Pelvic Pain During Pregnancy (SPD): Causes & Treatment

Symphysis pubis dysfunction (SPD), also called pelvic girdle pain, causes sharp pain in the front center of your pelvis, especially when walking, climbing stairs, or rolling over in bed. It’s caused by the hormone relaxin loosening the ligaments around your pelvic joints, allowing too much movement. Treatment includes physical therapy, pelvic support belts, modified movements, and pain management. Most SPD resolves after delivery.¹

What is SPD?

The symphysis pubis is the joint at the front center of your pelvis where the two halves of your pelvis meet. Normally, this joint moves very little (1-2 mm). During pregnancy, the hormone relaxin loosens ligaments to allow your pelvis to expand for delivery. Sometimes this causes excessive movement (4-5 mm or more), leading to inflammation and pain—this is SPD.²

Symptoms of SPD

Sharp, shooting pain: In the center front of your pelvis (pubic bone area), groin, inner thighs, or lower back.

Clicking or popping sensation: When moving, especially when lifting one leg.

Pain triggered by:

• Walking (especially long distances)
• Climbing stairs
• Standing on one leg (getting dressed, getting in car)
• Rolling over in bed
• Spreading legs apart (getting in/out of car, sex)
• Weight-bearing activities

Waddling gait: Walking with legs farther apart to reduce pain.

Pain worse at night: Often disrupts sleep.

Safe Treatments for SPD

Physical Therapy

Pelvic floor physical therapy is the gold standard treatment. A specialized PT can:³

• Assess pelvic alignment
• Teach stabilizing exercises
• Provide manual therapy
• Recommend appropriate modifications
• Fit a support belt properly

Pelvic Support Belt

A support belt worn low around your hips (not your belly) can stabilize the pelvis and significantly reduce pain.⁴

Movement Modifications

Keep knees together: When getting in/out of car, rolling in bed, getting dressed.

Take smaller steps: Reduce stride length when walking.

Avoid stairs when possible: Use elevators or limit stair climbing.

Sit to get dressed: Put on pants and shoes while sitting.

Sleep with pillow between knees: Maintains pelvic alignment.

Avoid standing on one leg: Sit to put on shoes and pants.

Pain Management

Ice or heat: Apply to painful areas for 15-20 minutes.

Acetaminophen: Safe pain reliever during pregnancy (consult your provider).

Rest: Avoid overdoing activities that worsen pain.

Water exercises: Swimming or water aerobics reduces weight-bearing stress.⁵

When to See Your Provider

Contact your healthcare provider if:⁶

• Pain is severe or interfering with daily activities
• You need a referral to pelvic floor physical therapy
• Pain is accompanied by fever, bleeding, or contractions
• You’re unable to walk or bear weight

References

Footnotes

1. Vleeming A, et al. (2008). “European guidelines for the diagnosis and treatment of pelvic girdle pain.” European Spine Journal, 17(6), 794-819. ↩

2. Leadbetter RE, et al. (2004). “Symphysis pubis dysfunction: a review of the literature.” Journal of Maternal-Fetal & Neonatal Medicine, 16(6), 349-354. ↩

3. ACOG. (2020). “Physical Activity During Pregnancy.” ↩

4. Carr CA. (2003). “Maternity support binder for relief of pregnancy-related back pain.” JOGNN. ↩

5. Vleeming A, et al. (2008). “European guidelines for pelvic girdle pain.” ↩

6. ACOG. (2025). “Back Pain During Pregnancy.” ↩