SPD and Pelvic Girdle Pain in Pregnancy

What is SPD in pregnancy?

The symptoms, specifically

The RCOG publishes patient information on pelvic girdle pain, and the recognizable pattern is:

• Pain over the pubic bone at the front, or over one or both dimples above your buttocks, or both.
• Pain that can refer into the groin, the inner thigh or the back of the thigh.
• Worse on single-leg movements — the single most useful diagnostic clue.
• A clicking or grinding sensation in the pelvis, in some people.
• A waddling walk, because it hurts less than a normal stride.
• Difficulty turning over in bed, which is often the first thing people notice.

This is not the deep muscular ache in the small of your back that builds through the day — that is lumbar pain and it wants different treatment. See pregnancy back pain relief if you are unsure which you have.

The movement changes, which matter most

This is where most of the improvement comes from, and all of it is free.

• Keep your knees together whenever you can: turning over in bed, getting in and out of a car, getting up from a chair. Swinging both legs together rather than leading with one is the whole trick.
• Make turning over easier. Satin or silky pajamas, or a plastic bag on the sheet, let you pivot instead of hauling yourself across the mattress. This sounds absurd and works remarkably well.
• Sit down to dress. Standing on one leg to put trousers or socks on is the most reliable provocation there is.
• Take stairs one at a time, leading with the less painful leg, or go up sideways if that is easier.
• Shorten your stride. Smaller steps load the pelvis less than pushing through longer ones.
• Avoid breaststroke and anything forcing the legs apart symmetrically. Swimming otherwise is usually helpful because the water takes the load.
• Do not stand on one leg, including leaning on one hip while you wait for something.
• Sit to do things you would normally stand for — ironing, chopping, drying your hair.
• Avoid carrying on one side, including a toddler on one hip.

The referral worth asking for

Pelvic health physiotherapy is the actual treatment, and everything else on this page is management around it. A physiotherapist can assess how your pelvis is actually moving, which generic advice cannot, and give you specific exercises and often a properly fitted belt.

Ask for the referral earlier than feels reasonable. Waiting lists are long, pelvic girdle pain tends to progress through pregnancy rather than settle, and there is no advantage in waiting until it is severe. If you are told it is just part of pregnancy, it is reasonable to ask again — the RCOG's own patient information describes physiotherapy as part of management.

A belt, and what it is for

A narrow pelvic or sacroiliac belt compresses the pelvic ring so the joints move less. Worn low — around the widest part of your hips, below the belly, roughly level with the top of your pubic bone — it can make walking and stairs noticeably easier.

A wide belly-lift maternity belt generally does not help pelvic girdle pain, which is the commonest wasted purchase in this whole category. See maternity belt versus pelvic belt and the pelvic-pain belt picks.

Pain relief and labor

Ask your midwife, OB, GP or pharmacist about pain relief rather than choosing from a shelf. Some common painkillers are specifically not recommended at certain stages of pregnancy.

It is also worth raising pelvic girdle pain with your midwife in the context of labor, because positions that force your legs wide apart can be painful afterwards. Many people find it useful to note a comfortable range of hip movement in advance and mention it in their birth plan. That is a conversation with your own team rather than something to settle from a website.

After the birth

Pelvic girdle pain often improves substantially over the weeks after birth as ligament laxity reduces, and for many people it resolves. It does not always resolve immediately, and a minority have it for longer.

If it is still limiting you weeks later, ask for a pelvic health physiotherapy referral rather than waiting it out. Treatment after birth is effective, and the referral takes time.

Contact your provider if…

• You cannot weight-bear, or the pain is severe and getting rapidly worse
• You have pelvic pain with a fever, or pain on passing urine
• You have bleeding, fluid leaking, or regular tightening before 37 weeks
• You notice reduced or changed fetal movements
• You have new weakness or numbness in a leg