Pelvic Girdle Pain After Pregnancy: Causes, Symptoms and Treatment
Still experiencing pelvic or lower-back pain after having your baby? Pelvic girdle pain can continue after pregnancy, but you don’t necessarily have to simply wait for it to disappear.
Perhaps you experienced pelvic pain during pregnancy and expected it to settle once your baby arrived.
Or maybe you didn’t have much trouble during pregnancy, but started noticing pain around your pelvis, hips or lower back after giving birth.
Now you’re several weeks or months postpartum and everyday things have become surprisingly difficult.
Getting out of the car hurts.
Turning over in bed wakes you up.
Walking with the pram feels uncomfortable.
Going up the stairs is harder than it should be.
Or standing on one leg to put your trousers on has suddenly become an exercise in balance.
If this sounds familiar, you may be experiencing pelvic girdle pain (PGP) after pregnancy.
PGP is common during pregnancy and usually improves after birth, but around 1 in 10 women continue to experience pain after having their baby. (RCOG)
At Family Osteopathy Hammersmith, we work with women during pregnancy and after birth to understand their symptoms, assess their movement and musculoskeletal function, and determine what support may be appropriate.
What Is Pelvic Girdle Pain?
Pelvic girdle pain (PGP) is pain experienced around the joints and surrounding areas of the pelvis.
It can be felt:
At the front of the pelvis around the pubic bone
Around one or both sides of the lower back
Around the buttocks or hips
In the groin
Along the thighs
The pelvis is a ring of bones supported by muscles, ligaments and joints. PGP can involve the sacroiliac joints at the back of the pelvis, the pubic symphysis at the front, or both. (RCOG)
You may also hear PGP referred to as symphysis pubis dysfunction (SPD), particularly when symptoms are mainly felt around the front of the pelvis.
PGP is now generally used as the broader term because pelvic girdle pain isn’t necessarily confined to the pubic symphysis.
Importantly, PGP isn’t simply a sign that your pelvis is “out of alignment”.
It’s a clinical description of a pattern of pain and movement-related symptoms, and there can be several factors contributing to it.
Why Can Pelvic Girdle Pain Continue After Birth?
Pregnancy changes how you move, how much load your body is carrying and how your pelvis and surrounding tissues are working.
Then your baby arrives — and your physical workload changes again.
There isn’t necessarily one single reason why PGP persists after pregnancy.
Several factors may contribute.
Your body has been through significant physical changes
During pregnancy, your posture, movement and load through the pelvis change as your baby grows.
Hormonal changes also affect connective tissues during pregnancy.
However, it’s too simplistic to say that persistent postpartum PGP is simply because your ligaments are still “loose”.
The causes of PGP are more complex than that, and persistent symptoms shouldn’t automatically be attributed to hormones.
Your movement patterns have changed
New motherhood can involve a huge amount of repetitive movement.
You may now be:
Carrying your baby
Lifting a car seat
Getting in and out of the car
Feeding in the same position repeatedly
Walking while pushing a pram
Going up and down stairs
Getting up during the night
Carrying your baby predominantly on one side
None of these activities are inherently harmful.
But if a movement repeatedly aggravates your symptoms, modifying how you perform it temporarily can help you stay active while your tolerance improves.
Your strength and activity levels may have changed
Pregnancy and early motherhood can interrupt your normal exercise routine.
You may have spent months doing less than you normally would, followed by a sudden increase in lifting, carrying and general activity once your baby arrives.
Your body may simply need time to rebuild its capacity.
That doesn’t mean your pelvis is weak or damaged.
It means your current capacity and your current demands may not yet match.
PGP may have started during pregnancy
If you experienced PGP during pregnancy, symptoms usually improve after birth, but they don’t always disappear immediately.
RCOG reports that approximately one in ten women with PGP continue to have pain after birth. (RCOG)
If your symptoms are persisting, it’s worth getting them assessed rather than assuming you simply need to wait longer.
Other conditions can sometimes feel similar
Not every episode of postpartum pelvic pain is PGP.
