Many pregnant women are told pelvic pain is “normal” and just “part of pregnancy.” While it is a common occurrence, it is not something you simply have to endure. Pelvic girdle pain (PGP) is a recognised condition that can be assessed and treated, and the earlier it’s addressed, the better the outcome.
What is Pelvic Girdle Pain?
In short, Pelvic Girdle Pain is discomfort or pain felt around your pelvis, the bony area between your hips and lower back, that can make everyday activities like walking, rolling over in bed, or climbing stairs uncomfortable. The pain can be felt in the front or back of the pelvis, groin, pubic region and the inner thighs.
The key joints involved in pelvic girdle pain are the sacroiliac joints and the pubic symphysis. You may have heard the term SPD or Symphysis Pubis Dysfunction, which is the older term for PGP.
The most important thing to note is that although pelvic girdle pain can be very uncomfortable, it does not pose any risk or harm to the baby.
What Are the Symptoms?
- Pain around the front of the pelvis (pubic bone) or across the lower back and hips
- Discomfort when walking, especially longer distances or on uneven ground
- Pain when turning over in bed or getting in and out of bed
- Difficulty standing on one leg, for example when getting dressed
- Pain getting in and out of the car or climbing stairs
- A feeling of clicking, grinding, or instability in the pelvis
- Pain that may spread into the groin, inner thighs, or buttocks
- Symptoms that feel worse with activity and ease with rest
If this sounds familiar, you’re not alone, and it’s worth mentioning to your midwife, GP, or osteopath. Starting treatment early makes a real difference.
How Common Is It?
- PGP affects 1 in 5 women during pregnancy
- Up to 45% of pregnant women experience some degree of pelvic girdle or low back pain
- It is one of the leading causes of sick leave during pregnancy
- Discomfort can begin at any stage but most commonly starts in the second and third trimesters
- For most women, symptoms resolve after birth
What Causes It?
During pregnancy, your body goes through remarkable changes to support your growing baby. Hormones help the ligaments around your pelvis become softer and more flexible, which is completely normal and an important part of preparing your body for birth.
It’s often thought that pregnancy-related lower back and pelvic pain is caused solely by the hormone relaxin. While relaxin does contribute to ligament laxity, it’s unlikely to be the main cause of pain. In reality, pelvic girdle pain is multifactorial.
Your pelvis is made up of three joints that need to work together in a coordinated way. As your posture changes, your centre of gravity shifts, and the physical demands on your body increase, the way these joints move can become less well coordinated. When this happens, the surrounding muscles and soft tissues work harder to provide stability, which can lead to irritation, fatigue, and discomfort.
Importantly, this doesn’t mean anything is damaged or that something is “out of place.” Pregnancy-related pelvic girdle pain reflects the body’s adaptation to the changes of pregnancy rather than an injury. Some women are simply more susceptible than others, but with the right support and management, most experience significant improvement.
Factors that may increase the likelihood of developing pelvic girdle pain:
- Previous pelvic injury or trauma
- Previous pelvic girdle pain or low back pain
- Joint hypermobility
- Multiple pregnancies
- Family history
How Osteopathy Can Help
In clinic, we regularly see women who have been living with pelvic girdle pain for weeks, and sometimes months, before seeking treatment. Many tell us they wish they had sought help sooner, often noticing a meaningful improvement in their comfort and mobility within the first few sessions.
At Inline Osteopathy on Auckland’s North Shore, we take a whole-body approach to assessing and treating pelvic girdle pain. Every pregnancy is different, which is why we take the time to understand your symptoms, movement patterns, and the physical demands of your daily life.
Treatment is gentle, tailored to your individual needs, and adapted to each stage of your pregnancy. Our aim is to reduce pain, improve the way your body moves, and help you stay as active and comfortable as possible throughout your pregnancy.
1. Hands-On Treatment
Osteopathic treatment for PGP may include soft tissue therapy, joint mobilisation, and gentle techniques aimed at improving movement and reducing pain in the pelvis, hips, lower back, and surrounding structures. Research strongly supports the use of manual therapy as part of a broader management approach for pregnancy-related pelvic girdle pain.
The Royal College of Obstetricians and Gynaecologists (RCOG) recommends that women with pregnancy-related PGP consider manual therapy provided by a healthcare professional with expertise in managing the condition. The RCOG also advises that treatment should be gentle and should not be painful.’
2. A Whole-Body Approach
The pelvis doesn’t work in isolation. Restrictions in the thoracic spine, tightness through the hips, changes in how you’re loading one side of your body, all of these contribute to how your pelvis is functioning. We assess the whole picture and treat accordingly.
In clinic, we often find that women who have had previous lower back pain, or who carry most of their tension in one area, tend to experience more asymmetrical pelvic loading, and this can drive PGP symptoms. Identifying and addressing these patterns early is key.
