If you feel pain around your hips or pelvis during pregnancy, you may wonder what is causing it. Is it pregnancy-related pelvic girdle pain (PGP), or is it hip bursitis? Both can cause sharp or aching pain, but they affect different parts of your body and need different care.
Pregnancy-related pelvic girdle pain usually causes pain in the front or back of your pelvis, while hip bursitis causes pain on the outer side of your hip that gets worse when you press on it or lie on it. When you know where the pain starts and what makes it worse, you can spot the difference more clearly.
Understanding these signs helps you take the right steps early. When you know what your body is telling you, you can seek proper treatment and protect your comfort during pregnancy.
Key Takeaways
- Pelvic girdle pain and hip bursitis affect different areas of your hip and pelvis.
- The location of your pain and what triggers it help you tell them apart.
- Early care and proper diagnosis support better comfort and recovery.
Understanding Pregnancy-Related Pelvic Girdle Pain
Pregnancy-related pelvic girdle pain (PGP) affects the joints and ligaments that support your pelvis. It often causes pain in the front or back of your pelvis and can limit how you move during pregnancy and, at times, after birth.
Definition and Epidemiology
Pelvic girdle pain (PGP) refers to pain that comes from the joints that form your pelvic ring. These include the sacroiliac joints at the back and the symphysis pubis joint at the front. In the past, many people called this condition symphysis pubis dysfunction (SPD), but PGP is now the preferred term.
You may feel pain in the front of your pelvis, your lower back, hips, groin, or thighs. The pain can affect one or both sacroiliac joints and may overlap with lumbar spine dysfunction.
PGP is common. According to the Royal College of Obstetricians and Gynaecologists, about 1 in 5 pregnant women experience pelvic girdle pain and pregnancy. For most women, symptoms improve after delivery, but some continue to have postpartum pelvic girdle pain for weeks or months.
Common Causes During Pregnancy
During pregnancy, your body releases hormones that loosen ligaments. This change prepares your pelvis for birth but can also reduce joint stability.
As your baby grows, your center of gravity shifts forward. You may lean back more when you stand or walk. This posture increases stress on the sacroiliac joints and the symphysis pubis.
Weak or strained muscles around your abdomen, pelvic floor, and lower back can also play a role. When these muscles do not support your pelvis well, joint movement may increase and trigger pregnancy-related lumbopelvic pain.
You are more likely to develop symptoms if you stand on one leg often, climb stairs frequently, or twist your body while carrying weight.
Symptoms and Clinical Presentation
Symptoms of pelvic girdle pain vary, but most women describe a deep, aching pain. You may feel it:
- In the front of your pelvis near the pubic bone
- In one or both sacroiliac joints
- In your lower back, hips, groin, or inner thighs
Pain often gets worse when you walk, roll in bed, climb stairs, or stand on one leg. You may notice clicking or grinding at the front of your pelvis.
Some women struggle to turn over in bed or get out of a car. Others find that long periods of sitting or standing increase pelvic pain during pregnancy.
The NHS explains that pelvic pain in pregnancy can affect daily tasks and sleep. In most cases, pain improves after birth, but a small number of women continue to have symptoms in the postpartum period.
Risk Factors
Certain factors increase your risk of pelvic girdle pain in pregnancy.
You may be at higher risk if you:
- Had low back pain or pelvic pain before pregnancy
- Experienced PGP in a previous pregnancy
- Have physically demanding work
- Carry more than one baby
Poor core strength and limited pelvic stability can also contribute. If you already have lumbar spine dysfunction, you may notice more intense pregnancy-related pelvic pain.
PGP does not mean something is “wrong” with your pelvis. It reflects how your body responds to pregnancy changes. Early assessment and targeted exercises can reduce strain and help you stay active.
Distinguishing Pelvic Girdle Pain from Hip Bursitis
You can tell these conditions apart by looking at where you feel pain, how it behaves, and which movements make it worse. Pelvic girdle pain involves joints in your pelvis, while hip bursitis affects soft tissue on the outer hip.
Key Differences in Symptoms
Pelvic girdle pain (PGP) often causes pain in the front or back of your pelvis. You may feel it near your pubic bone, lower back, buttocks, or deep in the hips. Many people link it to the sacroiliac joint or to symphysis pubis dysfunction.
The pain often feels sharp with movement. You may notice it when you:
- Turn in bed
- Climb stairs
- Stand on one leg
- Get in or out of a car
PGP is common in pregnancy. About 1 in 5 pregnant women report symptoms, according to the RCOG overview of pelvic girdle pain and pregnancy.
Hip bursitis, by contrast, causes pain on the outside of your hip. The pain may spread down your outer thigh. It often feels worse when you lie on that side or press on the bony part of your hip.
