PGP affects 1 in 5 pregnant women and is consistently under-treated. Here's what it feels like, why you should ask for physio immediately, and what actually helps.
Pelvic girdle pain (PGP), sometimes called symphysis pubis dysfunction (SPD), affects around 1 in 5 pregnant women. It's caused by the joints of the pelvis becoming less stable during pregnancy — a combination of hormonal changes (relaxin loosening the ligaments) and the shifting weight distribution as the bump grows.
Despite being one of the most common pregnancy complaints, it's frequently dismissed or normalised — 'just part of pregnancy' — in a way that means many women don't ask for help. It isn't something you have to just endure. It's a musculoskeletal condition that responds to physiotherapy.
PGP presents differently in different people. The most common descriptions:
• Pain across the pubic bone (symphysis) — sometimes described as a sharp or burning sensation, often worse when walking or climbing stairs
• Pain in the lower back, buttocks, hips, or inner thighs
• A clicking or grinding sensation in the pelvis
• Difficulty or pain when turning over in bed, getting out of a car, or standing on one leg
• Waddling gait
Symptoms can range from mild discomfort to severe pain that limits mobility. The severity at onset doesn't predict how bad it gets — early physiotherapy referral significantly improves outcomes.
Your midwife or GP can refer you to a physiotherapist with experience in pelvic girdle pain. Ask for this as soon as you have symptoms — don't wait to see if it improves, because it rarely does without intervention, and the earlier treatment starts the better the outcome.
Physiotherapy for PGP typically includes: exercises to strengthen the muscles supporting the pelvis (not stretching — stretching can worsen it), manual therapy, advice on movement modification, and often a pelvic support belt. A belt worn correctly can make a significant difference to daily functioning.
Sleep: a pillow between your knees keeps the pelvis neutral. Getting out of bed by rolling onto your side and pushing up with your arms reduces strain.
Movement: keep your knees together when getting in and out of cars (swing both legs together, use a plastic bag on the seat to help you turn). Avoid single-leg activities — don't stand on one leg to dress. Take smaller steps when walking.
Stairs: go up and down one step at a time if bilateral movement causes pain. Going sideways is an option if it's more comfortable.
Sex: may become uncomfortable or impossible depending on severity. Positions that don't require wide hip abduction are usually more manageable. Your physiotherapist can advise specifically.
For most women, PGP resolves significantly within a few weeks of giving birth as hormone levels normalise and the pelvis restabilises. Some women notice improvement within days. For others, it takes a few months. A small number experience persistent pain that requires postnatal physiotherapy.
PGP does not mean you can't have a vaginal birth. The position matters — positions that require wide hip abduction (like traditional lithotomy/on your back with legs in stirrups) should be avoided. All fours, kneeling, or side-lying positions are usually more manageable. Tell your midwife and put it in your birth plan.
If you have PGP in one pregnancy, you're more likely to experience it in subsequent pregnancies — but earlier physiotherapy intervention often results in better management.