Pelvic girdle pain affects around one in five pregnancies and, for a significant minority, is severe enough to disrupt walking, sleeping and working. It is also one of the conditions most often dismissed — "it is just the pregnancy hormones" — which leaves women managing serious pain with no plan.
PGP is a mechanical problem of load transfer through the pelvis, and it responds to mechanical treatment. Most women improve substantially with the right combination of manual therapy, specific exercise, load management and, where useful, external support.
What pelvic girdle pain actually is
The pelvis is a ring of three joints — the pubic symphysis at the front and the two sacroiliac joints at the back. Those joints move very little, and they rely on a combination of joint shape, ligament tension and muscular control to transfer load between your trunk and your legs.
In pregnancy, relaxin and other hormonal changes increase ligament laxity, while the growing uterus shifts your centre of mass forwards. The passive stability drops just as the load demand rises. If the muscular control system does not adapt, load transfer becomes inefficient and the joints become painful and sensitised.
Two things follow from that. First, the old term SPD (symphysis pubis dysfunction) describes one location of a wider problem — "pelvic girdle pain" is the more accurate term. Second, the pelvis is not "unstable" in the sense of coming apart, and treatment is not about bracing it rigidly; it is about restoring efficient control.
Typical symptoms
PGP presents in a recognisable pattern. You may have some or all of these:
- Pain at the pubic bone at the front, sometimes with a grinding or clicking sensation
- Pain at the back of the pelvis, over one or both dimples above the buttocks
- Pain in the groin, inner thigh or buttock, sometimes referring down the leg
- Worse when turning over in bed — often the single most recognisable feature
- Worse on stairs, getting in and out of a car, or standing on one leg to dress
- Worse with asymmetrical loading — carrying a toddler on one hip, pushing a buggy
- A waddling gait, or pain that builds through the day and is worst by evening
How it is treated
Assessment first: which joints are painful, how load transfers through the pelvis, and what is driving it. Treatment then targets the specific pattern rather than applying a generic protocol.
Manual therapy
Hands-on treatment of the sacroiliac joints, pubic symphysis and the surrounding muscles that have become overactive and painful — commonly the hip adductors, hip flexors, gluteals and lumbar muscles. Safe throughout pregnancy with appropriate positioning.
Targeted stability exercise
Specific retraining of the deep abdominal muscles, pelvic floor and gluteals so the pelvis transfers load efficiently. This is not generic core work — it is aimed at the particular control deficit found on assessment, and it is progressed as symptoms allow.
Pelvic support belt
A correctly positioned support belt reduces pain for many women, particularly on walking and standing. Position and tension matter enormously — a belt worn too high or too tight often makes things worse, which is why so many people conclude they "do not work".
Load management strategy
Practical changes with a disproportionate effect: keeping knees together when turning in bed and getting out of the car, sitting to dress, avoiding the stairs-two-at-a-time and one-hip-carrying patterns, and pacing activity across the day rather than doing everything in one burst.
Pelvic floor assessment
The pelvic floor contributes directly to pelvic load transfer, and in PGP it is frequently overactive rather than weak. That distinction changes treatment completely — strengthening an already overactive pelvic floor tends to worsen pain.
Birth planning
Where PGP is significant, it is worth establishing your comfortable range of hip abduction before labour and discussing positions with your midwife, so that positioning during birth does not aggravate the pelvis.
PGP after birth
For many women, pelvic girdle pain improves markedly in the weeks after birth as ligament laxity reduces and load drops. For others it persists — and persistent PGP is a treatable condition, not a permanent consequence of pregnancy.
Postnatal PGP has an additional layer: the demands of new parenthood are relentlessly asymmetrical and involve constant lifting from awkward positions, usually while sleep-deprived. Treatment addresses the control deficit while also making the daily reality workable.
If your PGP has not settled by around three months postnatal, it is worth having it assessed rather than continuing to wait. See postnatal physiotherapy.
Pubic pain accompanied by fever, or pain that is severe and constant rather than movement-related, needs medical assessment to exclude other causes such as infection. Contact your GP, midwife or NHS 111.
Frequently Asked Questions
What is the difference between PGP and SPD?
SPD (symphysis pubis dysfunction) refers specifically to pain at the pubic joint at the front of the pelvis. Pelvic girdle pain (PGP) is the broader and now preferred term, covering pain at the pubic symphysis, the sacroiliac joints at the back, or both. The underlying problem — inefficient load transfer through the pelvic ring — is the same, and so is the treatment approach.
Will pelvic girdle pain damage my pelvis or my baby?
No. PGP is a painful, sensitised load-transfer problem, not a structural injury, and the pelvis is not coming apart. It does not harm your baby. It can be genuinely disabling in terms of pain and function, which is reason enough to treat it — but it is not causing damage.
Do pelvic support belts actually help?
For many women, yes — particularly for pain on walking and standing. Position and tension are critical: a belt should sit low, around the level of the hip bones rather than the waist, and be firm without being tight. Incorrectly worn belts frequently make symptoms worse, which is the usual reason people conclude they do not work.
Can I still exercise with pelvic girdle pain?
Usually yes, with modification. Activities involving wide leg positions, single-leg loading or asymmetrical movement tend to aggravate PGP, while swimming (avoiding breaststroke leg action), stationary cycling and specific targeted exercise are often well tolerated. The aim is to find what your pelvis tolerates rather than stopping altogether, since deconditioning makes matters worse.
How long does treatment take?
Many women notice meaningful improvement within two to four sessions, particularly once load-management strategies and a correctly fitted support are in place. During pregnancy the aim is usually to manage symptoms well until birth, since the underlying hormonal and load factors continue. Postnatal PGP often resolves more completely with a course of treatment over six to twelve weeks.
Should I just wait until after the birth?
That is common advice and it is not well founded. A significant proportion of women with pelvic girdle pain in pregnancy still have symptoms a year after birth, and outcomes are generally better in those treated during pregnancy. Waiting also means months of avoidable pain and reduced activity.
Clinically reviewed by Jency Sudha, Consultant Pelvic Health Physiotherapist & Biofeedback Specialist — last updated 26 July 2026
The information on this page is for general guidance and does not replace individual clinical assessment. If your symptoms are new, worsening, or accompanied by bleeding, fever or severe pain, contact your GP or NHS 111.
You Do Not Have to Wait It Out
Pelvic girdle pain is mechanical and treatable. Most women improve substantially with the right assessment and plan.
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