Anatomical Locations of Pain
With pelvic girdle pain, the problem sits in the pelvic ring, a group of joints at the base of your spine. This includes:
- The sacroiliac joints at the back
- The symphysis pubis joint at the front
You may feel pain on one or both sides. Some women describe deep buttock pain near the sacroiliac joint. Others feel aching or stabbing pain just below the belly at the pubic bone. The CUH guide to pelvic girdle pain in pregnancy explains that pain can occur in the front, back, or both areas of the pelvis.
Hip bursitis affects a small fluid-filled sac over the outer hip bone. You can often point to one sore spot. Pressing on that area usually increases pain. PGP pain is deeper and harder to pinpoint with one finger.
Common Misconceptions
Many people assume all hip pain during pregnancy comes from the hip joint itself. In reality, pelvic girdle pain often mimics hip pain because the pelvis and hips work together.
You might also hear the term symphysis pubis dysfunction (SPD). This older name refers to pain at the front of the pelvis, but doctors now group it under pelvic girdle pain.
Another common mistake is thinking rest alone will fix either problem. Hip bursitis may improve with rest and reduced pressure on the outer hip. Pelvic girdle pain, however, often needs targeted exercises and joint support because it involves the sacroiliac joint or pubic joint rather than soft tissue alone.
Clear diagnosis matters. The treatment plan depends on whether your pain starts in pelvic joints or in a bursa on the outer hip.
Diagnosis of Pelvic Girdle Pain and Hip Bursitis
Your clinician uses a focused history, hands-on tests, and simple questionnaires to tell pelvic girdle pain (PGP) from hip bursitis. Each condition shows a different pain pattern and responds to different movement tests.
Clinical Assessment Methods
Your provider starts by asking where you feel pain and what triggers it.
PGP often causes pain between the back of your pelvis and the buttock fold, near the sacroiliac joints. It may also affect the front of your pelvis at the pubic joint. Hip bursitis usually causes pain on the outer side of your hip that worsens when you lie on that side.
During the exam, your clinician uses specific provocation tests:
- Posterior pelvic pain provocation test (P4 test) to stress the sacroiliac joint
- Active Straight Leg Raise (ASLR) test to check load transfer through your pelvis
- FABER test (Flexion, ABduction, External Rotation) to assess hip joint pain
Pain with ASLR that improves when the pelvis is supported points toward PGP. Sharp pain over the greater trochanter with direct pressure supports hip bursitis.
For a detailed definition of PGP and its pain location, see this description from the Standards of Care: Pelvic Girdle Pain – Brigham and Women’s Hospital.
Differential Diagnosis Strategies
You need a clear plan to rule out other causes of pelvic and hip pain.
PGP can overlap with low back pain, hip joint problems, or pelvic floor dysfunction. In pregnancy, clinicians must also rule out lumbar disc issues and nerve irritation.
Hip bursitis, often called greater trochanteric pain syndrome, can mimic hip arthritis or tendon injuries. Your clinician checks for:
- Local tenderness over the outer hip
- Pain with resisted hip abduction
- Pain when lying on the affected side
For pregnancy-related cases, clinicians follow guidance outlined in the European guidelines for the diagnosis and treatment of pelvic girdle pain available through NCBI. These guidelines stress careful physical testing rather than relying only on imaging.
Imaging such as ultrasound or MRI is rarely needed unless symptoms are severe, persistent, or unusual.
Relevant Tests and Questionnaires
You may complete a validated questionnaire to measure how much pain affects your daily life.
The Pelvic Girdle Questionnaire (PGQ) is designed specifically for PGP. It asks about pain intensity and difficulty with activities like walking, standing, and turning in bed. Higher scores show greater disability.
Clinicians also use pain scales and functional tests such as repeated ASLR to track progress over time.
For pregnancy-related PGP, patient education materials such as those from the Royal Women’s Hospital on pregnancy-related pelvic girdle pain explain common symptoms and when to seek care.
Hip bursitis does not have a condition-specific questionnaire like the PGQ. Instead, providers track pain location, tenderness, and response to treatment to confirm the diagnosis.
Managing Pregnancy-Related Pelvic Girdle Pain
You can reduce pain and protect your joints with targeted exercise, proper support, and small daily changes. Focus on steady movement, joint stability, and habits that limit strain on your pelvis.
Exercise and Physical Therapy
You should stay active, but choose controlled movements that improve stability. A women’s health physical therapy program can assess joint motion, muscle strength, and signs of pelvic floor dysfunction.
