Part of Pregnancy back and pelvic pain
Sciatica in pregnancy, or pelvic girdle pain? How to tell them apart
Warning signs, and when to get help
Is it sciatica in pregnancy, or pelvic girdle pain?
Start with what the word means. Sciatica is a description of a nerve being irritated or compressed, and the NHS puts it plainly: sciatica happens when something presses or rubs on the sciatic nerve, most commonly a slipped disc. It is not a word for leg pain in general, which is how it usually gets used.
That distinction matters in pregnancy because the pelvis is a far more frequent source of the same complaint. The European guideline's definition of pelvic girdle pain places it between the back of the pelvic rim and the buttock crease, particularly around the joints where the pelvis meets the base of the spine (the sacroiliac joints), and says the pain may radiate into the back of the thigh (Vleeming 2008). The RCOG lists hips, groin, thighs and knees among the places women feel it. So the buttock and thigh pain that sends somebody searching for sciatica stretches has an obvious alternative explanation sitting right there.
The 2024 systematic review on lumbar disc herniation in pregnancy is the other half of the argument. It states that back pain in pregnancy is common while pain from lumbar disc herniation in pregnancy is rare, describes symptomatic herniation in pregnancy as uncommon, and pulls together 41 studies, of which only 6 addressed incidence. One study from 1983 found 5 cases among 48,760 deliveries, which is about 1 in 10,000, and other figures in the review disagree with it widely. The authors rate the overall evidence as suboptimal and say it should be interpreted cautiously (Chan 2024). Treat all of that as a direction of travel, not a number to quote at anyone.
Which is more common in pregnancy?
Pelvic girdle pain, by a distance that is not really in dispute. The RCOG says it affects about 1 in 5 pregnant women, and POGP puts lower back and back-of-pelvis pain at about half of pregnant women. Against those figures, the disc numbers above sit in a different order of magnitude altogether.
There is a quieter point in the same review that is worth having. MRI studies it collected found no significant predisposition to disc herniation during pregnancy, although women with herniations visible on MRI were more likely to report back pain (Chan 2024). In other words, pregnancy does not appear to be busy producing disc problems, which fits what you see in a clinic: plenty of pregnant women with pelvic and buttock pain, very few with a genuine nerve root problem.
None of this means your leg pain is pelvic. It means the odds sit there, and that a label arrived at from a symptom list on a phone deserves checking. The European guideline is explicit that a pelvic girdle pain diagnosis is reached after lumbar causes have been excluded, and excluding them is an examination, not a quiz.
Where each one hurts, and how far down the leg
The most useful single question is how far the pain travels. The NHS describes sciatica as pain in your bottom and the back of one leg, often including your foot and toes, with pins and needles, numbness and weakness alongside it. Pelvic girdle pain, as defined above, lives in the back of the pelvis, the buttock and often the pubic joint, and spreads into the back of the thigh at most.
A second question sorts a good number of cases: what makes it worse. POGP's list for pelvic girdle pain is walking, standing on one leg while dressing or on the stairs, moving the legs apart getting in and out of bed or the car, lying in certain positions, and intercourse. The European guideline adds that endurance for standing, walking and sitting drops. Nerve pain has a different relationship with movement, and is often there in some form whatever position you choose.
Third, where the sharp edge is. Pelvic girdle pain is commonly reproducible: the same movement brings the same jab, and it settles again when you stop. Pelvic girdle pain or contractions deals with the one pattern that overrides all of this, which is pain that comes and goes in a rhythm.
Pelvic girdle pain that goes down your leg
This is the trap, and it catches more women than anything else in this comparison. Pain referred into the back of the thigh is part of the pelvic girdle pain definition, not a complication of it, and it does not mean the nerve is involved. Treating it as sciatica leads a woman toward nerve stretches and figure-four positions, which pull the legs apart and load one side of the pelvis, which is the opposite of what the pelvis wants.
What should change your reading is the company the thigh pain keeps. Pain that travels below the knee, numbness or pins and needles anywhere in the leg or foot, a foot that drags or slaps as you walk, or a leg that is losing strength are nerve findings, and they get assessed rather than stretched. Ask for that assessment within a few days rather than waiting for your next routine appointment. The NHS already asks you to contact your GP or midwife urgently about new back pain in the second or third trimester, and a leg symptom on top of that does not make it less urgent.
