Many pregnant women experience pelvic girdle pain (PGP), but it's often dismissed as "just part of pregnancy." This discomfort can significantly impair a woman's ability to work, sleep, and care for her family. A proactive approach, starting with prenatal screening for risk factors, can dramatically improve outcomes. We need to move beyond simply acknowledging the pain and start actively managing it.
This means integrating simple screening questions and evidence-based exercises into routine prenatal visits. Let's equip ourselves with practical tools to address PGP head-on and improve the quality of life for our pregnant patients.
Clinical Key Takeaways
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- The Pivot Shifting from passive acceptance to active management of pregnancy-related musculoskeletal pain through early screening and intervention.
- The Data Studies suggest that targeted exercises and manual therapy can reduce pain intensity and improve function in women with PGP.
- The Action Incorporate a brief questionnaire assessing pain location, intensity, and functional limitations into the first prenatal visit, and provide tailored exercise recommendations or referral to physical therapy as needed.
Risk Factors
Identifying women at higher risk for pregnancy-related musculoskeletal conditions is the first step. Several factors can predispose a patient to pelvic pain during pregnancy. These include:
- Previous history of low back pain or pelvic girdle pain
- Hypermobility or joint laxity
- Multiple pregnancies
- High body mass index (BMI)
- Psychosocial factors such as stress, anxiety, and depression
- Occupations requiring prolonged standing or heavy lifting
Asking about these factors during the initial prenatal visit allows for early intervention and tailored management strategies. It's about being proactive, not reactive.
Screening Questions
Here are some practical questions to incorporate into a standard 15-minute prenatal visit:
- "Have you experienced any back pain or pelvic pain in the past, even before this pregnancy?"
- "Do you feel any pain or discomfort in your hips, lower back, or pubic area when walking, standing, or changing positions?"
- "Does this pain interfere with your daily activities, such as sleeping, working, or caring for your other children?"
- "Have you noticed any clicking, popping, or grinding sensations in your hips or pelvis?"
- "On a scale of 0 to 10, with 0 being no pain and 10 being the worst pain imaginable, what is your average pain level?"
A positive response to any of these questions should prompt further evaluation and consideration for referral to a physical therapist specializing in women's health.
Exercise Recommendations
While formal physical therapy is ideal, we can provide basic exercise recommendations to patients during their prenatal visits. These exercises aim to improve core stability, strengthen pelvic floor muscles, and reduce pain. Some examples include:
- Pelvic Tilts: Lie on your back with knees bent and feet flat on the floor. Gently tilt your pelvis upward, pressing your lower back into the floor. Hold for a few seconds and repeat.
- Bridge Exercises: Lie on your back with knees bent and feet flat on the floor. Lift your hips off the floor, squeezing your glutes. Hold for a few seconds and repeat.
- Cat-Cow Stretch: Start on your hands and knees. Alternate between arching your back like a cat and dropping your belly towards the floor.
- Modified Side Plank: Lie on your side with your knees bent. Lift your top hip off the floor, maintaining a straight line from your shoulder to your knee. Hold for a few seconds and repeat on the other side.
- Pelvic Floor Exercises (Kegels): Squeeze the muscles you would use to stop the flow of urine. Hold for a few seconds and repeat.
Emphasize the importance of proper form and advise patients to stop if they experience any pain. It's about gentle movement and strengthening, not pushing through discomfort.
These recommendations align with general advice from the American College of Obstetricians and Gynecologists (ACOG) regarding exercise during pregnancy. However, ACOG does not offer specific guidance on managing PGP beyond general recommendations for pain relief.
The Catch
The biggest hurdle is time. A 15-minute prenatal visit is already packed. Adding more screening questions and exercise recommendations can feel overwhelming. We need to streamline the process, potentially using questionnaires completed before the appointment and providing handouts with clear instructions for exercises. Also, remember the data supporting these interventions is often from small, underpowered studies. We need more robust research to definitively prove the effectiveness of these strategies.
Implementing these strategies requires a shift in workflow. It means prioritizing musculoskeletal health as part of routine prenatal care. This may involve training staff to administer the screening questions and provide basic exercise instruction. Furthermore, clear referral pathways to physical therapists who specialize in prenatal and postpartum care are essential. Let's also be honest about the financial burden. While some insurance plans cover physical therapy, many do not, or they require high co-pays. This creates a significant barrier for many patients, particularly those from low-income backgrounds. Advocacy for better insurance coverage for prenatal and postpartum musculoskeletal care is crucial.
LSF-4776422554 | December 2025
How to cite this article
Sato B. Managing pregnancy-related pelvic girdle pain a practical guide. The Life Science Feed. Published December 25, 2025. Updated December 25, 2025. Accessed January 31, 2026. .
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This summary was generated using advanced AI technology and reviewed by our editorial team for accuracy and clinical relevance.
References
- Vleeming, A., Albert, H. B., Östgaard, H. C., Sturesson, B., & Stuge, B. (2008). European guidelines for the diagnosis and treatment of pelvic girdle pain. European Spine Journal, 17(6), 794-819.
- Wu, W. H., Meijer, O. G., Uegaki, K., Mens, J. M., van Dieën, J. H., Kokke, F., ... & van Wingerden, J. P. (2004). Risk factors for persistent pelvic girdle pain after pregnancy. Spine, 29(11), 1283-1289.
- American College of Obstetricians and Gynecologists. (2020). Exercise During Pregnancy. Committee Opinion, Number 804. Obstetrics & Gynecology, 135(4), e178-e188.
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