Common exercises for pelvic girdle pain include:
- Pelvic tilts while lying on your back with knees bent
- Gentle bridges with both feet flat and hips level
- Clamshells to strengthen outer hip muscles
- Modified squats with feet hip-width apart
These exercises target your glutes, deep core muscles, and pelvic floor. Strong support muscles reduce stress on the sacroiliac joints and pubic joint.
Avoid uneven weight-bearing movements such as lunges, deep single-leg squats, or wide-leg stretches. If pain increases during or after exercise, stop and adjust the activity. A physical therapist can teach you how to move in and out of bed, stand on one leg safely, and activate your pelvic floor without straining.
Pain Relief and Support Devices
You can manage pelvic girdle pain with simple tools that stabilize the pelvis. A pelvic support belt wraps around your hips and applies gentle compression. This support can reduce joint motion and ease pain during walking or standing.
Wear the belt low around your hips, not across your abdomen. Use it during activities that trigger pain, such as grocery shopping or long walks.
Other options include:
- Warm compresses on the lower back or pubic area
- Cold packs for short periods if swelling or sharp pain occurs
- Sleeping with a pillow between your knees
Some providers may suggest acetaminophen if needed, but always confirm medication safety with your prenatal care provider. Avoid self-adjusting your pelvis or seeking forceful manipulation without medical guidance.
Lifestyle Modifications for Relief
You can lower daily strain by changing how you move. Keep your knees together when getting out of bed or a car. Sit down to put on pants or shoes.
Stand evenly on both feet instead of shifting your weight to one side. Take smaller steps when walking and avoid high-impact activity.
Plan your day to limit repeated stair climbing or heavy lifting. If you must carry items, divide the load into smaller bags.
Good posture matters. Keep your back straight, shoulders relaxed, and avoid arching your lower spine. These small changes play a key role in managing pelvic girdle pain and preventing flare-ups as your pregnancy progresses.
Prevention and Early Intervention Strategies
You can lower your risk of ongoing pain when you act early and use the right support. Clear education, team-based care, and close follow-up after birth all play a direct role in recovery.
Education and Awareness During Pregnancy
You benefit most when you learn the early signs of pregnancy-related pelvic pain. Pelvic girdle pain often starts in the lower back, buttocks, or pubic bone. Many clinical guides stress that early assessment improves management, as noted in guidance on pregnancy-related pelvic girdle pain.
Report pain that affects walking, turning in bed, or climbing stairs. Do not ignore sharp pain at the front of the pelvis or pain that spreads to the groin.
Focus on daily habits that reduce strain:
- Keep your knees together when getting in and out of a car
- Sit to get dressed
- Avoid standing on one leg
- Use small steps instead of wide movements
Targeted exercise can help prevent or reduce symptoms. Research on exercise for prevention and treatment of low back and pelvic girdle pain supports strengthening, posture training, and education as part of care.
Role of Multidisciplinary Care
You often need more than one provider to manage symptoms well. A team may include your obstetric provider, a physical therapist, and sometimes a pain specialist.
Pregnancy-related pelvic girdle pain affects about 1 in 5 pregnant women, and early treatment improves outcomes, as described in this NHS leaflet on pregnancy related pelvic girdle pain (PGP). Early referral to physical therapy helps you learn safe movement patterns and specific strengthening exercises.
Your care plan may include:
- Pelvic support belts
- Manual therapy
- Targeted gluteal and core exercises
- Advice on sleep positions
Coordinated care also reduces the risk of long-term disability. When providers communicate clearly, you avoid mixed advice and unsafe activity.
Long-Term Outlook and Postpartum Considerations
Most women improve after delivery, but some continue to feel pain during the postpartum period. Postpartum pelvic girdle pain can persist if muscles remain weak or joint strain continues.
Monitor symptoms in the first 12 weeks after birth. Seek follow-up care if you have ongoing pain with lifting, carrying your baby, or walking.
During the postpartum period, focus on:
- Gradual return to exercise
- Pelvic floor and deep abdominal strengthening
- Avoiding high-impact activity too soon
If pain lasts beyond a few months, ask for reassessment. Early postpartum treatment lowers the risk that pregnancy-related pelvic pain becomes a chronic condition.
When to Seek Professional Help
You should not ignore severe pain, nerve symptoms, or sudden changes in how you move. Early care from the right provider, including women’s health physical therapy, can reduce pain and prevent long-term problems.
Warning Signs and Complications
Contact your provider if your pain becomes sharp, constant, or severe, or if it limits your ability to walk, climb stairs, or turn in bed. Pain that wakes you at night or does not improve with rest also needs medical review.
Seek urgent care if you notice:
- Numbness or weakness in one or both legs
- Loss of bladder or bowel control
- Fever with pelvic or hip pain
- Sudden swelling, redness, or warmth in the calf
These signs may point to nerve issues, infection, or a blood clot. They are not typical for pregnancy-related pelvic girdle pain or hip bursitis.