A leg or foot that is getting weaker sits on a same-day footing in the warning list at the foot of this page, and goes to an emergency department if the weakness is getting worse by the hour. Loss of feeling in a leg is an emergency: the NHS pregnancy back pain page tells you to call emergency services or go to an emergency department if back pain comes with losing feeling in one or both legs, your bottom or your genitals.
Pelvic girdle pain on one side is the pregnancy page for a pain that only ever happens on the left or the right, lower back pain on one side covers that pattern more generally, and sciatica pain when sitting is for a pain that is at its worst in a chair, which has its own short list of causes.
What helps either one
Here is the comfortable part of an uncomfortable question. The first line of treatment is close enough for either that you do not have to wait for the label to start looking after yourself.
Two patterns take the question out of this section altogether, and they come first because the rest of it is self-help. Numbness or altered feeling around your genitals or bottom, or a new change in peeing or pooing, goes to an emergency department or emergency services before anything else, ahead of a call to your maternity unit. A leg or foot that is getting weaker needs medical advice the same day, and an emergency department if it is worsening by the hour. Both are in the warning list at the foot of this page with their own routes. If either is happening, use that list rather than this section.
Keep moving within what the pain allows and pace it: POGP advises against trying to get all your daily jobs done in one go and against pushing through activities that make the pain worse, and suggests spreading tasks out with rest in between. Shoes earn their place here. The HSE recommends a running shoe or sneaker with a gentle arch support and a cushioned sole, which it calls a runner, and advises against slippers and bare feet. For sleep, use a pillow between your knees, turn slowly with your knees together, and get out of bed by rolling onto your side first, which the log roll page teaches. How to sleep with pelvic girdle pain sets out the full night-time arrangement, and what to avoid with pelvic girdle pain goes through the daytime jobs task by task.
For symptom relief, the HSE's conditions on heat are specific: tender areas such as the lower back, hips, bottom or between the legs, never directly on your bump, not at all in the first 12 weeks, wrapped in a towel, 20 minutes at most, and with the room ventilated and water nearby if you are having a bath. It also suggests easing tight muscles with a tennis or spiky ball against the bottom or lower back, not over the spine, holding until the pain eases, which can take around 30 seconds. For medicine, the NHS says paracetamol can be taken as directed unless your doctor or midwife has said otherwise, and the RCOG says it is safe in pregnancy and may help in regular doses.
Two things to know before you buy anything. The NHS's own sciatica page says paracetamol is unlikely to help sciatica, so if the pain really is coming from a nerve, expect little from it and take that back to your doctor rather than taking more. And ibuprofen and the other anti-inflammatory painkillers are a different question in pregnancy: the NHS says to avoid ibuprofen while you are pregnant unless a doctor or pharmacist has advised it, and that paracetamol is usually the best painkiller to take when you are pregnant.
Movement itself is where the pregnancy back and pelvic pain program comes in. It stays even-weighted and knees-together on purpose, and as a starting guide its gentle pelvic and back movements often begin at 5 to 10 slow repetitions once or more a day, with the strength work built up from there. Treat that as a ceiling rather than a day-one target: start with however few you can do without the pain rising, stop if an exercise brings pain on while you do it, and leave it out and say so if it brings on pain that is still there that evening or the next morning. Check with your midwife or doctor before you start. Your physio will adjust this, and the point of a referral is that somebody decides which parts suit your pelvis rather than you guessing.
POGP puts a timeframe on when to stop managing it alone: if symptoms do not improve within a week or two, or they interfere with your normal day to day life, ask for help from your midwife, GP or physiotherapist, and you should be seen by a specialist pelvic health physiotherapist. That applies whichever of the two this turns out to be. The RCOG lists what a physiotherapist may offer: advice on movements to avoid, exercises, hands-on treatment, heat or ice, hydrotherapy, acupuncture, and a support belt or crutches. If walking stirs it up, exercise in water supports your weight and takes pressure off the pelvic joints, and the WA Health physiotherapy guidance suggests walking forwards and backwards in the water or working at the pool edge, with a flutter or dolphin kick rather than a breaststroke frog kick.
The strokes the HSE names as helpful are front crawl and gentle walking in the water. Impact stays out while this is active, whichever of the two it turns out to be. The HSE's instruction for pelvic girdle pain is not to run or do any high-impact exercise, WA Health asks you to walk rather than run and step rather than jump, and POGP advises against taking up a new high-impact sport or exercise in pregnancy. Since the pelvis is the likelier source, that is the rule to work to until somebody has examined you, and when impact goes back in is a decision for your own physio.
