Sacroiliac Joint and Pelvic Girdle Pain: Symptoms, Causes, and Physical Therapy

Can pregnancy cause pelvic girdle pain?

Yes. Pregnancy-related pelvic girdle pain is a recognized condition that may produce pain around the back or front of the pelvis, buttocks, hips, groin, or pubic region. It may become more noticeable with walking, stairs, rolling in bed, getting in and out of a car, standing on one leg, or changing position.

The pain should not simply be dismissed as something that must be endured because of pregnancy. It may involve changes in load tolerance, muscle function, movement demands, and sensitivity around the pelvic region. It does not prove that the pelvis is “out of alignment.”

Physical therapy, including pelvic-health physiotherapy when appropriate, should be considered when symptoms are persistent, worsening, or limiting mobility and daily activity. Treatment may include activity modification, movement strategies, support when indicated, individualized exercise, and ways to maintain function without repeatedly provoking symptoms.

Severe or rapidly worsening pelvic or back pain should be reported to the maternity or obstetric provider so pregnancy-related and nonmusculoskeletal causes can be considered. The physical therapist should coordinate with the maternity team whenever the presentation falls outside an expected musculoskeletal pattern.

Is my hip or my back causing this?

Pain location alone cannot determine the source. The hip, lumbar spine, sacroiliac region, muscles, and nerves can produce symptoms in overlapping areas, including the buttock, lateral hip, groin, thigh, and low back.

Groin pain or pain with hip rotation may suggest that the hip deserves closer examination. Symptoms that change consistently with lumbar movement or travel down the leg may suggest involvement from the low back or a nerve. Pain around the back of the pelvis during transfers, stairs, or single-leg loading may raise the possibility of the sacroiliac or pelvic region. These are clues, not diagnoses.

Attributing pain to the SI region depends on the overall clinical pattern and multiple examination findings, while also considering competing sources. One isolated movement, tender spot, alignment observation, or provocation test cannot establish the diagnosis by itself.

A physical therapy examination compares lumbar movement, hip mobility, neurological findings, strength, functional tasks, symptom behavior, and a cluster of appropriate provocation tests. The purpose is to determine which structure or system is most likely contributing and which treatment approach is appropriate.

Is SI joint pain the same as sciatica?

No. SI joint or pelvic girdle pain is generally felt around the back of the pelvis, buttock, or nearby hip and groin region. It may refer into the thigh, but radiating pain by itself does not automatically make the condition sciatica.

Sciatica describes symptoms associated with irritation of a lumbar nerve root or the peripheral sciatic nerve. Those symptoms may include pain travelling down the leg, tingling, numbness, altered sensation, or weakness. The exact pattern depends on where the nerve is affected.

SI-region pain and sciatica can also coexist. A person may have local pelvic pain together with a lumbar or peripheral nerve problem, which is why location alone is not enough to distinguish them.

Prompt medical evaluation is required for new foot drop, progressive leg weakness, saddle-region numbness, or new bowel or bladder changes. Outside of those urgent findings, an examination can determine whether the presentation is primarily local pelvic pain, lumbar nerve-root involvement, peripheral sciatic nerve irritation, a hip condition, or a combination.

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