Chiropractic
Pregnancy-related back and pelvic pain
Pelvic girdle pain, low back pain and sciatica in pregnancy — what causes them, what treatment involves, and which practitioner usually leads.
Back and pelvic pain in pregnancy is common enough to be treated as normal and dismissed as inevitable. It is neither. It is a mechanical problem with mechanical causes, and it usually responds to being assessed properly rather than waited out.
Roughly half of pregnancies involve significant back or pelvic pain at some point, and for a proportion of those it is limiting rather than merely uncomfortable — affecting sleep, walking distance, and the ability to keep working.
The three presentations
They overlap, and the assessment separates them because they are managed differently.
| Where it is felt | What provokes it | |
|---|---|---|
| Pelvic girdle pain | Pubic bone at the front, one or both dimples at the back | Single-leg loading — stairs, rolling in bed, getting out of a car |
| Low back pain | Across the lower back, sometimes into the buttock | Sustained postures, bending, end of the day |
| Sciatica | Down the leg, past the knee, often with pins and needles | Sitting, sometimes coughing or sneezing |
Pelvic girdle pain is the one most often mislabelled. People describe grinding, clicking, or a deep ache that makes them plan their movements around it, and are frequently told it is “just the ligaments”. The ligaments are part of it; what changes it is how the pelvis is loaded.
Why it happens
Three things at once, and no single one of them explains it.
- Load. The weight sits forward of the spine and increases over months, changing where the centre of mass sits and what the muscles have to do to hold it.
- Ligament laxity. Hormonal changes increase the give in ligaments across the whole body, so joints that relied on passive stability need more active support.
- Movement patterns. As the shape changes, the way you stand, walk and get up changes with it, often into a pattern that loads one side more than the other.
That is why treatment aimed only at the sore spot tends not to hold. What tends to help is a combination: settling the irritated joint, giving the muscles around it something to do, and changing the two or three daily movements that are reloading it — how you get out of bed, how you get out of a car, whether you are standing on one leg to dress.
When to seek urgent care
Pregnancy has its own set of symptoms that need obstetric assessment rather than an appointment here. Contact your maternity provider or go to your hospital’s maternity assessment unit now if you have:
- Vaginal bleeding, or any fluid loss
- Regular tightening or contractions before 37 weeks
- Reduced, absent or changed fetal movements
- A severe headache, visual disturbance, or sudden swelling of the face or hands
- Fever, or pain with burning on urination
- Rhythmic low back pain that comes and goes in a pattern, which can be labour
That is not a reason to leave ordinary mechanical pain alone. It is the reason the assessment starts with questions before anything else.
What treatment involves
Assessment establishes which of the three presentations you have, which side, what provokes it, and whether anything above needs ruling out first.
Treatment is adapted for pregnancy throughout. That means side-lying positions with pregnancy pillows or a drop-piece table rather than anything that loads the abdomen, gentler joint techniques as the pregnancy progresses, and soft tissue work through the muscles that have been compensating. You will also be given the specific movement changes that stop the joint being reloaded the same way every day — usually two or three things rather than a printed sheet.
A pelvic support belt helps some people substantially and others not at all. It is worth trying one fitted properly before buying one, since a belt worn too high is the most common reason people conclude they do not work.
Nothing here replaces your maternity care. It sits alongside it.
Who you would see here
This is one of the clearer cases for a multidisciplinary clinic, because the useful answer is often more than one person.
| If the picture is | Who usually leads |
|---|---|
| Joint irritation, pelvic girdle pain, restricted movement | Chiropractic |
| Strength, pelvic floor and load capacity, and returning to exercise after birth | Physiotherapy |
| Muscular tension, sleep position, general discomfort late in pregnancy | Pregnancy massage |
| Nutrition, iron and energy through pregnancy | Naturopathy |
Moving between them here is a conversation down the corridor rather than a new referral and a new waiting list.
One of the naturopaths at Brunswick Health is also a registered midwife and Division 1 nurse, registered with AHPRA through the Nursing and Midwifery Board — which means the nutritional side of a pregnancy can be discussed by someone who has worked the clinical side of one.
After the birth
Most pregnancy-related pelvic and back pain eases substantially in the weeks after birth as load and hormonal changes settle. Some does not, particularly where it was significant late in the pregnancy — and that responds to the same assessment-led approach afterwards.
If pain is still limiting you months on, it is worth having looked at rather than waiting it out. Carrying, feeding positions and broken sleep are their own load, and they are the part nobody warns you about.
Related reading: low back pain, sciatica, and mid-back and rib pain, which becomes common in the third trimester as the ribcage expands.