If it does turn out to be a disc, what can be done while you are pregnant?
Being pregnant does not close off treatment, and that is worth saying plainly, because two wrong ideas circulate here: that nothing can be done until the baby arrives, and that an operation must be around the corner. Neither is right.
Where there are no red flag symptoms, and bladder and bowel trouble is the pair that matters most, the 2024 review's own recommendation is that treatment without surgery is tried first, and most of the women in it managed that way had their symptoms settle completely (Chan 2024). That is the group nearly everybody reading this falls into. One detail in the same review is worth having: none of the women managed without surgery had bladder or bowel symptoms at all. Those symptoms sat in the group that had an operation.
Surgery for a disc does happen during pregnancy where it is needed, including in the second and third trimesters, and the review found no clear link to pregnancy complications among the cases it collected, with the caution that this is poor quality evidence from case reports and small series (Chan 2024). The commonest operation was a discectomy, which takes the pressure off the nerve, and the positioning on the table is adjusted for the pregnancy. It stays uncommon, and it is a decision made jointly by your obstetric team and a spinal surgeon rather than something you arrange. The review's other point belongs here too: diagnosing and treating a disc herniation promptly gives better outcomes and guards against lasting nerve damage (Chan 2024). That is the case for having leg symptoms looked at now rather than waiting out the pregnancy.
Leg symptoms that change the answer
Some symptoms take the question out of the physiotherapy field entirely, and the warning list at the foot of this page gives each one its own timeframe. Three are worth naming here, because they are the ones people talk themselves out of.
Numbness or altered feeling around your genitals, between your inner thighs or around your bottom is an emergency, as is new trouble starting to pee, not being able to pee, or losing control of your bladder or bowels. The NHS says the same on its own sciatica page and on its pregnancy back pain page, which sends a reader with loss of feeling in the legs, bottom or genitals straight to emergency services or an emergency department. Symptoms in both legs, or losing feeling in one leg, go the same way.
Pregnancy is the reason this one gets missed. Your bladder already behaves differently when you are pregnant, so a change there is the easiest thing in the world to put down to the baby, and that is how these cases get lost. Use the test the NHS wording itself uses: it is new, and it is not normal for you. Needing to pee more often is not what the warning is about. Finding that you cannot start, cannot pee at all, cannot feel yourself peeing, cannot control when you pee, or do not notice when you need to poo, is.
A bladder that has stopped emptying can be painless, and in reviews of these cases the delay often begins with someone who had not passed urine for several hours, was not alarmed by it and so said nothing until the damage was done (Gardner 2011). If that is you, the time to act is now, not after a night of seeing whether it settles.
The route matters as much as the timing. This is the one set of symptoms where an emergency department, or emergency services, comes before a call to your maternity unit. Say that you have back or leg pain along with numbness around your genitals or bottom, or a change in peeing, and that you have been told these can be cauda equina symptoms.
What the hospital needs to do is scan your lower back urgently, which means an MRI, a scan that is used in pregnancy too, and if it shows pressure on that bundle of nerves, relieve the pressure with an operation (Gardner 2011; Chan 2024). Caught while the bladder is still working, the outlook is better, and that is the entire reason for the speed (Gardner 2011). Tell your midwife or maternity unit as well, but do not wait for them to call you back first, and do not drive yourself: the NHS asks you to get someone else to drive you or to call for an ambulance, and to bring any medicines you take with you. Take your maternity notes as well.
There is a reason this list is unusually firm in pregnancy: in the 2024 review, among 79 women treated for symptomatic disc herniation, 23 of them, 29 percent, presented with cauda equina symptoms in the form of urinary retention (Chan 2024). Two things to hold alongside that number. It comes from a group already selected for treatment, mostly through case reports, so it is not a risk figure for you. And 28 of the 79 had no presenting symptoms recorded at all, so the share itself is uncertain in both directions. What it does show is what the rare serious version of this looks like when it turns up.
A weakening leg or foot is the second. A foot that drags, catches or slaps down when you walk needs medical advice the same day, and an emergency department if it is getting worse by the hour.
