Pelvic girdle pain in pregnancy: symptoms, assessment and exercise

The condition was formerly called pelvic girdle relaxation. NHI writes that the name gives a misleading impression, and that the term pelvic girdle pain is now used when the pregnant woman experiences the pain as a problem in daily life. That the joints of the pelvis become more pliable because of pregnancy hormones is regarded as a normal process [1].

The pain is located in the area between the posterior iliac crest and the gluteal fold, particularly near the joints between the sacrum and the pelvic bone, and can also be over the symphysis. It can radiate towards the back of the thigh [2]. You can read more on the page about pelvic girdle pain.

Typical symptoms are pain over the symphysis and at the back of the pelvis. The pain can radiate to the buttock, groin and thigh, and typically comes during or after loading. The symptoms often increase during the day and can appear with a delay after activity [1].

Many find it difficult to walk, stand, lift, lie flat on the back and sit for longer periods. Changes of position and twisting movements are particularly demanding [1]. The symptoms most often start in the fifth to eighth month of pregnancy, but can start earlier [1].

The diagnosis is made from how the woman describes the pain, meaning where it is, how severe it is and how it varies, and from a physical examination [1]. The European guideline points out that most clinical tests have low reliability individually, and that the diagnosis should therefore not be based on a single test. Pain provocation tests such as the P4 test and the active straight leg raise test are best documented [2]. Pain that originates from the lumbar spine must be ruled out [2].

X-ray or other imaging usually serves no purpose [1].

The first line is to adapt daily life. NHI emphasises even loading of the legs, good resting positions combined with adapted activity, and sitting more during tasks that are otherwise done standing [1]. Physical activity is recommended as long as it does not increase the pain, and swimming is mentioned as a good alternative [1]. The European guideline recommends individually adapted exercises in pregnancy [2].

According to NHI, physiotherapy with specific exercises for the pelvis has been shown to be far better than ordinary physiotherapy, and you do not need a referral from a doctor to see a physiotherapist [1]. Pelvic belts can help some people when used together with individual guidance [1], but according to Stuge there is insufficient scientific evidence to say that they reduce the pain [2]. NHI also mentions crutches for severe pain and acupuncture, which has an effect in some people [1].

After birth, the guideline recommends good information and reassurance as part of a combined treatment with exercises for control and stability [2].

In the vast majority of women, the symptoms disappear after birth [1][2]. In a large Swedish study that NHI refers to, almost everyone was well at the check-up after 12 weeks, and the prevalence falls to about 7 percent during the first three months [1]. Those who had severe pain during pregnancy have the greatest risk of long-lasting problems. For those who still have pain after birth, physiotherapy with individual exercises is described [1].

If the pain makes it difficult to manage daily life, you can contact a physiotherapist without a referral [1]. A doctor can consider sick leave, and NHI describes pelvic girdle pain as the most common reason for sick leave in pregnancy [1]. If you are unsure whether the symptoms have another cause, there is reason to raise it with your midwife or doctor.

A chiropractor can examine the pelvis, lower back and hips, go through your symptoms and give advice on exercises and adapting daily life. You do not need a referral from a doctor. You can also read about the pelvic floor muscles.

What is the difference between pelvic girdle relaxation and pelvic girdle pain?

Pelvic girdle relaxation is an older name for the condition. NHI writes that it gives a misleading impression, and that the term pelvic girdle pain is used when the pain is experienced as a problem in daily life [1].

How common is pelvic girdle pain in pregnancy?

About 15 percent of Norwegian pregnant women report symptoms in the last part of the pregnancy [1].

Does pelvic girdle pain go away after birth?

In the vast majority, the symptoms disappear after birth [1][2]. The prevalence falls to about 7 percent during the first three months [1].

Can I exercise when I have pelvic girdle pain?

NHI recommends physical activity as long as it does not increase the pain, and mentions swimming as a good alternative [1].

Do I need a referral to see a physiotherapist?

No. NHI writes that you do not need a referral from a doctor to receive physiotherapy [1].

The page about the pelvic floor muscles describes another area that many pregnant women and new mothers wonder about. 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). NHI.no. Last updated 1 September 2025. Symptoms, treatment

2. 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. Link