Hip problems, lower-back conditions, pelvic-floor problems and other causes of pelvic pain can produce overlapping symptoms.
This is particularly important when symptoms are persistent, severe, unusual or not behaving as expected.
A good assessment isn’t just about confirming PGP.
It’s also about considering whether something else needs to be investigated.
What Does Postpartum Pelvic Girdle Pain Feel Like?
PGP can affect different areas of the pelvis and may vary considerably between women.
Common symptoms include:
Pain over the pubic bone at the front of the pelvis
Pain on one or both sides of the lower back or buttocks
Pain around the hips or groin
Pain that spreads into the thighs
Clicking or grinding sensations around the pelvis
Pain when walking
Difficulty or discomfort going up or down stairs
Pain when getting in or out of the car
Pain when standing on one leg
Difficulty turning over in bed
Pain when moving your legs apart
Discomfort during sex
These are recognised patterns associated with PGP. (RCOG)
You may also find that symptoms fluctuate.
You might feel relatively comfortable in the morning and much worse after a busy day.
Or you may find that certain movements — such as getting out of the car or rolling over in bed — reliably trigger your pain.
These patterns are useful information during an assessment.
Is Pelvic Girdle Pain After Pregnancy Normal?
It’s common, but that doesn’t mean you have to ignore it.
PGP affects around 1 in 5 women during pregnancy, and most women improve after giving birth. (RCOG)
For the women whose symptoms continue, however, the pain can have a significant impact on daily life.
You might find yourself avoiding:
Longer walks
Exercise
Stairs
Driving
Carrying your baby
Going out with friends
Sleeping comfortably
Sexual activity
You may also become anxious about certain movements because you’ve learned that they trigger pain.
That can be exhausting — particularly when you’re already adjusting to life with a new baby.
What Can You Do Yourself?
Complete rest usually isn’t the answer.
RCOG and NHS guidance supports staying as active as you can while modifying activities that aggravate symptoms. (RCOG)
A few practical things may help:
Keep moving, but pace yourself
Try to maintain gentle activity within your current tolerance rather than alternating between doing far too much and then needing complete rest.
Pay attention to aggravating movements
If getting in and out of the car is painful, for example, keeping your knees together as you turn may be more comfortable.
If standing on one leg is painful, sit down to get dressed.
If stairs aggravate your symptoms, consider whether you can reduce unnecessary trips up and down them while you’re recovering.
Avoid prolonged positions
Long periods of sitting or standing can sometimes aggravate symptoms.
Changing position regularly can be more comfortable than trying to find one “perfect” posture.
Don’t be afraid to ask for help
Looking after a baby is physically demanding.
If your symptoms are significant, getting help with shopping, housework, lifting or other demanding activities isn’t a failure.
It’s part of managing your recovery.
Do You Need to Stop Exercising?
Not necessarily.
In fact, gradually rebuilding strength and activity is an important part of recovery for many women.
The key is finding the right starting point.
If walking is comfortable but running isn’t, start with walking.
If bodyweight exercises are comfortable but heavy lifting isn’t, build from there.
If an exercise consistently causes a significant increase in your symptoms, it may need to be modified rather than abandoned forever.
There isn’t one universal postnatal exercise programme.
Your rehabilitation should reflect your symptoms, current strength, previous activity level and goals.
How Is Postpartum Pelvic Girdle Pain Assessed?
A good assessment starts with your story.
We’ll want to understand:
Where your pain is
When it started
What makes it better or worse
How it affects walking and everyday activities
Your pregnancy and birth history
Any previous back or pelvic problems
Your current activity levels
Any other symptoms you’re experiencing
We’ll then assess relevant movement and musculoskeletal function.
The purpose isn’t simply to find a joint that’s “out of place”.
It’s to understand the pattern of your symptoms and how your body is currently coping with movement and load.
If your symptoms suggest that another healthcare professional or further investigation would be more appropriate, we’ll explain that.
Can Osteopathy Help With Pelvic Girdle Pain After Pregnancy?
Osteopathy can form part of the management of postpartum PGP when it is clinically appropriate.