The third is not a nerve at all. One-sided hip or groin pain that is worse putting weight on that leg, that makes you limp or reach for a crutch, and that is not easing with position changes and pacing, earns a review within a few days and the specific words that the pain is in your hip rather than only your pelvis. Pregnancy can cause a temporary weakening of the bone at the top of the thighbone, which is uncommon and is routinely read as pelvic girdle pain for weeks (Morton 2024).
For the non-pregnant version of the urgent end of all this, when sciatica needs urgent care goes through it in more detail, and sleeping with sciatica covers nights. Both are written for readers who are not pregnant, so take the pregnancy-specific advice on this page and in the program first where the two differ.
Related exercise programs
Warning signs
Get emergency help now
- Emergency: anything that looks life threatening, at any stage of pregnancy. Call emergency services without stopping to work out which line below fits: 999 in the UK, 112 in the UK and anywhere in Europe, 911 in the United States and Canada, 000 in Australia, 111 in New Zealand. Say how many weeks pregnant you are, and say it again to each new person you speak to (NHS).
- Emergency: numbness, tingling or altered feeling around or under your genitals, between your inner thighs, or around your bottom (anus), for example it feels different when you wipe after using the toilet. Call emergency services or go to an emergency department straight away. This can be a sign of pressure on the bundle of nerves at the base of the spine (cauda equina syndrome), which needs emergency treatment.
- Emergency: you find it hard to start peeing, cannot pee, cannot feel yourself peeing or cannot control when you pee, or you do not notice when you need to poo or cannot control when you poo, and this is not normal for you. The same applies to a new change in how your genitals feel during sex, or new trouble getting an erection or ejaculating. Call emergency services or go to an emergency department straight away. These can also be signs of cauda equina syndrome.
- Emergency: sciatica in both legs, or pain, tingling, numbness or weakness in both legs. The same applies if you lose feeling in one leg. Call emergency services or go to an emergency department straight away.
- Emergency: heavy bleeding from your vagina, for example soaking a pad soon after you put it on, or any bleeding with severe pain in your tummy, pain in your shoulder, or feeling sick, faint or dizzy. Call emergency services straight away.
- Emergency: a very high or a very low temperature, shivering you cannot control, breathing very fast or finding it hard to breathe, being confused or slurring your speech, skin, lips or a tongue that look blue, gray, pale or blotchy (on brown or black skin this can be easier to see on the palms of the hands or soles of the feet), or a rash that does not fade when you press it. Call emergency services, as this can be sepsis.
- Emergency: you suddenly become short of breath, you get chest pain or pain in your upper back that may be worse when you breathe in, you cough up blood, your heart is beating very fast, or you faint. Call emergency services straight away, even if your leg looks normal. These can be signs of a blood clot in the lungs (pulmonary embolism).
- Emergency: you have had cancer, now or in the past, and your back or neck pain feels like a tight band around your body, or comes with pain spreading down an arm or leg, weakness, numbness or pins and needles in your arms or legs, trouble walking, or trouble controlling your bladder or bowels. Call your cancer team's emergency number straight away, or go to an emergency department if you do not have one or cannot get through. This can be cancer pressing on the spinal cord (metastatic spinal cord compression), which needs treatment straight away.
- Emergency: hip or groin pain on one side that suddenly becomes much worse, or a leg that will not take your weight at all. Go to an emergency department straight away, and say you are pregnant and that the top of the thighbone may be involved, because pregnancy can weaken the bone there and weakened bone can crack. Call emergency services if you cannot stand or walk at all, or cannot get there safely.
- Emergency: back or leg pain that started after a serious accident, such as a car crash or a fall from a height, or back pain with chest pain. Call emergency services. If the pain started straight after the accident, keep still while you wait.
- Emergency: pelvic or pubic pain that has suddenly left you unable to stand, walk or put weight on one or both legs. Call emergency services if you cannot stand or walk at all, or you cannot get to a hospital safely. Until help reaches you, stay where you are rather than trying to get yourself up: lie on your side with your knees together and a pillow between them, and do not stand on one leg or let your legs come apart.
- Emergency: pain in your lower tummy or pelvis that is severe, is getting worse, or hurts when you move or touch the area, or that comes with feeling faint, dizzy or lightheaded, passing out, pain at the tip of your shoulder, trouble breathing, heavy bleeding from the vagina, or sudden confusion. Call emergency services or go to an emergency department straight away. Tell them if there is any chance you are pregnant.
