Pelvic girdle pain and low back pain in pregnancy

Pelvic girdle pain is pain from the joints of the pelvis, the two sacroiliac joints at the back and the pubic symphysis at the front. It arises during pregnancy or shortly after delivery [3]. The condition was previously called pelvic girdle relaxation (bekkenløsning in Norwegian). NHI points out that the name is outdated because it gives the impression that something comes loose [1].

Hormones in pregnancy make the joints more pliable. This is a normal process, but in some women the increased mobility causes pain [1]. The cause is not fully known [1][6]. About 5 percent of pregnant women have severe pain with reduced function [6].

Several previous deliveries, previous back pain and injuries to the pelvis are mentioned as risk factors. Regular exercise before pregnancy, especially at high intensity, appears to be associated with fewer symptoms. This is an association and not a proven cause [1][2].

The pain is typically felt over the pubic bone and at the back of the pelvis, and it can radiate to the buttock, groin and thigh [1]. It is often worse during and after loading, and there can be a delay between the activity and the pain [1][2].

Many notice it in daily life when walking, sitting for a long time and lifting, and some find it difficult to lie flat on their back. Changes of position, such as getting out of a car or turning in bed, can be especially difficult [1].

The symptoms most often start in the fifth to eighth month, but they can come earlier, including in the first trimester [1][3]. Poor sleep at night has been described in some women [1].

The diagnosis is made from a description of the pain and a clinical examination [1][3]. The European guideline for pelvic girdle pain describes that the examination should distinguish low back pain from pain in the pelvis, and that the pain or functional problem must be reproducible with specific tests [4].

Single tests have low reliability, so the diagnosis should not rest on one test alone. Several tests together are more accurate [4]. X-ray or other imaging usually serves no purpose [1][3].

During pregnancy, the European guideline recommends individually adapted exercises [4]. NHI describes an individual exercise programme without painful exercises, and says that swimming and water gymnastics can be good alternatives. You can contact a physiotherapist without a referral from a doctor [2].

A Cochrane review from 2015 on back and pelvic pain in pregnancy compared exercise with usual antenatal care. The studies suggested less pain and fewer sick leave days among those who exercised. The certainty of the evidence was low to moderate, and many of the studies were poorly described methodologically [5].

NHI suggests loading the legs evenly, taking short steps, sitting rather than standing, taking breaks and keeping activity within the limit of the pain. A pillow between the thighs and knees can help when lying on the side [2].

The sources differ on pelvic belts and acupuncture. The guideline did not find sufficient basis to say that maternity belts reduce pain, and acupuncture did not give a significant effect compared with sham acupuncture [4]. NHI describes that a belt has had an effect in some women and should be used together with guidance from a physiotherapist, and that acupuncture has shown an effect in some [2]. Manual treatment is not mentioned as a separate recommended measure in these sources [2][4].

After delivery, the guideline recommends a programme with good information and reassurance, combined with specific exercises for motor control and stability [4]. NHI writes that pelvis-specific exercises are better than ordinary physiotherapy [2].

In most women the symptoms are gone after delivery [1][2]. Three months after delivery, about 7 percent still have pelvic pain [1][6].

Greater pain during pregnancy gives a higher risk of long-lasting symptoms [2]. Women with several positive clinical tests and pain from all three pelvic joints have a poorer prognosis, and the guideline points out that they should receive particular attention [4].

Pain in the back and pelvis during pregnancy can have several causes, and the diagnosis is made through a conversation and an examination [1][4]. If you have severe pain, or the symptoms make everyday life difficult, there is reason to raise it with your midwife or doctor.

Pelvic girdle pain is the most common reason for sick leave in pregnancy, and partial sick leave can be an option when adjustments are needed at work [1][2].

At Dr.Dropin you can get an examination and guidance from a chiropractor or physiotherapist. The examination maps where the pain is and what triggers it, and you can get advice on activity, resting positions and exercises adapted to pregnancy. You can read more about pelvic girdle pain and about care during pregnancy.

What is pelvic girdle relaxation?

Pelvic girdle relaxation (bekkenløsning in Norwegian) is an older name for pelvic girdle pain in pregnancy, that is, pain from the joints of the pelvis. The name is regarded as outdated, because nothing actually comes loose [1].

What is the difference between pelvic girdle pain and low back pain in pregnancy?

Pelvic girdle pain is felt over the pubic bone and at the back of the pelvis [1]. Low back pain is pain in the back, and the two can occur together [5]. An examination by a healthcare professional is needed to tell them apart [4].

Can I exercise when I have pelvic girdle pain?

NHI describes an individual exercise programme without painful exercises. Swimming and water gymnastics are mentioned as good alternatives, and some tolerate cycling better than walking [2]. What suits you should be clarified with a physiotherapist or other healthcare professional.

Does pelvic girdle pain go away after delivery?

In most women the symptoms go away after delivery. Three months after delivery, about 7 percent still have symptoms [1][6]. Greater pain during pregnancy gives a higher risk of long-lasting symptoms [2].

Do I need a referral from a doctor to see a physiotherapist?

No. NHI writes that you can contact a physiotherapist without a referral from a doctor [2].

The page about pelvic girdle pain describes how we approach problems during pregnancy. You can find more articles in the overview of articles.

This article was written by Dr.Dropin Fysikalske and is based on the sources listed below. It gives general information and does not replace an examination by a healthcare professional.

The websites were accessed and read on 22 October 2026.

1. Bekkenleddsmerter (pelvic girdle pain, formerly bekkenløsning): symptoms. NHI.no. Last updated 1 September 2025. Link

2. Bekkenleddsmerter (pelvic girdle pain): treatment. NHI.no. Last updated 1 September 2025. Link

3. Stuge B (revision), Nytrøen G (editor). Bekkenleddsmerter (pelvic girdle pain). Norsk Elektronisk Legehåndbok, legehandboka.no. Revised 1 September 2025. Link

4. Stuge B. Pelvic girdle pain: examination, treatment, and the development and implementation of the European guidelines. Journal of the Association of Chartered Physiotherapists in Women's Health. 2012;111:5-12. Reports the European guidelines: Vleeming A et al. Eur Spine J. 2008;17(6):794-819. Link

5. Liddle SD, Pennick V. Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database of Systematic Reviews. 2015, CD001139. Link

6. Ryggsmerter i svangerskapet (back pain in pregnancy). NHI.no. Last updated 11 June 2024. Link