis moves differently from the other, the joint and the muscles around it can become irritated. That is why a thorough assessment of how you move, not just where it hurts, makes sense.
Who is more likely to get it
The RCOG says you are more likely to have PGP if you have had a back problem, injured your pelvis in the past, or have hypermobility syndrome. The NHS Inform guidance adds that if you have PGP and do not treat the symptoms, you are more likely to have it again in future pregnancies. That is a good reason to deal with it properly now rather than waiting for the birth to solve it.
If you have a history of back pain, it is also worth knowing how back problems are assessed. Our page on low back pain care in Maldon and Tiptree explains what a spinal examination involves.
When to tell your midwife or doctor
PGP is common, but The BMJ is clear that it is not a normal part of pregnancy. Pain that limits you deserves attention rather than patience.
The RCOG advises that you tell your midwife or doctor about your pain. You should be offered an appointment with a physiotherapist, who will assess your posture and your back and hip movements and rule out other causes of pelvic pain.
Contact your midwife or doctor promptly if:
- the pain is severe or you are struggling to walk or manage stairs
- pain is new, one-sided and comes with swelling or tenderness in a calf
- you have bleeding, fluid loss, fever, pain on passing urine, or you feel generally unwell
- the baby is moving less than usual
The last three are not typical of PGP and need urgent medical assessment, not self-care. If the problem is severe, the RCOG notes that short-term aids such as crutches or a wheelchair may be considered, and extreme pain or very limited mobility may lead to admission to an antenatal ward for physiotherapy and pain relief.
What about pelvic pain at 11 weeks, or at night? Early pregnancy pain on one side, especially with bleeding or dizziness, should always be checked by your GP, midwife or early pregnancy unit before anyone assumes it is a joint problem. Pain that is clearly movement-related and sits around the pubic bone or sacroiliac area is the typical PGP pattern.
Everyday ways to ease pelvic girdle pain
The NHS advice is practical: stay active, but avoid the things that make the pain worse, rest when you can and wear supportive shoes. In bed, put a pillow between your legs, and keep your knees together when getting in and out of a car or turning over. These are the details from the NHS pelvic pain page; here is how they work in a normal day.
Moving around
- Take smaller steps. A shorter stride reduces the shearing force across the pubic joint.
- Take stairs one at a time. Lead with the same leg and bring the other up to meet it, rather than alternating.
- Avoid standing on one leg. Sit down to dress, and lean against a wall if you need to balance.
- Keep your knees together when sliding in and out of the car. A plastic bag on the seat can help you swivel.
- Carry less, and carry evenly. One heavy shopping bag pulls the pelvis unevenly. Split it, or ask for help.
It also helps to break up the day. Alternate sitting and walking, and avoid long spells in one position. Housework such as vacuuming and ironing involves repeated twisting and one-leg loading, so sit for what you can and spread the rest across the week.
Sitting and working
Sit with both feet on the floor and your back supported. Crossing your legs tilts the pelvis and can provoke the pain. If sitting on hard surfaces aggravates the pelvis or tailbone, our guide to tailbone pain when sitting covers cushions and when they are not enough. Standing up often, even for a minute, keeps the joints from stiffening.
Staying active without making it worse
Rest is not the goal in itself. The aim is to keep moving within what your pelvis tolerates. Short walks on flat ground, gentle swimming with a kick that does not splay your legs (many women find breaststroke leg movement aggravating) and the exercises your physiotherapist gives you are usually better tolerated than sitting all day. A useful rule: if the pain is clearly worse that evening or the next morning, you did a little too much, so scale back next time rather than stopping altogether.
Night pain and the final months
Many women find the night is the hardest part, and it is a frequent search: is pelvic pain at night normal in pregnancy? It is common with PGP because rolling over opens the legs and loads the joints. It is still worth reporting, since it tells your midwife or physiotherapist how much the condition affects you.
What tends to help:
- A pillow between your knees and ankles when lying on your side, as the NHS suggests.
- Keep your knees together as you turn. Tighten your tummy gently and turn your whole body as a unit, rather than letting one leg fall away.
- Satin sheets or a satin pyjama top can make turning easier. Many women find this a small change with a big payoff.
- A supported side-lying position with a longer pregnancy pillow, so the top leg does not drop forward.
- A warm bath or heat pack over the lower back or hips can ease muscle tension. Keep the water comfortably warm rather than hot.
In the ninth month, the baby sits lower and heavier in the pelvis, and pain on walking is common. Shorten outings, plan sitting breaks and ask your midwife about supports and crutches if mobility drops. If you also have pain that runs down the leg, our article on sciatica and leg pain explains how nerve-related pain differs from joint pain, and thigh numbness is covered in our piece on meralgia paresthetica symptoms.
Treatment for SPD and PGP in pregnancy
The NHS says recommended treatment may include referral to a physiotherapy service specialising in obstetric pelvic joint problems, exercises to strengthen the pelvic floor, stomach, back and hip muscles, and equipment such as crutches or pelvic support belts. Physiotherapy aims to ease pain, improve muscle function, and improve the position and stability of the pelvic joints.
The RCOG stresses that PGP is treatable at any stage during or after pregnancy, and that early diagnosis and treatment can relieve pain and help stop symptoms getting worse. An Australian general practice review also recommends a conservative, multidisciplinary approach that takes in the effect on the woman and her family, not only the joint.