- Emergency: you have a lump in your groin and the pain in it is severe or came on suddenly, you cannot poo or pass wind at all, you are vomiting blood or your vomit looks like coffee grounds, or you have suddenly become confused. Call emergency services or go to an emergency department straight away, and do not try to push the lump back in yourself. A hernia that has become trapped can block the bowel or cut off the blood supply to whatever is caught in it (NHS).
- Emergency: you have thoughts of ending your life or of harming yourself or your baby and feel you might act on them, you have already harmed yourself, or you do not feel you can keep yourself or your baby safe. Call emergency services or go to an emergency department straight away.
Get help now, day or night
- Who to call for every line below that says to contact your midwife or maternity unit: call them straight away, day or night, on the number in your maternity notes. In the first 12 weeks, before your first midwife appointment, the NHS routes these calls to a GP surgery or an early pregnancy unit, and from 12 to 19 weeks to a midwife or an early pregnancy unit, so you do not need a maternity unit of your own yet to be seen. Outside the UK, call your obstetrician, or the maternity or labor and delivery unit where your birth is booked. If you cannot reach anyone and you are worried, call NHS 111 in the UK, and anywhere, go to your maternity unit or an emergency department rather than waiting at home (NHS).
- Any bleeding or spotting from your vagina, even if it is light and you have no pain. Contact your midwife or maternity unit straight away.
- Your waters break, or you have a gush or trickle of fluid from your vagina, at any stage of pregnancy. Contact your midwife or maternity unit straight away.
- Before 37 weeks, you have regular tightenings or contractions, period-type pains, or backache that is not usual for you. Contact your midwife or maternity unit straight away, as this can be a sign of early (premature) labor.
- New back pain in the second or third trimester (from 13 weeks), even if you think it is PGP or ordinary backache. Contact your midwife or maternity unit straight away, as it can be a sign of early labor. Once they have checked it, follow their advice about when to call again.
- Your baby is moving less than usual, you cannot feel your baby moving anymore, or the usual pattern of movements has changed. Contact your midwife or maternity unit straight away, even in the middle of the night. Do not wait until the next day, and do not use a home heartbeat monitor to check.
- A severe headache that does not go away with simple painkillers, problems with your vision such as blurring or flashing lights, pain just below your ribs, sudden swelling of your face, hands or feet, being sick (vomiting), heartburn that does not go away with heartburn medicines, or feeling very unwell. Contact your maternity unit straight away, as these can be signs of pre-eclampsia, which needs checking and treating quickly. The same applies to a headache after an epidural or spinal anesthetic that gets worse when you sit or stand up and eases when you lie down. Call emergency services if you have a fit (seizure), or a headache that came on suddenly and is very severe. Call emergency services too if you have a headache with a stiff neck and either a high temperature or bright light hurting your eyes, as this can be meningitis.
- Tummy pain that does not go away after you have rested for 30 to 60 minutes, or that comes with lower back pain, vaginal discharge that is unusual for you, regular cramping or tightenings, pain when you pee, or needing to pee suddenly or more often than usual (NHS). The same applies to back or pelvic pain that comes on suddenly, is getting worse quickly or is much worse than your usual pain. Contact your maternity unit straight away. Call emergency services if the tummy pain is severe, any pain comes with bleeding from your vagina, or tummy pain comes with pain in your shoulder or feeling sick, faint or dizzy.
- Back pain with a high temperature (38C or above), feeling hotter than usual or shivery, pain or burning when you pee, pee that looks cloudy, pink, red or brown, or pain in one or both sides of your back just under the ribs. Contact your midwife, maternity unit or doctor straight away, as this can be a urine or kidney infection, which is usually treated easily once someone has seen you (NHS). Call emergency services instead if you have any of the signs of sepsis in the emergency warnings above.
- A calf or thigh that is newly swollen or getting more swollen, warm, tender, red or darker than usual, has swollen veins that are sore to touch, or has a throbbing or cramping pain that does not fit your injury or condition, or that feels different from normal muscle soreness after exercise. This can be a sign of a blood clot (deep vein thrombosis), especially after surgery, an injury, time in a cast or boot, a long trip or a spell of being much less mobile than usual. Get medical advice the same day. If you are also short of breath or have chest pain, call emergency services. Pregnancy and the first 6 weeks after giving birth also make a clot more likely, so if you are pregnant or gave birth in the last 6 weeks, contact your maternity unit, midwife or GP straight away.
