More than half of pregnant women will experience pelvic girdle pain during pregnancy (1).
It is the most common pregnancy-related pain. For some, the reported pain is mild and goes away independently. But for others, the pain can be severe and last for weeks, even months, and up to 7 percent of women will continue to have pain long after giving birth (2).
The pain pattern can vary from a diffuse dull ache along the low back to pain in the groin with walking. Sciatica is also a common symptom associated with pelvic girdle pain. If you’re dealing with pelvic girdle pain, you’re not alone.
Causes of pelvic pain in pregnancy
The pain generators, or the structures that cause pain, are the sacroiliac joints and the pubic symphysis.
The robust sacroiliac joints are in the back of the pelvis, just below the low back, and can cause posterior pelvic pain. The symphysis pubis is a more minor, focal joint in the front of the pelvis.
Both pelvic joints can cause pelvic girdle pain. The baby, your organs, and your intestines all sit in the middle. It is easy to see how this might start getting a little overworked!
There are, however, many risk factors that may contribute to pregnancy-related pelvic girdle pain.
Risk factors of pelvic pain in pregnancy
Some women are more likely to experience pelvic girdle pain during pregnancy due to certain risk factors. These include:
Previous back injury
Previous back injuries are a risk factor for pelvic girdle pain during pregnancy. If you have had a previous back injury, you are more likely to experience pelvic girdle pain during pregnancy. Strengthening exercises can help. This pain can be a result of the extra weight and strain on your body during pregnancy.
History of pelvic floor weakness
History of a woman’s pelvic floor can affect them during pregnancy. Pelvic girdle pain is a common complaint among pregnant women, and one of the risk factors for this pain is a history of pelvic floor problems.
If you’ve had any kind of pelvic floor dysfunction in the past, be sure to tell your doctor or midwife. They can help you manage your symptoms and care for your pelvis during pregnancy.
Increased standing is a risk factor for pelvic girdle pain during pregnancy. If you stand more often, you’re more likely to experience pelvic pain.
Obesity can lead to pelvic girdle pain during pregnancy because the extra weight puts pressure on the joints of the pelvis. This can be extremely painful and make it difficult to carry on with everyday activities.
Advanced gestational age
Gestational age has been correlated with the amount of pelvic girdle pain a woman experiences during pregnancy. As a woman’s pregnancy progresses, her risk for pelvic girdle pain increases.
Multiparity is a risk factor for pelvic girdle pain during pregnancy. Pregnancy puts a lot of strain on the pelvis, and multiple pregnancies increase the risk of developing pelvic girdle pain. If you’ve had multiple pregnancies, be sure to talk to your doctor about ways to manage the pain.
While some of these factors cannot be changed, such as your history or how far along you are in your pregnancy, others can be managed to help lessen the amount of pain you experience (3).
Diagnosis of Pregnancy-related Pelvic Pain
A diagnosis is typically made in the office with a physical examination.
Be sure to be specific about your pain, such as:
- the location
- the duration
- movements that bother it
- positions that seem to help
A differential diagnosis between generalized low back pain, pelvic instability, lumbar pain, and pregnancy-related lumbopelvic pain is essential for treatment.
Movements such as transitioning from sitting to standing, getting in and out of a car, standing for long periods, or rolling over in bed often worsen the pain and are common triggers.
A series of five basic orthopedic tests have shown a high degree of accuracy and specificity for pelvic girdle pain (4). This is typically performed in the office and takes only a few minutes.
Management and treatment
Treatments of pelvic girdle pain during pregnancy are limited. Because of the risk to the fetus, options typically accessible for non-pregnancy-related pelvic girdle pain are not available.
In addition, the research lacks quality evidence regarding management and treatment, often leaving doctors and midwives with limited recommendations (5).
However, there is still a lot you can do to help manage your pain.
Treatment Options Pelvic Pain
Ibuprofen and other pain medications are typically not recommended for use during pregnancy for extended periods. Tylenol may be recommended and can be effective. Check with your health professionals before starting any medication for pelvic joint pain while pregnant.