You should also speak up if pain affects your mood, sleep, or daily tasks. Ongoing strain can slow recovery and increase muscle tension, which may worsen both PGP and hip bursitis.
Referral Pathways
Start with your OB-GYN, midwife, or primary care provider. They can assess your symptoms and rule out serious causes.
If PGP is likely, ask for a referral to women’s health physical therapy. A therapist trained in pelvic care can assess your sacroiliac joints, pubic symphysis, core strength, and movement patterns. They will guide you through safe exercises, pelvic support options, and daily movement changes.
If your pain sits on the outer hip and worsens when you lie on that side, your provider may refer you to an orthopedic specialist. Imaging such as ultrasound or MRI may help confirm hip bursitis when symptoms do not improve.
Early referral improves function and lowers the risk of chronic pain after pregnancy.
Frequently Asked Questions
Pelvic girdle pain and hip bursitis can feel similar, but they affect different joints and tissues. You can often tell them apart by the pain pattern, triggers, exam findings, and response to specific movements.
What symptoms help distinguish pelvic girdle pain in pregnancy from hip bursitis?
Pelvic girdle pain (PGP) usually starts during pregnancy and affects the joints that connect your spine to your pelvis. It may involve the sacroiliac joints in the back or the pubic joint in the front. About 1 in 5 pregnant women report this type of pain, as noted in this overview of pelvic girdle pain and pregnancy.
You may feel sharp or aching pain that spreads to your lower back, groin, hips, or thighs. Some women notice clicking or grinding in the pelvic area.
Hip bursitis, often called trochanteric bursitis, causes pain on the outer side of your hip. The pain feels tender to touch and may burn or ache along the outer thigh. It does not usually involve the front pubic bone.
Where is the pain typically located for pelvic girdle pain versus hip bursitis?
PGP often causes pain deep in your pelvis. You may feel it:
- At the front, just below your belly, near the pubic bone
- On one or both sides of your lower back
- In the buttocks or groin
Pain in these areas is common in pregnancy-related PGP, including pain in the hips and sacroiliac joints as described by CUH’s guide to pelvic girdle pain in pregnancy.
Hip bursitis causes pain on the outside of your hip, over the bony point you can feel at your side. The pain may travel down the outer thigh but rarely moves into the groin or pubic area.
Which movements or activities tend to worsen pelvic girdle pain compared with hip bursitis?
PGP often worsens when you:
- Walk for long periods
- Climb stairs
- Turn over in bed
- Stand on one leg to dress
These movements load one side of your pelvis and stress the pelvic joints.
Hip bursitis pain often worsens when you lie on the affected side. It can also flare with long walks, climbing stairs, or standing from a seated position. Direct pressure on the outer hip usually makes bursitis pain sharper.
What self-checks or clinical tests are commonly used to differentiate pelvic girdle pain from hip bursitis?
Clinicians often use pain provocation tests for PGP. These tests stress the sacroiliac joints or the pubic joint in a controlled way. Pain during these maneuvers supports a diagnosis of pregnancy-related pelvic girdle pain, which is described in detail by the NHS overview of pelvic pain in pregnancy.
For hip bursitis, your clinician may press directly over the outer hip. Local tenderness over the greater trochanter strongly suggests bursitis.
They may also test hip range of motion. Pain with side-lying pressure or resisted hip abduction points more toward bursitis than PGP.
When should persistent hip or pelvic pain in pregnancy prompt medical evaluation or imaging?
You should seek medical care if your pain:
- Is severe or worsening
- Limits your ability to walk
- Causes numbness, weakness, or fever
- Does not improve with rest and simple measures
Most PGP cases are diagnosed by history and exam. Early assessment helps manage symptoms, as noted in this leaflet on pregnancy related pelvic girdle pain (PGP).
Imaging is not routine for typical PGP. Your clinician may consider ultrasound or MRI if symptoms suggest another cause, such as a stress fracture or severe bursitis that does not improve.
What treatment approaches differ between pelvic girdle pain during pregnancy and hip bursitis?
PGP treatment focuses on stabilizing your pelvis. You may benefit from:
- Physiotherapy with targeted pelvic exercises
- A pelvic support belt
- Advice on posture and safe movement
Many guidelines suggest staying active within pain limits and strengthening core and pelvic floor muscles, as outlined by Pregnancy Birth and Baby on pelvic pain during pregnancy.
Hip bursitis treatment targets inflammation of the bursa. Care may include activity changes, ice, physical therapy for hip muscles, and in some cases, corticosteroid injections.
During pregnancy, your clinician will adjust any medication plan to protect you and your baby.