- You fall, or your bump is knocked or hit, for example in a car accident, even if you feel fine. Contact your maternity unit straight away so you and your baby can be checked.
- Pelvic or pubic pain that came on in a single moment, for example during the birth, a fall or a wide step, with a crack, pop or tearing feeling over your pubic bone. Contact your maternity unit straight away, and ask them to check the joint at the front of your pelvis. While you wait, keep off it rather than walking it off: lie on your side with your knees together and a pillow between them, get help to move if there is someone with you, and do not stand on one leg or let your legs come apart. If you cannot stand or walk at all, or you cannot get to a hospital safely, call emergency services. Separation of that joint (pubic symphysis diastasis) is uncommon, is not the same as the pelvic girdle pain this page is about, is confirmed on a scan rather than by how much it hurts, and is first treated with a pelvic support belt and side lying, so ask about a belt at that appointment (Stolarczyk 2021). Pain that has built up over days or weeks, even when it is severe, is the usual pattern of pelvic girdle pain.
- Lower tummy or pelvic pain and you are pregnant or think you might be. Contact your midwife or maternity unit straight away if you are pregnant, or get medical advice the same day if you might be. Pain low in the tummy early in pregnancy needs checking, because a pregnancy can grow outside the womb (ectopic pregnancy).
- You are out of breath when you lie down, or breathlessness comes with dizziness. Contact your maternity unit straight away. If you are severely short of breath when you are resting, or so breathless that you are gasping or cannot get your words out, call emergency services. Feeling a little more out of breath as your baby grows is common, but this pattern needs checking.
Get help today
- Same day: a leg or foot that is getting weaker, for example your foot drags, catches on the ground or slaps down when you walk (foot drop). Get medical advice the same day. If the weakness is getting worse by the hour, go to an emergency department.
- Same day: new back pain and you have had cancer, now or in the past. Get medical advice the same day and mention your cancer history. If you are being treated for cancer now, contact your cancer team the same day.
- Same day: a lump in your groin that becomes painful, hard or red, that you cannot push back in, or that comes with a bloated tummy, feeling or being sick, constipation or a high temperature. Get medical help the same day, in person rather than by phone, for example at urgent care or an emergency department, as these can mean a hernia has become trapped (NHS). Do not try to push the lump back in yourself.
- Same day: dizziness, lightheadedness or feeling faint while you are exercising, or the room seems to spin. Stop, and sit down or lie on your side until it passes. Contact your midwife or maternity unit the same day, and do not exercise again until you have been checked, as dizziness is one of the signs to stop exercising in pregnancy. If you faint, it does not settle within a few minutes of keeping still, or you cannot stand or walk steadily, call emergency services.
- Thoughts of suicide or of harming yourself or your baby, even if you do not plan to act on them. Get urgent help the same day from your GP, midwife or health visitor, or NHS 111 in the UK. In the UK, you can also talk to Samaritans on 116 123.
Book an appointment
- Within a few days: hip or groin pain, usually on one side, that is worse when you put weight on that leg, that makes you limp or need a stick or crutch, or that has not eased with position changes and pacing. Ask your midwife or doctor for a review, and say the pain is in your hip rather than only your pelvis. While you wait, take the weight off that leg where you can: lean on a crutch, a stick, a shopping cart or a stroller, use the rail and one step at a time on stairs, sit down for jobs you would do standing on one leg, and do not push through pain you have to limp on. Pregnancy and the weeks after the birth can cause a temporary weakening of the bone at the top of the thighbone, which is uncommon, is often read as pelvic girdle pain for weeks, and shows up on an MRI scan, which is the test to ask about when hip pain has no other explanation (Morton 2024). If the pain suddenly becomes much worse, or that leg will not take your weight at all, do not wait for the review: go to an emergency department straight away, as the emergency warnings above say.
- Within a few days: a new lump or swelling in your groin, especially one that gets bigger when you cough, sneeze or stand and smaller when you lie down. Tell your midwife or doctor, because a lump there needs examining rather than explaining, and an ultrasound scan is what separates swollen veins alongside the round ligament from a hernia (Yeo 2021). Do not try to push the lump back in yourself, and use the same day line above instead if the lump becomes painful, hard or red or you cannot push it back in.
- Low mood, anxiety or stress that is affecting your day to day life, or pain that is causing you considerable distress. Tell your midwife or doctor and ask what support is available, because this is part of what gets treated rather than something to put up with (NHS; RCOG; POGP).
