Why Does My Pelvis Hurt When I Walk or Roll Over During Pregnancy?

Pelvis pain when you walk or roll over during pregnancy is often pelvic girdle pain, which comes from the joints at the front and back of the pelvis becoming irritated as they loosen and carry more load. It tends to be sharpest with steps, stairs, turning in bed, and standing on one leg. It usually is not dangerous to the baby, but it needs prompt evaluation when it comes with bleeding, fever, regular tightenings, one swollen leg, or trouble breathing. This article covers causes, what may help, and when to get checked.

Why Your Pelvis Hurts When You Walk or Roll Over in Pregnancy

Pelvic girdle pain is a name for pain around the joints of the pelvis during pregnancy. The pelvis is a ring made of bones joined at the front, where the two pubic bones meet at the pubic symphysis, and at the back, where the sacrum meets the hip bones at the sacroiliac joints. These joints normally move only a little. In pregnancy, several factors may change that, and the exact mechanism is not fully understood.

Hormonal loosening of the ligaments that hold the pelvis together is one proposed contributor, and it may allow more movement than usual, though the cause is not fully understood. Your growing uterus shifts your center of gravity, your posture changes, and your weight rises. If the two sides of the pelvis share load unevenly, the joints and nearby muscles can become irritated. Previous back or pelvic injuries, a physically demanding job, and earlier pregnancies are sometimes associated with more pain, though many people with none of these still develop it.

Walking and rolling over are common triggers because both move one side of the pelvis relative to the other. Each step loads one leg at a time. Turning in bed twists the pelvis while the joints are under strain from the weight of your legs.

What Pelvic Girdle Pain Can Feel Like

People describe it in different ways, and where you feel it can offer clues:

• Front of the pelvis: a deep ache or sharp pain over the pubic bone, sometimes spreading to the groin or inner thighs.
• Lower back, one or both sides: pain just below the waistband, often near the dimples above the buttocks, sometimes spreading into the buttock or the back of the thigh.
• A clicking, grinding or catching feeling in the pelvis with movement.
• Pain with specific movements: climbing stairs, getting in and out of a car, putting on pants while standing, standing on one leg, spreading the knees, or turning over in bed.

The pain can start at any point in pregnancy, but it often becomes more noticeable as the baby grows. It may ease with rest and return with activity. Some people also notice that it is worse at the end of the day or after a long walk. Pain that changes with position and movement is a pattern clinicians associate with the musculoskeletal system, though that alone does not rule out other causes.

Pelvic girdle pain can overlap with ordinary pregnancy back pain. MedlinePlus (NIH) describes back pain as a common condition with many possible causes, so describing exactly where your pain sits and what triggers it can help your clinician sort it out.

How Clinicians Sort Out the Cause

There is no single test that confirms pelvic girdle pain. Clinicians combine your history, an examination and, when needed, other testing. They may ask where the pain is, what movements set it off, and whether it affects your sleep or walking. During an exam they may press on the pelvic joints or ask you to move your legs in set positions to see which movements reproduce the pain. A physical therapist who treats pregnancy-related pain can also assess how your hips, back and pelvic muscles are working together.

Imaging is not usually the first step. If a clinician is concerned about another problem, such as a fracture or a joint problem, they will decide which test is appropriate during pregnancy. MedlinePlus (NIH) explains what MRI scans are and how they work, which can help you understand a test if one is suggested. Tell your clinician you are pregnant before any imaging, so they can choose with that in mind.

Other Causes of Pelvic Pain to Keep in Mind

Not all pelvic pain is pelvic girdle pain, and the pattern matters. Pain that comes and goes in waves, tightens the belly and grows more regular can be a sign of contractions. Contractions before the end of pregnancy need prompt evaluation. Brief, sharp pain on one side or in the groin when you stand up or change position is often related to the stretching ligaments that support the uterus; our article on round ligament pain covers that in detail.

Other possibilities include a urinary tract infection or kidney infection, which can cause pelvic or flank pain along with burning, urgency, fever or chills. A blood clot in a leg vein can cause pain in the groin, thigh or calf with swelling on one side. Pain in the upper right abdomen, especially with a severe headache or vision changes, can be linked to preeclampsia and needs urgent evaluation. Pelvic pain with vaginal bleeding also needs attention; MedlinePlus (NIH) has information about vaginal bleeding and when to seek care. In early pregnancy, pain with bleeding can sometimes come from an ectopic pregnancy, one that implants outside the uterus, and in later pregnancy it can be linked to a problem with the placenta. These conditions are less common than ordinary musculoskeletal pelvic pain, and pain alone does not establish any of them, but they are why new or unusual features are worth describing to your care team.

