Causes Of Pelvic Girdle Pain In Pregnancy And Its Treatment

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During pregnancy, your body is likely to undergo several changes. While some can make you happy, others can cause pain and discomfort.

One such pain is pelvic girdle pain which affects about 80% of pregnant women. The pain might impact your daily activities, and in some women might lead to a chronic condition later (1).

MomJunction gives you insights into the causes and symptoms of pain, along with precautionary measures to manage it effectively.

In This Article

What Is Pelvic Girdle Pain?

The pelvis, which is the largest bone of the skeleton, is where the hip bones are situated. The pubic symphysisiXA joint situated between the left and right pelvic bones that supports the body during labor. joins them at the front, and two sacroiliac jointsiXA joint that forms a connection between the lower region of the spine with the pelvis. link it at the back. A strong network of ligaments surrounds these joints, keeping the bones intact.

Pelvic girdle pain (PGP) refers to the pain anywhere from the front of the pelvis to the back, buttocks or down the leg, groin, lower abdomen, inner thigh, and vaginal area. The pain can be mild to severe. Severe pain might limit your mobility.

It may begin anytime during pregnancy or when you are nearing labor. It can develop after delivery as well (2). According to the Australian Journal of General Practice, It is believed that 4–84% of pregnant women experience lower back discomfort and pelvic girdle pain.

When Does PGP Develop In Pregnancy?

  • You might feel the pain during early pregnancy (or first trimester) or a few days before labor.
  • There might be pain and discomfort in the later stages of pregnancy (or third trimester) as the baby moves down into the pelvic region.
  • You might also feel the pain during the postpartum period (3). Keep reading to know why you experience this pain during pregnancy.

What Causes Pelvic Girdle Pain?

The primary cause of pelvic girdle pain is the low positioning of the fetus in the pelvic region. The increasing size of the fetus puts pressure on the pelvic bones, joints, and ligaments, leading to discomfort. However, the pain might increase due to a combination of factors such as (4) (5):

  • Uneven movements of the pelvic joints
  • Changes in the way the pelvic muscles work to support the girdle
  • Abnormal functioning of one pelvic joint, which stresses the other joints
  • Increasing maternal weight
  • Change in the center of gravity as the fetus grows
  • Pregnancy hormones affecting the connective tissues in the pelvic region
  • Prior injury or trauma to the pelvic region, from an accident or a fall
  • Exercise routines that strain the pelvic movements
  • The position of the fetus putting pressure on the pelvic area
  • History of lower back or pelvic pain
  • Physically demanding work routine

So, how do you know if it is PGP and not something else?

What Are The Symptoms Of Pelvic Girdle Pain?

The location and severity of pain vary from woman to woman. The pain can only be on one side, move from one side to another, or it can be a general ache or shoot up suddenly and disappear.

The common signs and symptoms of PGP include:

  • Pain in the lower back, hips, knees, groin, pubic region and thighs
  • Grinding or clicking in the pelvic region
  • Pain is noticeable during movements such as – walking on rough surfaces or for long distances, climbing stairs, sitting or standing for a long time, moving your knees while getting in and out of the car or a bathtub, lying on the bed in some positions and sexual intercourse

Pain might increase at night if you are active throughout the day. Symptoms may aggravate with the increasing weight of the baby and change in the center of gravity. It occurs due to the relaxin hormone, which usually softens the ligaments, allowing the pelvis to widen and make room for the baby (6).

Esay Querubin experienced severe pelvic pain a week before her expected delivery. Recalling her ordeal, she says, “I started feeling a sharp pain in my pelvis — on my pubic bone area —which I found out later is called the symphysis pubis. It started as a slight discomfort, something not to worry about as it seems normal in pregnancy. But in two days, the pain went from manageable to severe.

“It made walking, adjusting positions in bed, getting dressed, getting in and out of the car, more or less all activities which involved movement of legs, very painful. Stepping one leg forward felt like my pubic bone was being torn apart. From then on, I used a wheelchair whenever possible (i).”

During a visit to the doctor five days after her C-section, Querubin was diagnosed with symphysis pubis dysfunction.

How Is Pelvic Girdle Pain Diagnosed?

If you happen to feel any discomfort in the pelvic region, go to the doctor. The doctor will examine you thoroughly, and ask you about the origin of the pain and its severity. Provide all the relevant information about your activities or movements that may be causing the pain, so that the doctor can make the right diagnosis.

Pelvic girdle pain may be mistaken as sciatica pain. A physiotherapist can differentiate between both the conditions as they take a detailed look at the pelvic muscles and joints.