Common questions
How do I know if it is sciatica or pelvic girdle pain in pregnancy?
You will not settle it alone, and the reason is that the two can produce pain in the same patch of buttock and thigh. What you can do is gather the three things that actually change the answer. First, how far down it goes: pain travelling below the knee, into the calf, foot and toes, fits the nerve description the NHS gives for sciatica, while pain that fades at the back of the thigh fits the pelvic description in the European guideline (Vleeming 2008). Second, whether there is numbness, pins and needles or weakness anywhere in the leg or foot, which are nerve symptoms rather than joint ones. Third, what sets it off: pelvic girdle pain is set off by standing on one leg, stairs, turning in bed and moving your legs apart, which POGP lists, while nerve pain is often there whatever you do. Take those three answers to your midwife, doctor or a pelvic health physio, because the European guideline says a pelvic girdle pain diagnosis is only reached once lumbar causes have been excluded, and that needs an examination.
What helps sciatica in pregnancy?
The first line looks much the same for either diagnosis, which is the practical reason not to panic about the label. Keep moving within what the pain allows and break jobs into shorter spells rather than pushing through, which is POGP's pacing advice. Wear supportive shoes: the HSE suggests a running shoe or sneaker with a gentle arch support and a cushioned sole, and advises against slippers and bare feet. Sleep on your side with a pillow between your knees, and keep your knees together when you turn over. The HSE allows heat on tender areas, but not on your bump, not in the first 12 weeks, wrapped in a towel, and for 20 minutes at most. For medicine, the NHS says paracetamol can be taken as directed unless you have been advised otherwise and the RCOG says it is safe in pregnancy in regular doses, although the NHS's sciatica page adds that paracetamol is unlikely to help sciatica. Ibuprofen is a different question: the NHS says to avoid it in pregnancy unless a doctor or pharmacist has advised it, and that paracetamol is usually the best painkiller to take when you are pregnant. The RCOG also sets out what a physiotherapist may add, including exercises, hands-on treatment, hydrotherapy, a support belt or crutches, so ask your midwife or doctor for a referral rather than working through it alone.
Can pelvic girdle pain travel down your leg?
Yes, and this is the single commonest reason a woman arrives convinced she has sciatica. The European guideline's own definition says the pain may radiate into the back of the thigh (Vleeming 2008), and both the RCOG and POGP list the thighs among the places pelvic girdle pain is felt, with the RCOG adding the knees. So thigh pain on its own does not make it a nerve problem. What is not part of that picture is pain running below the knee into the calf and foot, numbness or pins and needles anywhere in the leg or foot, or a foot that drags or slaps, and those get assessed rather than explained.
Are sciatica stretches safe in pregnancy?
Some are and some are not, and the ones most often shared online are the ones a pelvic girdle pain program deliberately leaves out. The pregnancy program avoids single-leg standing, lunges, side leg lifts, clamshells and wide-legged stretches, because the NHS and POGP both name standing on one leg and moving your legs apart among the movements that most often hurt. A piriformis or figure-four stretch does both of those things at once. Lying flat on your back is a second problem later on, and the program is built sitting, standing, side lying or on hands and knees for that reason. If you want a stretch routine, get it from someone who has examined you. Exercises to avoid with sciatica covers the non-pregnant version of the same question, and what to avoid with pelvic girdle pain is the pregnancy one.
Can you get sciatica in pregnancy in the first trimester?
Leg pain can turn up at any stage, and nothing about early pregnancy rules out a disc problem that would have happened anyway. What the evidence does not support is the idea that pregnancy itself brings these on: the 2024 review of lumbar disc herniation in pregnancy reports MRI studies finding no significant predisposition to herniation during pregnancy, while also finding that women with herniations seen on MRI were more likely to report back pain (Chan 2024). Early pregnancy pain still gets mentioned to your midwife or doctor rather than filed as ordinary. The NHS asks you to contact your GP or midwife urgently about back pain in the second or third trimester specifically, because it can be a sign of early labor, and to call emergency services or go to an emergency department if you lose feeling in one or both legs, your bottom or your genitals at any point.
