Pelvic Girdle Pain (PGP) in Pregnancy: NHS Guide

What pelvic girdle pain is

Your pelvis has three joints connected by ligaments. During pregnancy, relaxin hormone loosens these ligaments. In PGP, the joints become too mobile or move unevenly, causing pain and inflammation. It is not caused by anything you did wrong.

Symptoms

Pain in the front of the pelvis (over the pubic bone), lower back on one or both sides, perineum, or inner thighs. A clicking or grinding sensation. Pain is worse when walking, climbing stairs, standing on one leg, turning in bed, or getting in and out of a car. It is typically activity-related and worsens as the day goes on.

When it starts

Most commonly in the second or third trimester, though it can begin in the first trimester or during labour.

Getting help early

Tell your midwife or GP as soon as possible. Ask for a referral to a physiotherapist with pregnancy experience. Early treatment is more effective than waiting.

Management strategies

Physiotherapy. Manual therapy, strengthening exercises, movement advice, and assessment for a pelvic support belt. Movement modifications. Keep knees together when turning in bed or getting out of the car. Take smaller steps. Sit down to get dressed. Pillow between knees when sleeping. Pelvic support belt. Worn low around the hips, ideally fitted by your physiotherapist. Pain relief. Paracetamol is safe throughout pregnancy. Speak to your GP about other options if needed. Ice or heat. Experiment to see what works for you.

What to avoid

Standing on one leg, crossing legs, sitting on the floor, carrying heavy loads on one side, and breaststroke swimming.

PGP and birth

PGP does not prevent vaginal delivery. Discuss it with your midwife so they can note your comfortable range of movement. Water birth can be particularly beneficial.

After the birth

Most people improve significantly within weeks to months. If pain persists beyond 3 months postpartum, ask for a physiotherapy referral.