3. Practical Advice for Daily Life
Just as important as hands-on treatment is knowing how to move through your day in a way that doesn’t aggravate your pelvis. We’ll work with you on:
- Sleeping positions – side-lying with a pillow between your knees and support under your bump to reduce pelvic torsion overnight
- Getting in and out of bed – using a log-roll technique, keeping your knees together, and moving your shoulder and hip as one unit
- Sitting and posture – sitting well back in your chair with lower back support, avoiding perching or slouching
- Getting in and out of the car – sitting down first, then swinging both legs in together rather than stepping in one leg at a time
- Footwear -supportive, flat shoes rather than heels
- Pacing your activity – identifying which tasks aggravate symptoms and spreading them through the day rather than doing them all at once
What Surprises Patients Most
One of the things women tell us most often is that they hadn’t realised how much their sleep position was contributing to their symptoms. Waking several times a night to turn over and allowing the top knee to drop forward can place repeated rotational stress through the pelvis and sacroiliac joints, often aggravating pelvic girdle pain. A few simple adjustments to sleeping position and pillow support can make a noticeable difference, sometimes within just a night or two.
Another common surprise is how quickly symptoms can begin to improve with the right treatment. Many women with mild to moderate pelvic girdle pain notice meaningful improvements within the first one or two sessions, particularly when hands-on treatment is combined with an individualised home exercise programme and practical advice to reduce everyday aggravating factors.
Is Treatment Safe During Pregnancy?
Yes, absolutely. Many women are understandably cautious about having treatment during pregnancy, but osteopathic care is designed to be safe and appropriate for both mother and your baby.
At Inline Osteopathy, a detailed case history is taken before any hands-on treatment begins. This allows the osteopath to understand each woman’s pregnancy, symptoms, health history, and individual circumstances, while also screening for any factors that may require further medical input.
The aim of treatment is to provide a gentle, supportive, and reassuring experience. Techniques are carefully selected based on each woman’s needs, with comfort and safety remaining the priority throughout the appointment. Every step of the process is explained, ensuring women feel informed and at ease with their care.
Research, including systematic reviews published in the Journal of Bodywork and Movement Therapies, suggests that osteopathic manipulative treatment may help reduce pregnancy-related pelvic and lower back pain, with no significant adverse effects reported in the studies reviewed.
When Should You Seek Help?
Don’t wait until you can barely walk to the letterbox. Come in if:
- Pain is affecting your walking or daily function
- Sleep is being disrupted by pain when turning in bed
- Symptoms are worsening despite rest
- You’re pregnant and have had PGP before, early treatment is particularly beneficial in subsequent pregnancies
- You’re not sure whether what you’re experiencing is PGP, we can assess and advise
⚠️ Please note: If you experience sudden, severe pelvic pain, or pain accompanied by any other concerning symptoms, please contact your midwife, GP, or lead maternity carer promptly.
Home Tips: What You Can Do Right Now
✅ Keep Moving Gently
Staying gently active but within your pain limits is important. Walking at a comfortable pace, swimming, and water exercise are all well supported for managing PGP during pregnancy. Avoid high-impact or asymmetrical activities that load one side of the pelvis more than the other.
✅ Strengthen Your Pelvic Floor and Deep Tummy Muscles
Gentle pelvic floor exercises and lower tummy activation help support the pelvic joints and reduce strain. These are safe throughout pregnancy and are one of the most effective things you can do to help manage PGP from the inside out.
✅ Try Pelvic Tilting
Pelvic tilting. Gently rocking your pelvis forwards and backwards in a sitting or standing position helps mobilise the lower back and pelvis and is a useful warm-up before other movement.
✅ Sleep with Support
Side-lying (preferably on your left) with a pillow between your knees and support under your bump is the recommended sleep position for PGP. The goal is to keep your hips stacked directly on top of each other and avoid that top knee dropping forward overnight.
✅ Move Symmetrically
Try to keep your knees together when getting into or out of bed, the car, or when dressing. Avoid standing on one leg, taking the stairs one at a time, or carrying loads on one side.
✅ Consider a Pelvic Support Belt
A sacroiliac support belt can provide additional stability during activity for some women. Ask your osteopath whether this is appropriate for you and how to use it correctly.
⚠️ Please note: These tips are general in nature and intended as educational guidance only. If you are currently experiencing pain or recovering from an injury, please consult a qualified health professional before starting any new exercises or making significant changes to your routine.
What is appropriate varies from person to person, when in doubt, book in and we’ll help you work out what’s right for you.
