The pain caused by pregnancy-related pelvic girdle pain (PGP) can be managed by:
Most women find that individualised treatment including manual therapy is the most effective treatment for PGP. However, it is not offered by all NHS trusts and waiting lists can be long. The suggestions in this section can help you manage your day-to-day activities while you are waiting for treatment. If you have been experiencing PGP for a long time , you may need different types of treatment.
It is important to find ways to lessen the pain you are feeling. Being in pain can affect your physical health, relationships and mental health. It can make you feel hopeless and can make other problems in your life seem harder to deal with.
Changes to your day-to-day activities can lessen the pain from pregnancy-related pelvic girdle pain (PGP). This will not cure your PGP but can make life easier. We would still suggest that you seek hands-on treatment including manual therapy to deal with the underlying cause of your pain.
Try to listen to your body and rest as often as you need to. Pain is often worse when you are tired and stressed, so getting a good night’s sleep can be really important.
You can also try:
Some women find their PGP is worse if they spend a long time walking, sitting or standing. Try to move little and often, and avoid movements that cause you more pain. Make sure you are sitting properly, especially if you work at a desk. Take regular breaks to get up and walk around. This is especially important if you are working from home as you may be sitting for much longer periods than usual.
Many women report that their PGP is worse if they have been more active than usual during the day. The pain may not come on until the evening or night-time. It can be helpful to work out what your limits are and avoid doing too much. If you have a partner they could take on tasks you find difficult, or ask friends to help. You can use online services to make your life easier, such as internet shopping.
Activities that put uneven stresses on your pelvis can make PGP worse, including:
chores like vacuuming, mopping, pushing shopping trolleys.
Going up and down stairs on your bottom may be easier, or going one step at a time. There is no method that works for everyone so choose useful tips that help you, which are not necessarily the same that will work for someone else.
Medication is an important way of managing your pain. You may have concerns about taking pain relief because of possible side effects for you or your baby. The information below can help you decide upon the best option for you.
It’s important to explain to your midwife or GP how much pain you are in and how it affects you. Pregnancy-related pelvic girdle pain (PGP) is common in pregnancy, but it is not normal. It is important that your pain is treated and reduced as much as possible.
To help you with these discussions, we have developed a free toolkit to help you explain how PGP is affecting you physically and emotionally.
You may have concerns about taking medication for pain during pregnancy. Medication can have side effects. It’s important to remember that being in pain can also have unwanted effects. Pain can prevent you from staying active, disturb your sleep and affect your mental health.
Your midwife and GP can give you advice and help you weigh up the risks and benefits of medication. The bumps website has very helpful information on the use of medication in pregnancy.
Your GP is likely to suggest that you try paracetamol at first. Paracetamol works best if you take it regularly before you are in a lot of pain. If you wait until your pain gets bad you may find paracetamol does not help as much. You may need to take paracetamol regularly for a day or two before you feel the full benefit.
Some women find that paracetamol has little or no impact on their pain, even when taken regularly. If that is the case for you, talk with your GP or midwife about options for stronger medication.
Some GPs are reluctant to prescribe pain relief during pregnancy because of the possible side effects. You may need to ask for a referral to a consultant who has more experience of managing pain during pregnancy.
The British National Formulary gives information on different medications, including about using them while breastfeeding or pregnant.
There are many more pain relief options for you postnatally.
If you are breastfeeding, you and your doctor will need to take account of how any medication could affect your baby. Information on the risks and benefits of different medication changes regularly. It is a good idea to check with your GP about the latest information because advice that you or your friends and family have been given in the past may have changed.
The Breastfeeding Network website has more information about medication while breastfeeding.
The British National Formulary gives information on different medications, including about using them while breastfeeding or pregnant.
Please note that because PGP is not caused by hormones, breastfeeding doesn’t impact your PGP symptoms.
If you have been in pain for more than three months, you may need different approaches and different types of medication to manage your pain. See the section on longer-term pain below.
There are many other options to relieve pregnancy-related pelvic girdle pain (PGP). You can try these alongside or instead of medication.
Applying heat or cold to painful areas can be surprisingly effective.
A hot water bottle is a good way of applying heat. This can be especially helpful when you are trying to get to sleep.
An ice pack can also provide pain relief. Try using an ice pack if you experience soreness or stiffness after manual therapy treatment.
Heat and ice should not be applied straight on to your skin. Make sure there is a layer of clothing or a cloth between your skin and the hot water bottle or ice pack.
The heat or cold increases circulation to the area which may have an anti-inflammatory effect. Warmth can also help to relax tight or painful muscles.
The NHS recommends avoiding jacuzzis, hot tubs and very hot baths during pregnancy.
Transcutaneous electrical nerve stimulation (TENS) is best known as a way of relieving pain during labour. However, a TENS machine can also be used to treat other types of pain, including PGP.
We would suggest you speak to your midwife before using TENS in pregnancy, as it may not be suitable in some situations.
Sticky electrode pads are placed around the area of pain and these are connected to a battery-powered unit that is small enough to be attached to a belt. Mild electrical impulses are then transmitted to stimulate the nerves in the affected area and you will usually feel a slight tingling sensation. It causes your body to release natural painkillers called endorphins, which reduce the pain messages reaching your brain. TENS can be used alongside medication.
Mindfulness and meditation can help you to relax and can be particularly useful to help you cope with long-term (chronic) pain. They do not cure the underlying problem, but can help you feel more in control of the situation.
The NHS website can direct you to free online resources for mindfulness and meditation. Yoga nidra and raja yoga are forms of meditation which are freely available on YouTube. There are also free or low-cost apps available, such as Headspace.
Acupuncture is a complementary treatment derived from ancient Chinese medicine. Fine needles are inserted at certain sites on the body. It is sometimes available on the NHS, but most people have to pay for acupuncture.
The evidence about the effectiveness of acupuncture is unclear. Acupuncture may provide pain relief but will not solve the underlying cause of PGP. It is safe during pregnancy and can also be used for pain relief during labour.
Read more on the NHS website.
Hypnotherapy is sometimes suggested as a way of relieving pain. In the UK, hypnotherapists do not need to have any specific training. This means that hypnotherapy can be provided by people with little training who may not have knowledge of PGP or pain relief.
Hypnotherapy is not available on the NHS as a treatment for PGP. We would suggest that manual therapy from a physiotherapist, osteopath or chiropractor with experience of PGP is a better treatment option than hypnotherapy.
Some women tell us that complementary therapies such as massage, homeopathy and reflexology are helpful to manage their pain during and after pregnancy.
Women usually find that manual therapy is a better treatment for PGP than complementary therapies, because manual therapy will treat the underlying cause of PGP. Having said that, complementary therapies may help you to feel calm and relaxed and might make it easier to sleep or deal with pain and can help alongside manual therapy.
Pain that lasts more than three months is known as chronic pain. You may need different approaches to manage your pain if it has been going on for a long time. One reason for this is that your brain can become more sensitive to pain. Different medication may be needed for chronic pain.
Find out more about chronic pain here:
You can also call and leave a message on our volunteer helpline to talk through your experience in more detail, on 01235 820921.