RCOG includes physiotherapy, osteopathy and other appropriately trained practitioners among professionals who may provide hands-on care for PGP, alongside exercise and practical advice. (RCOG)
Treatment may include gentle hands-on techniques aimed at improving comfortable movement and addressing relevant muscular or joint symptoms.
However, hands-on treatment isn’t the whole treatment plan.
Current guidance emphasises movement, exercise and practical management alongside symptom relief. NICE notes that the evidence for manual therapy alone is insufficient to recommend it as a standalone treatment for PGP. (Nice)
That’s why, where appropriate, we combine treatment with:
Movement advice
Gradual strengthening
Activity modification
Practical advice around lifting and carrying
A progressive return to exercise
The aim is not to repeatedly “put your pelvis back into alignment”.
It’s to help you become more comfortable and more capable of doing the things that matter to you.
Could a Mummy MOT Be Appropriate?
If you’re experiencing several postnatal concerns alongside your pelvic pain, a Mummy MOT may be an appropriate part of your care.
At Family Osteopathy Hammersmith, your Mummy MOT will sit alongside your osteopathic care rather than replacing it.
Depending on your symptoms and clinical presentation, a postnatal assessment can consider areas such as:
Abdominal-wall function
Diastasis recti
Musculoskeletal function
Movement patterns
Pelvic symptoms
Your recovery following pregnancy and birth
If you’re also experiencing urinary leakage, pelvic heaviness, pelvic pain or pain during sex, these symptoms are important to mention.
Where specialist pelvic-floor assessment or rehabilitation is indicated, we may recommend referral to a pelvic-health physiotherapist.
The aim isn’t to diagnose everything in one appointment. It’s to understand your recovery and make sure you’re receiving appropriate care.
How Long Does Postpartum PGP Take to Improve?
There isn’t a reliable “three sessions and you’ll be better” timeline — and I’d be wary of anyone promising one.
Most women with pregnancy-related PGP improve after birth, but recovery varies considerably between individuals. Around one in ten women may continue to experience pain. (RCOG)
Your recovery can depend on:
How severe your symptoms are
How long you’ve had them
Your current activity levels
Other musculoskeletal problems
Your sleep and recovery
How much physical demand you’re managing every day
Whether there are other contributing factors
The goal is steady improvement in pain, movement and confidence, rather than promising a particular number of appointments.
When Should You Get Pelvic Pain Checked?
You don’t need to wait until your pain becomes severe.
It’s worth seeking professional advice if your pelvic pain:
Is interfering with walking
Makes stairs difficult
Is affecting your sleep
Is making it difficult to care for your baby
Is preventing you from exercising
Is affecting your sex life
Isn’t improving after birth
Has returned after initially improving
RCOG specifically recommends seeking advice if PGP persists after birth, including assessment to exclude other causes of pain. (RCOG)
And there’s no arbitrary expiry date on asking for help.
If you’ve been living with pelvic pain for six months, two years or longer after having your baby, it can still be worth finding out what’s contributing to it.
When Should You Speak to Your GP?
Not all postpartum pelvic pain is musculoskeletal.
Speak to your GP or another appropriate healthcare professional if your pelvic pain is persistent or unexplained, particularly if you have other symptoms such as:
Unusual vaginal bleeding or discharge
Pain when urinating
Difficulty passing urine or opening your bowels
Persistent bloating
Unexplained weight loss
Fever or feeling significantly unwell
NHS guidance recommends medical assessment for persistent or unexplained pelvic pain and highlights these symptoms as reasons to seek further advice. (nhs.uk)
Seek urgent medical attention for severe or rapidly worsening pelvic pain, fainting, significant bleeding or difficulty breathing. (nhs.uk)
You Don’t Have to Simply Live With Pelvic Girdle Pain
Pelvic girdle pain can be incredibly frustrating — particularly when you’ve already been through pregnancy and childbirth and expected things to feel better afterwards.
But persistent pain doesn’t mean your pelvis is permanently damaged.
It doesn’t mean you need to stop moving.
And it doesn’t mean you have to accept pain