Supporting Women Through Pregnancy on Auckland’s North Shore
At Inline Osteopathy, we have experience working with pregnant women across all stages of pregnancy and understand the nuances of managing pelvic girdle pain safely and effectively. We offer longer initial appointments so we can take the time to properly assess your whole body, understand your history, and create a plan that works for your life, not just your pelvis.
You don’t have to just put up with it. Early support genuinely makes a difference.
📍 North Shore, Auckland
🌐 [inlineosteo.co.nz]
FAQs
When in pregnancy can I start treatment?
Treatment is safe and appropriate at any stage of pregnancy, including the first trimester. Ultimately, it is about what feels right for each woman, and treatment can begin whenever she feels comfortable.
What should I tell my midwife?
Let your midwife or lead maternity carer know you have PGP. They can flag it for your birth team, ensure appropriate positioning is planned for labour, and support referrals if needed.
Can I still exercise if I have pelvic girdle pain?
Yes. Staying active within your comfort levels is usually encouraged during pregnancy. An osteopath can help guide you on suitable movements, modifications, and exercises to support your symptoms and keep you moving confidently.
Is pelvic girdle pain the same as sciatica?
Not always. While the symptoms can overlap, pelvic girdle pain usually relates to discomfort around the pelvic joints and surrounding muscles, whereas sciatica involves irritation of the sciatic nerve and may cause pain, tingling, or numbness down the leg.
Why does pelvic girdle pain feel worse at night?
Many women notice symptoms when turning in bed or finding a comfortable sleeping position. Small adjustments, such as using pillows for support and changing movement strategies, can often reduce strain on the pelvis.
Do I need a referral from my midwife or GP?
No. In New Zealand, you can book directly with an osteopath. However, keeping your midwife or GP informed is recommended so they can support your overall pregnancy care.
Can I use ACC for pelvic girdle pain treatment?
Yes. If your pelvic girdle pain is related to an injury or accident, ACC may contribute towards your osteopathy treatment. Your osteopath can discuss your eligibility and help guide you through the process. If your symptoms are related to pregnancy changes rather than an injury, ACC coverage may not apply.
How many osteopathy sessions will I need?
This varies depending on your symptoms, how long they have been present, and your individual goals. Some women notice improvements within the first few sessions, while others benefit from ongoing maintenance treatment throughout pregnancy as their body continues to change. Treatment plans are always tailored to each woman’s needs and may change as pregnancy progresses.
If you have any further questions about the topics covered above or any other questions on how Osteopathy can help you, then please do not hesitate to reach out.
Our Osteopathic clinic is situated on the North Shore in Auckland. A list below are the areas we serve:
- Albany
- Rosedale
- Glenfield
- Browns Bay
- Takapuna
- Milford
- Wairau Valley
- Mairangi Bay
More Information:
References
- Royal College of Obstetricians and Gynaecologists (RCOG). *Pelvic Girdle Pain and Pregnancy.* [rcog.org.uk](https://www.rcog.org.uk/for-the-public/browse-our-patient-information/pelvic-girdle-pain-and-pregnancy)
- Vleeming A et al. *Pregnancy-related pelvic girdle pain (PPP), I: Terminology, clinical presentation, and prevalence.* European Spine Journal. 2008. [PubMed](https://pmc.ncbi.nlm.nih.gov/articles/PMC2518998/)
- Franke H, Franke JD, Belz S, Fryer G. *Osteopathic manipulative treatment for low back and pelvic girdle pain during and after pregnancy: a systematic review and meta-analysis.* Journal of Bodywork and Movement Therapies. 2017;21:752–762.
- Pelvic, Obstetric and Gynaecological Physiotherapy (POGP). *Pelvic Girdle Pain — Patient Guidance.* [thepogp.co.uk](https://thepogp.co.uk/_userfiles/pages/files/resources/23697pogppelvic_girdle_pain.pdf)
- Puri SN, Fating T, Dhage PP. *The Impact of Functional Stability Exercises on Alleviating Pelvic Girdle Pain in Pregnancy: A Review.* Cureus. 2023;15(11):e48769. [pmc.ncbi.nlm.nih.gov](https://pmc.ncbi.nlm.nih.gov/articles/PMC10719549)
- Health Service Executive (HSE) Ireland. *Managing Pelvic Girdle Pain.* [hse.ie](https://www2.hse.ie/conditions/pelvic-girdle-pain-pregnancy/managing-pain)
- Health Service Executive (HSE) Ireland. *Exercises to Help Pelvic Girdle Pain.* [hse.ie](https://www2.hse.ie/conditions/pelvic-girdle-pain-pregnancy/exercises)
About The Author
Hannah is an experienced Osteopath with multiple years of clinical experience treating a wide range of musculoskeletal conditions, including pregnancy, postnatal and paediatric care.
Masters of Osteopathy (UK).