Treatment For Pelvic Girdle Pain During Pregnancy

PGP is treatable, and you can manage the pain with a few home care tips. Specific exercises and lifestyle changes can help in easing the pain and make the pregnancy better (4).

A physiotherapist usually treats pelvic girdle pain who may also administer heat treatments and relaxation techniques besides physical therapy. A brief explanation of the treatments are listed below.

  • Advice on avoiding movements that aggravate the pain, best positions for resting and movement, and pacing your activities to reduce your pain.
  • Exercises that can relieve your pain, and help you move comfortably. They help strengthen your pelvic floor muscles to improve your balance and make the spine stable.
  • Manual therapy that includes chiropractic adjustments or manual realignment of joints is done in multiple visits until the muscles become stronger enough to hold the joints.
  • Pain relief methods such as TENS (transcutaneous electrical nerve stimulation)iXA technique that uses mild electric currents to stimulate nerve cells in order to treat or reduce pain.
  • Hydrotherapy, which involves exercising in water, can provide relief to a certain extent.
  • AcupunctureiXAlternative medicine where thin needles are inserted at specific points of the body typically used to manage intense pain. from an experienced acupuncturist
  • A warm bath, heat therapy and ice therapy.
  • Pelvic support belts or crutches

If you have severe pain that is limiting your mobility, your doctor may prescribe pain medication such as paracetamol or topical analgesics or topical oils for relief.

Exercises That Help Relieve Pelvic Girdle Pain

Some exercises or yoga postures can help relieve the pain but check with your doctor before trying them. Stretching and strengthening the muscles of your lower back, hips, and quads can help (7).

  1. Bridge exercise: Lift your hips up by squeezing the pelvic floor and breathe out. Remain in this pose for two to three seconds, and lower the hips. Repeat.

  1. Hip lifts: Kneel on all fours, lift one foot upwards and back down. Repeat.

  1. Leg press: Lie on a side and lift the hip towards the chest. Next, push out by squeezing the pelvic floor muscles and buttocks.

  1. Leg lifts: Lie on one side and lift your leg, but not too high. Bring it down slowly and involve in only small movements.

You can also do pelvic floor exercises such as pelvic tilts, kegels, cat stretch and hip bridge. Stability ball exercises will also help.

protip_icon Be watchful
If considering swimming, avoid the breaststroke style as it may worsen the pelvic girdle pain (9).

How To Cope With Pelvic Girdle Pain During Pregnancy?

You can manage the pain before and after treatment, with the below measures (8):

  • Stay active as much as the pain allows you to, and rest whenever possible.
  • Try alternating the positions from sitting to standing during an activity.
  • Sleep on a side, with a pillow to support your belly and upper leg.
  • Explore different ways of climbing stairs. While using the staircase, use the pain-free leg first and then the other leg.
  • Avoid activities such as bending to lift something or carrying anything, as they put stress on the pelvis.
  • Indulge in safe sex positions such as kneeling on all the fours, or lying on one side.
  • While walking, take shorter steps rather than longer strides.
  • Avoid sitting down in a cross-legged position to maintain a safe and proper posture.
  • Be alert while involving pelvic floor muscles before laughing, coughing or sneezing.
  • Use chairs that have a backrest, or use a cushion for supporting your lower back.
  • Keep your knees together while getting out of the bed.
  • Use footwear with low heels and that have arch support.
  • Get a prenatal massage from a specialized therapist.

Following these tips can help keep the pain away during pregnancy. That brings us to the next question.

Does Pelvic Girdle Pain Affect Your Labor?

PGP will not affect your labor in any way. But if you are apprehensive about your delivery, talk to your doctor about the birth options. They might suggest a few positions for vaginal delivery:

  • Sitting upright or in a kneeling position
  • Side-lying with knees or pillows against the chest
  • Avoid lying down with your back

In some cases, PGP can make it difficult to open your legs up during delivery. If natural birthing is ruled out due to pain, your doctor would recommend a cesarean section.

protip_icon Did you know?
A water birth might help with pelvic girdle pain because the water can give you support and allow easy movement (9).

How Soon Does Pelvic Girdle Pain Reduce?

PGP will go away within a few weeks or months after birth. The chances of postpartum pelvic girdle pain usually exist if the condition was severe during pregnancy (4).

Mild pain might recur before periods, as the hormones (estrogeniXA hormone responsible for the development and functioning of female reproductive organs. and progesteroneiXA female reproductive hormone that plays a vital role in menstruation, pregnancy, and breastfeeding. ) that act upon the menstrual cycle might affect as the pregnancy hormones do.

