Pelvic girdle pain (PGP) in pregnancy: symptoms, causes and how physiotherapy can help

Written by Hannah Gray, Women's and Men's Health Specialist Physiotherapist.
Medically reviewed by James Walker, Service Development Director & Senior Physiotherapist, on 14/09/26.

Pelvic girdle pain, or PGP, is pain in and around the joints of the pelvis that many women experience during pregnancy. It is usually felt over the pubic bone at the front, across the lower back, or spreading into the hips and thighs, and it is often worse when walking, going up or down stairs, or turning in bed.

PGP is common. It is estimated to affect up to 1 in 5 pregnant women to some degree¹. For some women it is mild and manageable; for others it makes ordinary movement genuinely difficult. PGP is not harmful to your baby, but it can be painful and make it hard to get around¹.

Specialist women's health physiotherapy can help. At the White House Clinic, our women's health physiotherapists provide assessment and treatment for PGP at any stage of pregnancy and postnatally, at our Sheffield West and Chesterfield clinics.

What does pelvic girdle pain feel like?

Women with PGP may feel pain anywhere in the pelvic region. It is most often described over the pubic bone at the front, as pain across the lower back, or as pain spreading into the hips and thighs. Some women also feel it in the perineum, the area between the vagina and the back passage¹.

The pain is usually worse during everyday movement, including:

• walking
• going up or down stairs
• standing on one leg, for example when getting dressed
• turning over in bed
• getting in and out of a car
• moving your legs apart

Some women hear or feel a clicking or grinding in the pelvis when they move. You may notice it, and it is not harmful [2].

What causes pelvic girdle pain in pregnancy?

The cause of PGP in pregnancy remains unknown. What is well established is that certain things make it more likely, and the two most consistently reported are a history of lower back or pelvic girdle pain and a previous injury to the pelvis [3].

The recognised risk factors are:

• a history of lower back pain or pelvic girdle pain
• a previous injury to the pelvis, for example from a fall or an accident
• having had PGP in a previous pregnancy
• a physically demanding job
• being overweight [1]

It is also worth knowing that pain does not always mean that the body, or the pelvis, has been damaged². Pregnancy changes how you move, how you sleep and how much load your body carries, and pain can be part of that without anything having gone wrong.

If you are pregnant and recognise that you may be at risk of PGP, an early assessment with a specialist women's health physiotherapist can be beneficial. Treatment is usually more straightforward the sooner symptoms are looked at².

How is pelvic girdle pain assessed?

A specialist women's health physiotherapist will begin with a full initial assessment. That covers all of the pelvic joints, and also the nearby joints, such as the lower back and the hips, so that those areas can be excluded as the source of your pain.

They will then use clinical tests developed specifically for the pelvic joints. These include tests that gently reproduce your pain, so the structures involved can be identified, and a test of how well you can lift each leg while lying down, which shows how your pelvis is coping with load³. They will also look at how the muscles around your pelvis, hips and lower back are working, since strength and control in these muscles affect how comfortable everyday movements feel.

Getting the diagnosis right matters, because not all pelvic pain in pregnancy is PGP. Other causes are considered first, including a urinary tract infection, problems arising from the lumbar spine, and Braxton Hicks contractions or the onset of labour⁴. That is one of the reasons a proper assessment is worth having, and why anything that concerns you should be discussed with your midwife, GP or physiotherapist rather than assumed to be PGP.

How is pelvic girdle pain treated?

Treatment is individual to you and is agreed after your assessment. Your physiotherapist will give you information and advice for managing PGP through your pregnancy, including postural advice, sleeping positions and practical ways to handle everyday activities.

Treatment may also include:

• exercises for the muscles of the pelvic floor, stomach, back and hips¹
• hands-on treatment such as manual therapy or massage²
• advice on movement and exercise that is comfortable and appropriate for you, including pelvic floor exercises ²
• equipment such as a non-rigid pelvic support belt, or crutches, where that is appropriate^{1 5}

Movement in pregnancy is encouraged, although taking up a new high-impact sport is generally not recommended². Pelvic floor exercises are worth doing in their own right: POGP, the professional body for pelvic health physiotherapy, notes that getting the pelvic floor working well can also help you during labour and may reduce PGP after the birth².

