Struggling to roll over in bed? Finding it painful to put your underwear on? Getting in and out of the car has suddenly become a whole process?
If you’re pregnant and experiencing pain around your pelvis, pubic bone, hips, groin or lower back, you may be experiencing symphysis pubis dysfunction (SPD) — now more commonly referred to as pregnancy-related pelvic girdle pain (PGP).
And while pelvic pain can be common during pregnancy, you don't simply have to put up with it because you're pregnant.
Pregnancy is a huge physical change for your body, but being pregnant shouldn't mean accepting that every step, roll, turn or trip to the toilet needs to hurt.
What does SPD actually feel like?
SPD/PGP can feel different from person to person.
You might experience:
Pain directly over your pubic bone
Pain or aching in your groin
Pain around one or both hips
Lower back or buttock pain
Pain travelling into your thighs
A feeling of pulling, aching, clicking or grinding around the pelvis
Pain when turning over in bed
Difficulty walking, particularly for longer distances
Pain going up or down stairs
Pain when standing on one leg
Difficulty getting dressed
Pain getting in or out of the car
Discomfort getting in and out of bed
Pain when getting in or out of the bath
Difficulty separating your legs
Pain with some exercise or certain movements
These symptoms can make ordinary daily activities surprisingly difficult.
And sometimes it's not the big things that are the hardest.
It's the little things.
Getting your pants on.
Putting your shoes on.
Getting out of the car.
Rolling over at 2am.
Walking around the supermarket.
Getting your toddler in and out of their car seat.
Going up the stairs.
Turning around in bed.
By the end of the day, all those little moments of pain can really add up.
Why does pregnancy cause pelvic pain?
During pregnancy, your body goes through significant changes. Your growing baby and changing body shape alter the demands placed on your pelvis, hips and surrounding muscles. Hormonal changes also affect the ligaments and joints around the pelvis.
It's a combination of these changes, along with how your muscles and joints are adapting to your changing body, that can contribute to pelvic girdle pain.
Importantly, experiencing PGP does not mean that your pelvis is damaged or that something is wrong with your baby.
However, pain that is interfering with your everyday life is worth getting assessed.
The everyday movements that can be surprisingly painful
Rolling over in bed
This is one of the classic complaints I hear from pregnant patients.
You finally get comfortable, fall asleep and then realise you need to turn over — and suddenly moving your legs apart or twisting through your pelvis hurts.
Try: keeping your knees together as you roll rather than letting one leg move independently. You can also use a pillow between your knees for support.
Some women find it more comfortable to turn underneath themselves or roll onto their side first rather than twisting through the pelvis.
Getting dressed
Standing on one leg to put your underwear, trousers or shoes on can aggravate pelvic pain.
Try: sitting down to get dressed, particularly for socks, underwear and trousers.
It may seem like a small change, but reducing repeated single-leg loading can make getting ready much more comfortable.
Getting in and out of the car
Opening the door and swinging one leg out can be surprisingly painful when your pelvis is sensitive.
Try: sitting down first and keeping your knees together as you swivel both legs in and out of the car.
A smooth bag or piece of fabric on the seat can sometimes make it easier to swivel your legs around together.
Walking
You may notice that walking longer distances, walking quickly or walking on uneven ground increases your pain.
This doesn't necessarily mean you need to stop moving completely.
Instead, think about pacing yourself. Smaller steps, supportive footwear, regular breaks and reducing activities that clearly flare your symptoms can help.
The aim is to find a level of movement your body can tolerate rather than becoming completely inactive.
Stairs
Stairs can be particularly uncomfortable because you're repeatedly loading one leg at a time.
Try: taking the stairs one step at a time and using the handrail for additional support.
If stairs are particularly painful, consider whether you can reduce unnecessary trips up and down during the day.
Getting in and out of bed
Instead of twisting and pushing yourself up using one leg, try rolling onto your side with your knees together and then using your arms to help push yourself up.
Small changes to how you move can sometimes make a surprisingly big difference.
Looking after other children
This can be particularly challenging if you're already pregnant with a toddler or young child at home.
Try to avoid carrying your child on one hip if this aggravates your symptoms. Where possible, encourage them to climb up to you for cuddles, sit with them rather than carrying them, and ask for help with heavier lifting.
Pregnancy is a very good time to accept help.
You don't need to prove that you can still do everything you did before pregnancy.
So, what can osteopathic treatment do?
This is where an individual assessment can be really helpful.
At your appointment, I will take the time to understand what you're experiencing and, importantly, what you're struggling to do.
Rather than simply focusing on where it hurts, I'll look at how your whole body is moving and how your pelvis, hips, lower back and surrounding muscles are functioning.
Treatment may include gentle hands-on techniques such as soft tissue work, joint mobilisation and articulation, alongside advice tailored to you and your stage of pregnancy.
I'll also look at the movements that are aggravating your symptoms and help you find ways of modifying them.
Sometimes the most useful advice isn't complicated.
It might be:
“Let's change how you're getting out of bed.”
“Try sitting down to get dressed.”
“Let's modify that exercise rather than stopping completely.”
“Here's a different way to get in and out of your car.”
The goal is to help you feel more comfortable and confident moving through pregnancy.
You don't have to just put up with it
One of the things I hear from pregnant patients is:
“I thought this was just part of being pregnant.”
Pregnancy certainly comes with aches, pains and physical changes — but that doesn't mean you have to suffer through significant pain without support.
If pelvic pain is affecting your sleep, walking, exercise, work, caring for your other children or simply getting through your normal day, it's worth getting assessed.
The earlier pregnancy-related pelvic pain is recognised and managed, the sooner you can start making changes that may help reduce its impact.
Pregnancy doesn't have to mean putting up with pain
Your body is doing something incredible, but that doesn't mean you should feel like you have to grin and bear every ache and pain for the next few months.
If you're struggling with SPD/PGP or pregnancy-related pelvic pain, I'd love to help.
I'm Sarah, a Milford osteopath specialising in pregnancy and postpartum care.
I provide individualised osteopathic treatment and practical advice to help you move more comfortably throughout pregnancy.
If pelvic pain is making everyday things harder than they need to be, book an appointment and let's see how I can help.
If you are experiencing significant or worsening pelvic pain, or are unsure whether your symptoms are pregnancy-related pelvic girdle pain, speak with your midwife, GP or other maternity healthcare professional for assessment.