References
- NHS. Sciatica. Page last reviewed 3 December 2024. https://www.nhs.uk/conditions/sciatica/
- NHS. Ibuprofen for adults. Page last reviewed 27 August 2025. https://www.nhs.uk/medicines/ibuprofen-for-adults/
- NHS. Back pain in pregnancy. Page last reviewed 10 January 2024. https://www.nhs.uk/pregnancy/common-symptoms/back-pain/
- NHS. Pelvic pain in pregnancy. Page last reviewed 12 December 2022. https://www.nhs.uk/pregnancy/common-symptoms/pelvic-pain/
- NHS. Premature labour and birth. Page last reviewed 10 January 2024. https://www.nhs.uk/pregnancy/labour-and-birth/premature-labour-and-birth/
- NHS. Pregnancy symptoms you need to get help for. Page last reviewed 24 June 2026. https://www.nhs.uk/pregnancy/common-symptoms/pregnancy-symptoms-you-need-to-get-help-for/
- NHS. Pre-eclampsia. Page last reviewed 23 March 2026. https://www.nhs.uk/conditions/pre-eclampsia/
- NHS. Your baby's movements. Page last reviewed 8 July 2024. https://www.nhs.uk/pregnancy/keeping-well/your-babys-movements/
- Vleeming A, Albert HB, Ostgaard HC, Sturesson B, Stuge B. European guidelines for the diagnosis and treatment of pelvic girdle pain. European Spine Journal. 2008;17(6):794-819. https://doi.org/10.1007/s00586-008-0602-4
- Chan NY, Le M, Reinecker S, Prince M, Murphy GT. Lumbar disk herniation in pregnancy: its incidence, presentation and management: a systematic review. Journal of Spine Surgery. 2024;10(2):274-285. https://doi.org/10.21037/jss-24-3
- Gardner A, Gardner E, Morley T. Cauda equina syndrome: a review of the current clinical and medico-legal position. European Spine Journal. 2011;20(5):690-697. https://doi.org/10.1007/s00586-010-1668-3
- Royal College of Obstetricians and Gynaecologists (RCOG). Pelvic girdle pain and pregnancy. Patient information leaflet. June 2015. https://www.rcog.org.uk/for-the-public/browse-our-patient-information/pelvic-girdle-pain-and-pregnancy/
- Pelvic, Obstetric and Gynaecological Physiotherapy (POGP). Pregnancy related pelvic girdle pain and low back pain during pregnancy and after having a baby. https://thepogp.co.uk/patient_information/womens_health/pregnancy_pgp_lbp.aspx
- Pelvic, Obstetric and Gynaecological Physiotherapy (POGP). Pregnancy related pelvic girdle pain and other common conditions in pregnancy. Booklet. 23 March 2023. https://thepogp.co.uk/Resources/112/pregnancy_related_pelvic_girdle_pain_and_other_common_conditions_in_pregnancy/
- Health Service Executive (HSE), Ireland. Looking after yourself: pelvic girdle pain in pregnancy. Last reviewed 18 March 2026. https://www2.hse.ie/conditions/pelvic-girdle-pain-pregnancy/looking-after-yourself/
- Fiona Stanley Fremantle Hospitals Group, WA Health. Manage pelvic girdle pain. Last updated 16 December 2025. https://fsfhg.health.wa.gov.au/Our-services/Maternity/Pregnancy-care/Physiotherapy-during-pregnancy/Manage-pelvic-girdle-pain
- Morton A, Savard-Heppel J. Transient osteoporosis of the hip in pregnancy. Obstetric Medicine. 2024;17(4):188-193. https://doi.org/10.1177/1753495X241236222
- Stolarczyk A, Stepinski P, Sasinowski L, Czarnocki T, Debinski M, Maciag B. Peripartum pubic symphysis diastasis, practical guidelines. Journal of Clinical Medicine. 2021;10(11):2443. https://doi.org/10.3390/jcm10112443
- NHS. Ectopic pregnancy. Page last reviewed 23 August 2022. https://www.nhs.uk/conditions/ectopic-pregnancy/
- NHS. Hernia. Page last reviewed 19 May 2026. https://www.nhs.uk/conditions/hernia/
- NHS. Inguinal hernia repair. Page last reviewed 28 February 2025. https://www.nhs.uk/tests-and-treatments/inguinal-hernia-repair/
- Yeo JHL, Tashi S. A rare but noteworthy diagnosis for lumps in the groin during pregnancy: round ligament varices. American Journal of Case Reports. 2021;22:e934313. https://doi.org/10.12659/AJCR.934313
Written and checked by the PocketPhysio editorial team. Last updated 2026-10-23.
This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.