Pelvic Girdle Pain (PGP) is a common musculoskeletal condition during pregnancy, characterized by pain localized to the joints of the pelvic ring. This discomfort can affect the sacroiliac joints at the back or the pubic symphysis at the front of the pelvis, often radiating to the lower back, groin, or thighs. PGP is thought to arise from a combination of hormonal changes that increase ligament laxity and the biomechanical stresses of a growing fetus and weight gain. The condition affects up to one in five pregnant individuals, and while it can significantly limit mobility and quality of life, management strategies exist to alleviate symptoms and improve daily function.
Daily Movement Modifications and Postural Adjustments
Immediate relief often comes from consciously altering daily movements to minimize strain on the pelvic joints. Simple, mindful adjustments can prevent the asymmetrical loading that often triggers pain.
When sitting, keep both feet flat on the floor with your weight evenly distributed, and avoid crossing your legs. Sit on a firm surface, using a cushion or lumbar roll for lower back support, and change your position frequently to prevent stiffness. For standing tasks, distribute your weight equally between both legs, and avoid standing on one leg, such as when getting dressed. Sit down to put on clothing, socks, and shoes, eliminating the need for an unbalanced posture.
Getting in and out of a car requires a specific technique to keep the pelvis stable and prevent twisting. Sit down sideways on the seat first, then swivel your entire body to face forward while keeping your knees together. To turn over in bed, keep your knees pressed together and roll your body as one unit, often called log-rolling. Sleeping with a pillow placed between your knees and ankles can maintain better pelvic alignment and reduce night-time discomfort.
When lifting objects, keep the load close to your body and avoid any twisting motion while carrying weight. Avoid heavy lifting altogether, and use a narrow stance to keep your weight centered and balanced. Pacing your activity level throughout the day is also helpful, as short, frequent periods of gentle activity are better than overexerting the joints.
Targeted Physical Therapy and Stability Exercises
Structured physical therapy is an effective, non-invasive method for managing PGP, focusing on improving muscle function and joint stability. A women’s health physical therapist can perform a thorough assessment and design an individualized program.
A core component of therapy involves strengthening the deep stabilizing muscles of the trunk, particularly the transversus abdominis and the pelvic floor. These muscles act as a natural corset, providing support and control to the pelvic ring. Exercises like gentle abdominal bracing and Kegels are often prescribed to improve stability and reduce strain.
Therapy also incorporates exercises to strengthen the gluteal and hip muscles, such as modified squats and clamshells, which contribute significantly to pelvic stability. These exercises should be performed with small, controlled movements to avoid pain, often incorporating a pillow between the knees for support. Gentle stretching, such as the Cat-Cow stretch or Child’s Pose modified for pregnancy, can help relieve tension in the back and hips without straining the pelvis.
Manual therapy techniques, such as hands-on joint mobilization, can help restore normal movement patterns in the pelvis. Hydrotherapy, or exercising in water, is a low-impact option that allows for greater movement and pain relief due to buoyancy. Always consult a healthcare provider or physical therapist before starting any new exercise routine.
Supportive Devices and Safe Pain Management
External aids and localized treatments can complement movement modifications and physical therapy by providing immediate physical support and symptom relief. Specialized supportive devices are designed to reduce the physical stress on the pelvic joints.
A pelvic support belt, sometimes called a sacroiliac belt, can provide compression and stability to the area. The belt is typically worn low, below the anterior superior iliac spines, to offer optimal support without being placed directly over the pubic symphysis. Supportive maternity pillows or wedges are useful for maintaining comfortable alignment during sleep by supporting the bump and keeping the knees separated and aligned. In severe cases, a physical therapist may recommend temporary use of crutches or a cane to reduce weight-bearing forces on the pelvis.
For pain relief, localized heat or cold therapy can be applied directly to the painful area. A warm compress or bath can relax tense muscles in the lower back and hips, while a cold pack can help numb the pain and reduce inflammation over a joint. Cold therapy, such as an ice pack wrapped in a towel, can be applied to the pubic bone or sacroiliac joints for about 20 minutes at a time.
Acetaminophen is generally considered a safe over-the-counter option for pain relief during pregnancy when taken at the recommended dose. However, all medication use should be discussed with a healthcare provider to confirm its safety. It is important to focus on regular, scheduled pain relief, rather than waiting until the pain becomes severe.