Pregnancy back and pelvic pain

How common it is

Pelvic girdle pain is very common during pregnancy. National consumer guidance describes it as pain in the bones and joints of the pelvis that usually starts between 14 and 30 weeks, most often from the sacroiliac joints at the back and the pubic symphysis at the front. ^[1]

Many people come to us in pregnancy having assumed they simply have to put up with it. Some find it manageable on their own; others want an examination to understand which joints are involved and what they can do about it day to day.

What can be behind it

The exact cause is not fully understood. Guidance describes a mix of physical and hormonal change: carrying more weight at the front alters posture and stresses the spine and pelvis, and the pelvic ligaments relax so the joints become more mobile. ^[1]

In practice that means the lower back, the pelvis and the hips are all sharing a load that keeps changing week to week, and the muscles around them often work harder to compensate.

• Weight carried further forward, changing how you stand
• Pelvic ligaments relaxing as pregnancy progresses
• Sacroiliac joints at the back of the pelvis taking more load
• Hip and lower back muscles working harder to keep you balanced

How we assess it

Your history first, including how many weeks you are, how your pregnancy is going and who is looking after your maternity care. Then an examination of how you stand and move, the lower back, the pelvic joints and the hips, with positions chosen for comfort at your stage.

Consumer guidance advises avoiding X-rays during pregnancy where possible. ^[1] We take X-rays only when they are clinically indicated, and your pregnancy is part of that decision.

Some symptoms in pregnancy are not musculoskeletal and need your maternity team, not a chiropractor. If you have bleeding, fluid leaking, severe or rhythmic abdominal pain, a headache with changes to your vision, or your baby is moving less than usual, contact your maternity unit straight away or call 000. ^[2]

What care looks like

Dr Arthur sees patients at any stage of pregnancy, in any trimester. What changes is the approach: the force, the technique and the positioning are adapted to your stage and comfort, with more attention on how you move, muscle tension, the mechanics of the pelvis and hips, and your balance.

Guidance lists practical changes that may help with pelvic girdle pain, such as sleeping on your side with a pillow between your legs, dressing while seated, and keeping your knees together getting in and out of the car. ^[1] We talk through which of these suit your day. We encourage you to keep your midwife or obstetrician informed about any care you have with us.

When to seek urgent care

We are not an emergency service. If you have loss of bladder or bowel control, numbness in the saddle area, weakness in both legs, or pain after a serious accident, call 000 or go to an emergency department.