In practice, a good plan has several parts:
| Part of the plan | What it is for |
|---|---|
| Assessment | Finds which joints and muscles are involved and rules out other causes |
| Exercises | Build support from the pelvic floor, abdominals, back and hips |
| Pacing and daily changes | Reduce the movements that provoke pain |
| Aids (belt, crutches) | Offload the pelvis when walking is difficult |
| Hands-on care | Addresses stiff or unevenly moving joints and tense muscles |
| Review | Checks progress so the plan changes as the pregnancy does |
Because the picture changes week by week, the plan should too. What suits you at 20 weeks may not suit you at 34.
Our perspective: why a thorough assessment matters
We see pelvic and lower back pain every week, and the pattern with pregnancy is consistent: women are told it is “just part of being pregnant”, they cut back what they do, and the pain narrows their life anyway. We do not agree that you simply have to wait. PGP is treatable, and the most useful first step is understanding exactly what is going on in your body.
That is the idea behind the Elaris Method™. We look at structural, neurological and emotional factors together, because pain in pregnancy is rarely only about one joint. Tiredness, worry about work and birth, poor sleep and a changing posture all play a part in how much a pelvis hurts. A hands-on examination, neurological testing where appropriate and a written plan explained in plain terms let you see what we are doing and why.
Continuity matters too. You see the same two practitioners each visit, there is no rush, and we measure progress at every stage, so you are not left guessing whether something is working. We work alongside your midwife and any NHS physiotherapist, not instead of them, and we are glad to hear what they have advised so the advice fits together.
If you want to know how we think about safety during pregnancy, our guide to chiropractic during pregnancy in the UK sets out five checks worth making with any practitioner you choose.
— Dr Stephen Davison
Booking an assessment at Elaris
If your pelvic pain is making it hard to walk, sleep or work, you can book a first consultation and examination at our Great Totham clinic for £105. It is a full hands-on assessment, not a quick look, and you leave knowing what we think is happening and what we suggest. We care for pregnant women and children as well as adults with back, neck and leg pain.
You can book your first consultation through our website. We are based in Great Totham and see patients from Maldon, Tiptree and the surrounding Essex villages. Before you come, mention your pain to your midwife, and bring any notes or physiotherapy advice you have been given.
After the birth: what to expect
For most women PGP improves after delivery. The RCOG says it usually improves after birth, although around 1 in 10 women will have ongoing pain. That means most women recover, but it also means a meaningful number do not, and persistent pain is not something to ignore on the assumption that it will pass.
Some practical preparation helps. If you know you have PGP, plan the first days at home so you are not climbing stairs repeatedly, and pack comfortable items for your hospital bag, including postpartum underwear options so that you are not struggling with awkward clothing when moving is already painful.
Tell your health visitor or GP if pain continues after birth. Ask about a referral to a physiotherapist who treats women’s pelvic health. Carrying, feeding and lifting a baby put new loads through the pelvis and back, so changes in how you lift, feed and sleep can matter as much as exercises.
If pain lingers in the buttock or deep in the hip, it may have another source. Our articles on deep gluteal syndrome and dead butt syndrome describe other causes of buttock and hip pain, and the quadratus lumborum pain guide covers a muscle that often tightens alongside pelvic problems. For wider reading, see our library of back pain and sciatica articles.
Planning another pregnancy
Because untreated PGP makes it more likely in future pregnancies, the months between pregnancies are a good time to address lingering stiffness, build strength and fix movement habits. Mention previous PGP to your midwife at the booking appointment so support is in place early rather than after the pain starts.
FAQ
Is it normal to have pelvic pain at night in pregnancy?
Night pain is common with PGP because turning over loads the pelvic joints. It is not, however, a normal part of pregnancy, so tell your midwife. A pillow between your knees and turning with your knees together can help. Pain with bleeding, fever or fluid loss needs urgent medical advice.
How do I reduce pelvic pain in the ninth month?
Pace your day, take shorter steps, sit to dress and avoid carrying uneven loads. Ask your midwife about a support belt or crutches if walking is hard. Physiotherapy can still help at this stage, as PGP is treatable at any point in or after pregnancy.
Will SPD go away after I give birth?
For most women it improves after birth, but around 1 in 10 still have pain. If yours continues, ask your GP or health visitor for a referral to a women’s pelvic health physiotherapist, and consider a full musculoskeletal assessment.
Can a chiropractor treat pregnancy pelvic girdle pain?
Chiropractors assess and treat joint and muscle problems of the spine and pelvis, and we see pregnant patients at our clinic. Tell your midwife you plan to attend, choose a practitioner who is experienced with pregnancy and use our five safety checks as a guide.
Do I need a support belt?
Belts and crutches are among the aids the NHS lists for PGP. Whether one suits you depends on your symptoms, so ask your physiotherapist to fit it and show you how long to wear it.
Sources
- Pelvic pain in pregnancy, NHS
- Pelvic girdle pain and pregnancy, RCOG
- Pelvic girdle pain, NHS inform
- Pregnancy-related pelvic girdle pain, The BMJ
- Pelvic girdle pain in pregnancy, Australian Journal of General Practice