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Low back & pelvic girdle pain

Common, but very treatable

Pregnancy-related Pelvic Girdle Pain (PGP) can affect 50%–70% of pregnant women to some degree. It describes pain experienced at the front and/or back of your pelvis the pubic bone, groin, lower back, hips or buttocks.

PGP is common, but it should not be considered “normal” or something you simply have to put up with. With the right advice and physiotherapy, most women see significant improvement, and the majority recover fully after delivery.

What does PGP feel like?

PGP is pain in the joints that make up your pelvic girdle (HSE definition). The onset can be sudden or gradual. Pain may include:

  • Lower back pain, usually to one or both sides — around your sacro-iliac joints
  • Pain in the pubic symphysis joint (pubic bone) between your legs at the front
  • Pain in the groin, hips or buttocks
  • Pain that travels into the back of the thigh

Movements that often trigger or worsen PGP include:

  • Moving from sitting to standing, or lying to sitting
  • Turning in bed
  • Getting in or out of a car
  • Driving
  • Getting dressed
  • Activities involving standing on one leg
  • Pain with sexual intercourse

If any of these sound familiar, it’s worth speaking to your midwife or GP about a physiotherapy referral.

Why PGP happens

PGP arises from a combination of normal pregnancy changes:

  • Hormonal changes — your pelvic ligaments become softer and looser, leading to small but uneven movements within the pelvis. The pelvis is still very stable despite this. Hormonal changes can also increase your sensitivity to pain.
  • Postural and muscular changes — as your baby grows, your posture changes. This shifts the activity of the muscles around your tummy, pelvic girdle, hips and pelvic floor. Some muscles work harder and become tight; others stretch and weaken. Both can become a source of pain.
  • Increased load on joints and ligaments — your growing baby adds load, and the way you move adapts.

Some factors make PGP more likely, including a previous history of PGP, being pregnant more than once within a short period (i.e. less than two years between pregnancies), and having had several pregnancies.

What helps

A combination of small daily changes, gentle exercise and physiotherapy is the most effective approach. Some general tips:

  • Avoid activities that trigger pain — particularly anything that involves taking your weight on one leg (climbing stairs slowly, sitting to dress).
  • Keep your knees together when getting in and out of a car, or rolling over in bed.
  • Take stairs one at a time, leading with your stronger/less painful leg going up.
  • Avoid carrying heavy loads unevenly (e.g. a toddler on one hip).
  • Pace yourself — break up long periods of activity with rest, before pain flares.
  • Certain sleeping positions help — typically side-lying with pillows between the knees and under the bump.

Some women find a pelvic support belt very helpful. Your physiotherapist can advise on whether one is suitable for you and how to use it.

Recovery and reassurance

Will it go away after the birth?

Pelvic girdle pain resolves on delivery of your baby in the majority of cases. For those whose symptoms persist postnatally, ongoing physiotherapy will help.

Most women with PGP have a normal labour and birth. Your midwife and physiotherapist can discuss comfortable positions for labour and delivery — side-lying or high-kneeling positions are often more comfortable than lying on your back.

No. PGP is uncomfortable for you but does not affect your baby’s development.

Yes — but the type of exercise matters. Swimming (avoiding breaststroke if it triggers your symptoms), gentle walking and physiotherapist-prescribed exercises are usually fine. Avoid wide-leg movements and high-impact activity.

Your physio will assess your individual pattern of pain, give you a tailored exercise programme, advise on positions and pacing, and may use manual therapy or recommend a support belt.

The HSE clinical guideline on PGP is available at hse.ie — search for “pelvic girdle pain in pregnancy and postpartum.