Modify your lifestyle
Moving slower and moving less will help ease the stress on your body. Simple modifications at work can go a long way to ease the cumulative stress on your body throughout the day. Make sure you have proper ergonomic adjustments at your workstation and can take breaks if you are on your feet. Your midwife or doctor may be able to write a note with specific accommodations for your employer.
Seek manual therapy
Osteopathic and chiropractic manipulation along with physical therapy has shown to help alleviate the pelvic girdle pain.
Mobilization of the joints coupled with strengthening and stretching exercises can help maintain support throughout the pelvis. Such therapists can work with you through your pregnancy as an addition to your pregnancy team.
Many pregnant women seek to natural therapies for pain relief. While most are safe, it is important to discuss all options with your doctor.
Back and night support can help ease pain
External support at night and throughout the day can help take the pressure off of the pelvis.
Check out our list of best back braces for 2022.
Pregnancy pillows can provide support and allow for a more peaceful sleep
There are many different types of support pillows on the market that can help alleviate pregnancy-related pelvic pain. Some are designed to prop up your belly, others your hips, and still others your back. There is no one perfect pillow, so it may take some trial and error to find the one that works best for pelvic pain
Pelvic support belt can help during the cay
This belt can help to provide support for the joints and pelvis, helping to ease some of the pelvic girdle pain. There are a variety of different types of braces available, so it is important to talk to your doctor or midwife to find the best type of brace for your individual needs. The right pelvic belt during pregnancy can help you to stay active and provide pain relief during this special time.
Symphysis pubis belt takes pressure off the front of the pelvic
This belt is different from the sacroiliac joint belt as it supports the front of the pelvis rather than the back. However, a high-quality sacroiliac joint belt may help with symphysis pubis dysfunction. Many women find them very helpful in alleviating pain.
Supportive footwear will support the back
Supporting from the ground up is step one in managing pregnancy-related pelvic pain. For this temporary period, consider wearing supporting sneakers if you are going to be on your feet for an extended time.
Pelvic girdle pain during pregnancy is a common condition that can cause severe pain to have a significant impact on a woman’s quality of life.
Studies have shown that results of pregnancy-related pelvic pain can have long-lasting physical and emotional effects and lead to postpartum pelvic girdle pain and chronic pain.
Additionally, pelvic pain is often seen as a regular part of pregnancy and can be overlooked or dismissed by health care providers for more significant issues (5).
There are various treatment and management options available. It is essential to work with a healthcare provider who will work with you to confirm your diagnosis and discuss treatment and management options.
Ceprnja D, Chipchase L, Fahey P, Liamputtong P, Gupta A. Prevalence and Factors Associated with Pelvic Girdle Pain During Pregnancy in Australian Women: A Cross-Sectional Study. Spine (Phila Pa 1976). 2021;46(14):944-949. doi:10.1097/BRS.0000000000003954
Elden H, Gutke A, Kjellby-Wendt G, Fagevik-Olsen M, Ostgaard HC. Predictors and consequences of long-term pregnancy-related pelvic girdle pain: a longitudinal follow-up study. BMC Musculoskelet Disord. 2016;17:276. Published 2016 Jul 12. doi:10.1186/s12891-016-1154-0
Wuytack, Francesca, et al. “Prognostic factors for pregnancy-related pelvic girdle pain, a systematic review.” Midwifery 66 (2018): 70-78.
Walters C, West S, A Nippita T. Pelvic girdle pain in pregnancy. Aust J Gen Pract. 2018 Jul;47(7):439-443. doi: 10.31128/AJGP-01-18-4467. PMID: 30114872.
Mackenzie J, Murray E, Lusher J. Women’s experiences of pregnancy related pelvic girdle pain: A systematic review. Midwifery. 2018 Jan;56:102-111. doi: 10.1016/j.midw.2017.10.011. Epub 2017 Oct 16. PMID: 29096278.
Franke H, Franke JD, Belz S, Fryer G. Osteopathic manipulative treatment for low back and pelvic girdle pain during and after pregnancy: A systematic review and meta-analysis. J Bodyw Mov Ther. 2017 Oct;21(4):752-762. doi: 10.1016/j.jbmt.2017.05.014. Epub 2017 May 31. PMID: 29037623.