Does PGP Recur In Your Next Pregnancy?

PGP might recur in the subsequent pregnancy, but it can be managed effectively if you remain fit and healthy. Consider having a gap between pregnancies, and try to stay fit and lose weight to lessen the pelvic girdle pain.

Strengthening the abdominal and pelvic floor musclesiXMuscles located at the bottom of pelvis that provide support to a woman’s bladder, bowel, and uterus. will lessen the chances of PGP in the following pregnancy.

Next, we answer some frequent queries about PGP.

Frequently Asked Questions

1. Can I get pelvic girdle pain when not pregnant?

Yes, you may develop PGP from any injury or arthritis. However, pregnant women are more prone to this condition than those who are not pregnant.

2. Are pelvic girdle pain and sciatica similar?

Pelvic girdle pain and sciatica are known to cause pain in the lower back or buttock region. Sciatica is a pain that radiates from the lower back, towards the buttocks and into one or both the feet, whereas PGP refers to pain in any part of the pelvic region to the vaginal area.

3. Can PGP cause early labor?

PGP is unlikely to cause early labor. Exercises, support belts, and some lifestyle changes will help you reach full term.

4. Will pelvic girdle pain affect my unborn baby?

No. Pelvic girdle pain during pregnancy is not known to affect the unborn baby in any way (8).

5. Can I give birth naturally with a pelvic girdle?

Yes. An experienced medical team can help women with pelvic girdle pain have a standard vaginal delivery (10). They can guide about the comfortable positions and pain relief techniques to ensure safe and healthy delivery.

Although common, pelvic girdle pain during pregnancy can be an uncomfortable and painful experience. Trying some effective exercises and tips on how to relieve pelvic girdle pain can come in handy. The key is to stay healthy, active, and aware of the symptoms so you can see your ob/gyn for treatment as soon as possible. Irrespective of the intensity of the pelvic pain, be it mild or severe, you must consult your doctor. They can recommend safe workouts and offer you effective measures to deal with the pain.

Key Pointers

  • Pelvic girdle pain affects approximately 80% of pregnancies.
  • The pain is commonly experienced in the pelvic region, lower back, hips, lower abdomen, groin, and vaginal area.
  • The condition is often caused by the pressure exerted by the growing fetus on the pelvic bones, joints, and ligaments, as well as other factors.
  • Pelvic muscle and joint changes, weight gain, and previous pelvic injuries can contribute to the pain.
  • Specific exercises, using pillows for support, and taking short steps while walking or changing seating positions may alleviate pelvic girdle pain.


Are you pregnant and suffering from pelvic girdle pain? Learn more about PGP and how to manage it in this informative video!

Personal Experience: Source

References

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
  1. Janneke M Bastiaanssen et al.; (2005); Etiology and prognosis of pregnancy-related pelvic girdle pain; design of a longitudinal study.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC548283/
  2. Pregnancy-related pelvic girdle pain and its relation to muscle function.
    https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.429.2697&rep=rep1&type=pdf
  3. Nikolaos K Kanakaris et al.; (2011); Pregnancy-related pelvic girdle pain: an update.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3050758/
  4. Pelvic girdle pain (symptomatic pelvic girdle relaxation pelvic joint syndrome).
    http://www.nfog.org/files/guidelines/18%20NGF%20Obst%20pelvic%20girdle%20pain%20Stuge.pdf
  5. Pelvic Floor Muscle T elvic Floor Muscle Training in Management of Paining in Management of Postpartum Pelvic Floor Dysfunctions: A Literature Review.
    https://stars.library.ucf.edu/cgi/viewcontent.cgi?referer=&httpsredir=1&article=1110&context=honorstheses
  6. Pelvic girdle pain (PGP) is common in pregnancy.
    https://www.nct.org.uk/pregnancy/worries-and-discomforts/common-discomforts/pelvic-girdle-pain-pgp-common-pregnancy
  7. Pregnancy-related low back pain and pelvic girdle pain (PGP).
    https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/pelvic-pain/
  8. Pelvic pain in pregnancy.
    https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/pelvic-pain/
  9. Pelvic pain in pregnancy.
    https://www.tommys.org/pregnancy-information/pregnancy-complications/pelvic-pain-pregnancy
  10. Pelvic girdle pain and pregnancy
    https://www.rcog.org.uk/for-the-public/browse-our-patient-information/pelvic-girdle-pain-and-pregnancy/
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