Pelvic girdle pain (PGP) is pain in the joints of the pelvis during or after pregnancy, felt at the front over the pubic bone, at the back near the sacroiliac joints, or both. It used to be called symphysis pubis dysfunction (SPD). PGP is common and not harmful to your baby, and early advice, exercise and support can make daily life easier.
Also known as PGP, symphysis pubis dysfunction, SPD, pregnancy-related pelvic pain
Symptoms
- Pain over the pubic bone, in the lower back, hips, groin or inner thighs
- Pain when walking, climbing stairs or standing on one leg
- Pain when parting your legs, such as getting out of a car
- Pain when turning over in bed
- A clicking or grinding feeling in the pelvis
Causes and risk factors
- Changes in how the pelvic joints move and are controlled during pregnancy
- Hormonal and body changes as pregnancy progresses
- A history of low back pain or pelvic pain
- Previous injury to the pelvis
- Having had PGP in an earlier pregnancy
What the evidence says helps
- Clear information and reassurance, plus exercises tailored to you, are the main approaches recommended in European guidelines for PGP in pregnancy.3
- UK guidance says you should be offered physiotherapy assessment. Treatment may include advice on movement and rest, pelvic floor and tummy exercises, hands-on therapy, and a support belt or crutches if needed.12
- A Cochrane review found that exercise during pregnancy may reduce the number of women reporting pelvic and back pain, although the quality of the evidence was only moderate.4
- A physical therapy guideline says manual (hands-on) therapy may be used, as evidence is emerging and few side effects have been reported in healthy pregnancies. It also suggests support belts can be considered, though evidence is limited.5
- A recent BMJ clinical summary advises practical help with pacing activity, sleep and simple pain relief such as paracetamol, with referral to pelvic health physiotherapy if symptoms persist or worsen.6
Things you can try at home
- Keep your knees together when getting in and out of the car or turning in bed
- Sit down to get dressed and avoid standing on one leg
- Take stairs one step at a time, leading with the less painful leg going up
- Put a pillow between your knees when lying on your side
- Stay active within comfort, change position often and avoid heavy lifting
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- Vaginal bleeding, fluid leaking from the vagina, or regular tightenings or contractions: contact your midwife or maternity unit straight away
- Your baby moving less than usual or a change in their pattern: call your midwife or maternity unit immediately, day or night
- Fever, feeling very unwell, or pain when you pee: contact your midwife or GP urgently
- Severe headache, vision changes, pain under the ribs or sudden swelling of the face, hands or feet: call your maternity unit (or NHS 111 if you cannot reach them)
- Loss of feeling in your legs, bottom or genitals, or problems controlling your bladder or bowels: call 999 or go to A&E
How Apollo can help
Our osteopaths can assess your pelvis, back and hips, explain what is going on, and offer gentle hands-on care where appropriate alongside practical advice for daily tasks and sleep. We can guide you through safe, tailored exercise, and Reformer Pilates with Beverley or pregnancy massage with Hannah may be options for staying active and comfortable. We work alongside your midwife and maternity team and will refer you back to them if anything needs their attention.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
Will pelvic girdle pain affect my labour?
Most women with PGP can have a vaginal birth, and a caesarean is not usually needed because of PGP. It helps to note PGP in your birth plan so your team can keep your legs within a comfortable range, especially if you have an epidural.
Does PGP go away after birth?
For most women, PGP improves after the baby is born. Around 1 in 10 women have ongoing pain, so speak to your GP if symptoms continue, as further help is available.
Is it safe to have osteopathy or massage while pregnant?
Gentle hands-on care is widely used in pregnancy, and guidelines report few side effects in healthy pregnancies. Tell your practitioner how many weeks pregnant you are and about any complications, and always follow your midwife's advice.
References
- Royal College of Obstetricians and Gynaecologists (2015). Pelvic girdle pain and pregnancy: patient information leaflet. RCOG. View source
- Pelvic, Obstetric and Gynaecological Physiotherapy (2018). Pelvic girdle pain and other common conditions in pregnancy: guidance for mothers-to-be and new mothers. POGP. View source
- Vleeming A, et al. (2008). European guidelines for the diagnosis and treatment of pelvic girdle pain. European Spine Journal. View source
- Liddle SD, Pennick V (2015). Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database of Systematic Reviews. View source
- Clinton SC, Newell A, Downey PA, Ferreira K (2017). Pelvic girdle pain in the antepartum population: physical therapy clinical practice guidelines. Journal of Women's Health Physical Therapy. View source
- Jakes A, et al. (2026). Identifying and managing pregnancy-related pelvic girdle pain. BMJ. View source
This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.
