Pelvic girdle pain is felt across a band of areas around the pelvis, most commonly at the back of the pelvis near the sacroiliac joints, at the front of the pelvis over the pubic bone, and in the groin. It can also spread into the lower back, buttocks, hips, thighs, and the pelvic floor. About 45% of pregnant women experience some form of pelvic girdle pain, making it one of the most common pregnancy-related complaints, though it can also affect people outside of pregnancy.
The Three Main Pain Sites
The pelvis is a ring of bone held together by joints and ligaments. Pelvic girdle pain tends to center on three key areas within that ring. The first and most frequently reported site is the sacroiliac joint, where the base of the spine meets the back of the pelvis on each side. Pain here is felt deep in the buttock area, below and to the side of the lower spine. Patients often describe it as a stabbing sensation or a catching feeling, distinct from the dull ache of typical low back pain.
The second major site is the symphysis pubis, the joint at the very front of the pelvis where the two halves of the pelvic bone meet. Tenderness here can feel like a deep bruise right over the pubic bone, and it often flares with any movement that forces the legs apart or shifts weight unevenly.
The third site is the groin, where the inner thigh meets the lower abdomen. Pain here is common enough that some women initially mistake pelvic girdle pain for a groin strain. You can have pain at just one of these three sites or at all of them simultaneously.
Where the Pain Spreads
Pelvic girdle pain doesn’t always stay neatly at the joints. It commonly radiates outward into surrounding areas. From the sacroiliac joints, pain can spread across the buttocks and down the back of the thigh. From the symphysis, it can radiate into the lower abdomen, the perineum (the area between the genitals and the anus), and down the front or inner thigh. Research on referred pain patterns shows that when pelvic structures are pressed during examination, the groin and pubic regions light up most consistently. A smaller number of people also feel distinct pain traveling down one leg, though this is less common than the local pelvic symptoms.
The pelvic floor itself can also be a source of discomfort. Some people feel a heaviness or pressure deep inside the pelvis, separate from the sharper joint pain. This can make sitting for extended periods particularly uncomfortable.
How It Differs From Low Back Pain
Because pelvic girdle pain and lower back pain overlap in the same general neighborhood, they’re easy to confuse. The distinction matters because they respond to different approaches. Low back pain during pregnancy tends to produce a dull ache that worsens when you bend forward, and pressing on the muscles running along the spine makes it worse. Pelvic girdle pain, by contrast, is felt lower, closer to the buttock creases and the sacroiliac joints. It’s more likely to feel sharp or catching rather than broadly achy, and it tends to flare with movements that load one side of the pelvis at a time rather than with forward bending.
A clinician can usually distinguish between the two using specific provocation tests. One common test involves lying on your back while the examiner pushes your bent knee toward the opposite shoulder. If that reproduces the familiar pain deep in the buttock, it points to the sacroiliac joint. Tenderness when pressing directly on the pubic bone, or pain when standing on one leg, points to the symphysis. These tests are straightforward and don’t require imaging.
Movements That Make It Worse
Pelvic girdle pain is activity-dependent, meaning it’s often tolerable at rest and flares with specific movements. The biggest triggers are activities that force asymmetric loading on the pelvis: climbing stairs, getting in and out of a car, rolling over in bed, standing on one leg to get dressed, and walking for longer distances. Even turning over under the covers at night can produce a sharp jolt at the pubic bone or sacroiliac joint.
Among pregnant women with pelvic girdle pain, more than half report moderate activity limitations, and about 13% experience severe restrictions that affect basic daily tasks like getting out of a chair or bending down. The pain tends to build over the course of the day, especially with prolonged standing or walking, and then ease with rest.
Timeline and Recovery
During pregnancy, about 25% of women develop pain serious enough to interfere with daily life, and roughly 8% experience severe disability. The reassuring news is that in 93% of cases studied, pelvic girdle pain resolves on its own within three months after delivery. The remaining 7% who don’t recover in that window are at higher risk for prolonged symptoms. Among those who still have some lumbopelvic discomfort postpartum, 80% describe it as mild.
For pain that persists, a physiotherapist experienced with pelvic conditions can help with targeted strengthening of the muscles that stabilize the pelvic ring. Support belts worn low across the hips can also reduce symptoms by compressing the sacroiliac joints. The goal of management is usually to modify activities that provoke pain (keeping knees together when rolling in bed, taking stairs one step at a time) while maintaining as much normal movement as possible.
Recognizing the Pattern
If you’re trying to figure out whether what you’re feeling is pelvic girdle pain, the clearest signal is location plus trigger. Pain that sits at or below the beltline, centers on the back of the pelvis or the pubic bone, radiates into the groin or thighs, and worsens with one-legged activities fits the pattern. Pain that’s higher up the back, worsens with forward bending, and doesn’t change with single-leg loading is more likely to be lumbar in origin. Many people have both simultaneously, which can make sorting them out more difficult without a hands-on assessment.