Rolling Over and Sleeping With Pelvic Pain

Turning in bed is often the hardest movement, so a few adjustments may help. These are general comfort measures, and your clinician or physical therapist can tailor them to you.

• Keep your knees together and move as one unit. Squeezing your knees together as you roll can reduce the sideways pull on the pelvic joints. Some people find it easier to roll with their arms crossed over the chest.
• Place a pillow between your knees when you lie on your side, and consider a second one under your belly. This can help keep the hips lined up.
• Use a smooth surface. Satin sheets or pajamas can make turning take less effort.
• Get in and out of bed carefully. Sit on the edge, lower yourself onto your side, then bring your legs up together. Reverse the steps to get up.

Sleep position in later pregnancy is a separate question; our article on sleeping on your back or stomach while pregnant covers what to know about positions.

Everyday Habits That May Ease Walking Pain

Many people find that small changes in how they move reduce flare-ups. Outcomes vary, and these steps may reduce pain without removing it.

• Take smaller steps and avoid wide strides. Walking at a comfortable pace may be easier than a long, brisk walk.
• Avoid standing on one leg. Sit down to dress, put on shoes and get into pants or underwear.
• Take stairs one at a time, leading with the same foot, and use the handrail.
• Keep your legs together when getting in and out of a car. Some people sit first and then swing both legs in together.
• Avoid carrying heavy loads on one side, and avoid twisting while lifting.
• Avoid sitting crossed-legged or standing with your weight on one hip if that sets off your pain.
• Break up long periods of standing or sitting, and rest when the pain climbs.

Posture also plays a part. MedlinePlus (NIH) offers a guide to good posture that covers standing and sitting habits. Pregnancy changes your balance, so adapt any advice to what feels comfortable for you.

Exercise can still be appropriate for many people with pelvic pain, but the type matters. Ask your clinician which activities are suitable. Our article on exercise in the third trimester covers general safety. Swimming or water exercise is sometimes more comfortable than walking, though that varies from person to person.

Treatments to Ask Your Clinician About

If self-care does not help, tell your clinician how the pain affects your sleep, walking and daily tasks. They can decide which options are appropriate for you. These may include:

• Physical therapy with a therapist experienced in pregnancy, who may teach exercises for the muscles that support the pelvis and spine and help you adjust daily movements.
• A pelvic support belt, which some people find helpful and others do not. A clinician or physical therapist can advise whether one is appropriate and how to wear it.
• Heat or gentle massage, if your clinician agrees it is suitable for you.
• Walking aids, such as a cane or crutches, for severe pain that makes walking hard.

Be cautious with pain medicines. Do not start or change any medicine on your own. Federal drug safety guidance advises avoiding nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen from about 20 weeks of pregnancy onward unless a health care professional directs it, because they can cause fetal kidney problems and low amniotic fluid. Ask your prenatal clinician or pharmacist which pain relievers, including acetaminophen and topical products, are suitable for you, and read the label, before you take any.

Planning Ahead for Birth and Recovery

Tell your delivery team if you have significant pelvic pain. They can discuss comfortable positions for labor and ways to avoid pushing your legs far apart if that is painful for you. For many people, pelvic girdle pain improves in the weeks after delivery as the joints settle and hormone levels change, but the time it takes varies and some people have lingering symptoms. Tell your clinician if pain persists, worsens, or limits walking or caring for your baby, so they can reassess it and consider options such as physical therapy.

When Pelvic Pain Needs Prompt Attention

Most pelvic girdle pain is uncomfortable but not an emergency. The CDC's urgent maternal warning signs include severe headache, vision changes, chest pain, trouble breathing, heavy bleeding, fluid leaking from the vagina, severe belly pain, swelling of the face or hands, and a baby who moves less than usual. These can occur during pregnancy and after birth.

The emergency box below sorts these signs by urgency. In short, heavy bleeding, a seizure, chest pain, trouble breathing, or something visible in the vagina needs 911. New numbness in the groin or buttocks, or new loss of bladder or bowel control, needs the emergency room right now. Fluid leaking, regular tightening or pelvic pressure before 37 weeks, bleeding with belly pain, a noticeable drop in your baby's movements, or severe constant pain needs care right away at labor and delivery or the emergency room. Burning with urination, fever, one swollen leg without breathing symptoms, sudden face or hand swelling, or light painless spotting needs same-day contact with your care team. If you are unsure, contact your maternity care team and describe what you feel.

When to Seek Medical Care