You should be able to have physiotherapy at any stage of pregnancy, and it is usually helpful to be seen as soon as you notice your symptoms².

What does PGP mean for labour and birth?

Most women with PGP are able to have a normal vaginal birth if they wish to¹. Many women worry that labour will make the pain worse. That is not usually the case, and a caesarean section is not normally recommended for PGP alone².

Your physiotherapist can explore birth plans and labour positions with you, so that you are able to make informed choices about the birth you want rather than having them made for you. It is also worth talking your options through with your midwife or doctor².

Does pelvic girdle pain get better after the birth?

For the great majority of women, yes. Research reports that symptoms settle in around 93% of women within the first three months after delivery, and that only 1% to 2% still report pain a year later⁴. This is the part of the picture that often gets left out when women are told to expect PGP as simply part of being pregnant.

In my clinical experience, women feel more confident about their diagnosis of PGP once they have been fully assessed by a specialist physiotherapist. They feel less anxious and less fearful about the rest of their pregnancy and about giving birth.

For the smaller number of women whose symptoms carry on after the birth, assessment and treatment are available postnatally as well as during pregnancy. If your pain began or worsened after a difficult birth, our article on birth trauma and how physiotherapy can help covers that ground.

When to seek urgent help

PGP itself is not dangerous². Some symptoms, though, need urgent medical attention rather than a physiotherapy appointment. Contact your midwife, your maternity unit or your GP straight away, or call NHS 111, if you experience any of the following²:

• pain going down both legs at the same time
• numbness in both legs at the same time
• difficulty passing urine
• leakage from your bowel that you cannot control
• numbness around the vagina or the back passage

If you are not sure whether what you are feeling is PGP or the start of labour, contact your midwife or maternity unit.

Where to find more information and support

• Pelvic pain in pregnancy, from the NHS
• Pregnancy-related pelvic girdle pain and low back pain, from the Pelvic, Obstetric and Gynaecological Physiotherapy group (POGP), whose patient guidance for mothers-to-be and new mothers is free to download
• The Pelvic Partnership, a charity supporting women who are experiencing PGP

How to see a specialist women's health physiotherapist

Specialist women's health physiotherapy is available at our Sheffield West and Chesterfield clinics, and you can read more about the service on our women's health pages. Our antenatal and postnatal Pilates and massage services run alongside it at Sheffield West.

If you are unsure which service you need, we would recommend being triaged by our team before arranging an appointment. Call 0114 230 2030 or email info@whitehouse-clinic.co.uk, and one of the team will briefly go over your concerns and identify the best person for you to see. For women's health at Sheffield West, ask to book in with Jackie Gibbon, Specialist Women's Health Physiotherapist; at Chesterfield, ask for Hannah Gray. You can also book online.

This article is general information and not a substitute for individual assessment. Book an appointment or call 0114 230 2030 to speak to our team.

References

1. NHS - Pelvic pain in pregnancy: https://www.nhs.uk/pregnancy/common-symptoms/pelvic-pain/
2. Pelvic, Obstetric and Gynaecological Physiotherapy (POGP) - Pelvic Girdle Pain and other common conditions in pregnancy: Guidance for Mothers-to-be and New Mothers, 2023: https://thepogp.co.uk/resources/112/pregnancy_related_pelvic_girdle_pain_for_mothers_to_be_and_new_mothers
3. Vleeming A, Albert HB, Ostgaard HC, Sturesson B, Stuge B - European guidelines for the diagnosis and treatment of pelvic girdle pain, European Spine Journal, 2008: https://pmc.ncbi.nlm.nih.gov/articles/PMC2518998/
4. Kanakaris NK, Roberts CS, Giannoudis PV - Pregnancy-related pelvic girdle pain: an update, BMC Medicine, 2011: https://pmc.ncbi.nlm.nih.gov/articles/PMC3050758/
5. National Guideline Alliance (UK) - Pelvic girdle pain in pregnancy, Evidence review U for NICE guideline NG201 (Antenatal care), 2021: https://www.ncbi.nlm.nih.gov/books/NBK573945/