Pelvic Girdle Pain (PGP) is a common musculoskeletal discomfort affecting many individuals during pregnancy. This condition involves pain in the front and/or back of the pelvis, often including the pubic bone and the sacroiliac joints. PGP results from the joints of the pelvic girdle moving unevenly, which is linked to the hormonal and physical changes that occur as the body prepares for childbirth. The growing uterus places increased strain on the pelvis, causing instability and pain that interferes with mobility and daily activities.
Non-Invasive Daily Management Techniques
Managing Pelvic Girdle Pain often begins with simple, self-directed modifications to daily movements and posture. The primary goal of these techniques is to minimize activities that cause asymmetrical loading or excessive separation of the legs, which can aggravate the pelvis. Learning to move the body as a single, stable unit helps prevent sharp pain and improves overall comfort.
Changing positions in bed is a common trigger for PGP, but “log rolling” can significantly help. To perform this, keep your knees pressed firmly together and roll your trunk and legs simultaneously, like a log, when turning over or getting out of bed. Using a pillow placed snugly between the knees and ankles while sleeping on your side helps maintain better pelvic alignment and reduces stress on the joints.
Maintaining balanced posture is important while sitting and standing. When seated, distribute your weight evenly across both hips and ensure both feet are flat on the floor, avoiding crossing your legs. Change your position frequently and avoid sitting for more than 30 minutes at a time to prevent stiffness and sustained pressure on the pelvis.
Standing should involve placing equal weight on both feet, rather than shifting weight or hanging on one hip, which creates a shearing force across the pelvic joints. Simple activities like getting dressed should be performed while seated to avoid standing on one leg, which is highly destabilizing. When walking, taking smaller steps helps to decrease the stress on the pelvic joints, making movement more manageable.
Other modifications involve avoiding movements that require twisting, heavy lifting, or prolonged standing, as these actions increase the load and instability of the pelvic girdle. Reducing the number of times you go up and down stairs or taking them one step at a time can protect the pelvis from painful asymmetrical strain.
Targeted Physical Therapies and Stabilization
While daily modifications help manage symptoms, professional physical therapy addresses the underlying muscular imbalances contributing to PGP. A women’s health physiotherapist performs a detailed assessment to determine which pelvic joints are affected and identify specific muscles that require strengthening or relaxation. They then develop a customized program focusing on stabilizing the core muscles that support the pelvis.
A primary focus of physical therapy is activating the deep stabilizing muscles, particularly the transverse abdominis and the pelvic floor. These muscles act like a natural corset, providing internal support and compression to the pelvic joints. Gentle exercises, such as pelvic tilts and Kegels, are introduced to improve the strength and coordination of this deep core unit without causing pain.
Manual therapy techniques are employed by the therapist to gently realign or mobilize stiff or misaligned pelvic joints. This hands-on treatment may involve soft tissue massage to release tension in surrounding muscles like the glutes or adductors, which often tighten in response to joint instability. These adjustments help restore normal joint movement and provide pain relief.
Hydrotherapy, or exercise performed in a warm pool, offers a beneficial environment for those with PGP. The buoyancy of the water reduces the gravitational load and weight-bearing stress on the pelvic joints, allowing for a greater range of pain-free movement. This setting is ideal for performing gentle strengthening exercises and improving mobility that might be too painful on land.
Supportive Devices and Safe Pain Relief
External supportive devices offer an immediate way to stabilize the pelvis and reduce pain during daily activities. The most common device is a maternity support belt, often referred to as a pelvic support belt or sacroiliac (SI) belt. When properly fitted, this non-rigid belt provides compression across the pelvis, supporting the joints and limiting their uneven movement.
The belt should be worn snugly around the widest part of the hips or just below the abdomen when upright, and it is used only during periods of activity to provide external joint stability. For individuals experiencing severe PGP that significantly limits mobility, a healthcare provider may recommend temporary use of crutches or a walking aid. These tools help reduce the total weight placed on the pelvis during walking by distributing the load through the arms.
For managing acute pain, over-the-counter medication may be used, though safety protocols for pregnancy must be followed. Acetaminophen (Paracetamol) is generally considered safe for use during pregnancy to help manage discomfort. Discuss dosing and frequency with a healthcare provider to ensure safe use.
Pregnant individuals should avoid taking non-steroidal anti-inflammatory drugs (NSAIDs), such as Ibuprofen or Naproxen, unless specifically advised by a physician. These medications can pose risks to the developing fetus, particularly during the later stages of pregnancy. Applying heat or cold packs directly to the painful areas, such as the back or pubic bone, can also offer localized, drug-free pain relief.