Pelvic and Joint Pain Are Disturbing My Sleep in Late Pregnancy But I Want to Stay Active

As your pregnancy progresses into the later stages, the physical demands on your body become increasingly apparent. Among the most common complaints in the third trimester are pelvic and joint pain, which can make it difficult to rest or get a good night’s sleep. These discomforts are often exacerbated by the body’s increasing weight and hormonal changes, which affect the ligaments and joints. Many expectant mothers struggle to manage these symptoms while also wanting to stay active and maintain their fitness.

It’s understandable to feel torn between the need for relief and the desire to stay physically active during pregnancy. The good news is that there are several strategies to help manage pelvic and joint pain while staying active, ensuring that you can maintain a sense of well-being and preparation for labour.

This article will delve into the causes of pelvic and joint pain in late pregnancy, explore the impact it has on sleep, and provide practical tips on how to stay active and manage discomfort through antenatal care, yoga, massage, and more.

Causes of Pelvic and Joint Pain in Late Pregnancy

Hormonal Changes and Relaxin

The primary cause of pelvic and joint pain during pregnancy is the hormonal changes that occur in the body, particularly the increased production of a hormone called relaxin. Relaxin helps the body prepare for childbirth by relaxing the ligaments, particularly around the pelvis, to allow for the baby to pass through the birth canal during labour. However, this hormone also affects other joints, leading to looseness and instability, which can cause discomfort, especially in the pelvic region [1].

As relaxin works to soften the pelvic ligaments, the added weight of the growing baby and uterus can also place extra strain on the pelvic joints. This results in discomfort that can feel like aching, pressure, or a sensation of instability. The most common areas affected include the sacroiliac joints (located where the spine meets the pelvis), the pubic symphysis (the joint between the left and right pelvic bones), and the hips.

Postural Changes

As pregnancy progresses, your body undergoes numerous postural changes to accommodate the growing baby. The shift in the centre of gravity and the increase in abdominal size cause you to lean back more, which places additional strain on your lower back, pelvis, and hips. This altered posture may lead to joint pain, especially in the lower back, pelvis, and legs, and it can contribute to discomfort when standing, walking, or even sitting for prolonged periods.

The stress on your joints is also compounded by the fact that the body’s connective tissues soften during pregnancy, further increasing the likelihood of pain and stiffness.

Weight Gain

Increased weight gain during pregnancy adds more strain on your joints, especially your hips, knees, and lower back. The added weight puts more pressure on the joints that are already softened by the action of relaxin, contributing to discomfort and pain in these areas. The weight of the baby and amniotic fluid can also create additional strain, further aggravating joint and pelvic pain.

Sciatica and Pelvic Girdle Pain

Another specific condition that causes pain in late pregnancy is pelvic girdle pain (PGP), which affects the pelvic joints and surrounding muscles. PGP can cause pain in the pubic area, hips, or lower back and may worsen during activities such as walking, climbing stairs, or getting in and out of bed.

In addition, some women experience sciatica, which occurs when the growing uterus presses on the sciatic nerve, causing sharp, shooting pain in the lower back, buttocks, and down the legs. Sciatica is most common in the third trimester and can be exacerbated by the growing size of the baby, the increasing pressure on the nerves, and the softening of the ligaments around the pelvis.

How Pelvic and Joint Pain Affects Sleep

Sleep disturbances in pregnancy are not uncommon, but the presence of joint and pelvic pain can make it particularly difficult to achieve restful sleep. The discomfort from pelvic and joint pain can interfere with your ability to get comfortable in bed, and the increased need for bathroom trips during the night can further disrupt sleep patterns.

For many expectant mothers, finding a position that alleviates joint pain while lying down can be a challenge. Lying on one side often places additional strain on the hips and pelvis, while lying flat on the back can increase pressure on the uterus and worsen discomfort. These factors can make it difficult to fall asleep and remain asleep, leading to increased fatigue during the day.

Managing Pelvic and Joint Pain While Staying Active

1. Prenatal Yoga and Antenatal Fitness

Staying active during pregnancy is important for both physical and emotional well-being, but it must be done in a way that is safe and beneficial. Prenatal yoga is an excellent way to maintain flexibility, strength, and balance during pregnancy. Yoga for pregnancy focuses on gentle stretches, strengthening poses, and relaxation techniques that are designed to relieve discomfort, improve posture, and support the body as it adapts to the physical demands of pregnancy.

Regular practice of antenatal yoga can help reduce pelvic and joint pain by increasing flexibility in the hips and pelvis, strengthening the core muscles that support the lower back, and improving circulation. Many pregnancy yoga classes also teach breathing techniques that can be helpful during labour and delivery. It’s important to choose a qualified instructor who specialises in prenatal yoga to ensure that the movements are safe for both you and your baby [2].

2. Hydrotherapy and Water-Based Exercises

Water-based exercises, such as swimming or water aerobics, can be an effective way to stay active while relieving joint and pelvic pain. The buoyancy of water reduces the pressure on your joints and supports your body’s weight, allowing you to perform movements that might be too difficult or painful on land. Swimming can help improve circulation, increase strength, and provide gentle relief for aching joints, all while minimising the risk of injury.

Hydrotherapy is another useful technique for alleviating pelvic and joint pain. Many antenatal clinics and fitness centres offer water-based prenatal classes that incorporate exercises designed to help relieve discomfort, improve posture, and strengthen muscles, particularly those in the pelvis and lower back.

3. Prenatal Massage

Prenatal massage, or antenatal massage, is a safe and effective way to relieve pelvic and joint pain during pregnancy. Professional massage therapists trained in prenatal care use gentle techniques to ease tension in the muscles and relieve pressure on the joints. A skilled massage can help reduce pain in areas like the lower back, hips, and pelvis, improving overall comfort and mobility.

The pregnancy massage benefits extend beyond pain relief; it also promotes relaxation, reduces stress, and improves circulation, which can contribute to better sleep. Studies have shown that regular prenatal massage can help reduce the severity of pelvic girdle pain, lower back pain, and sciatic nerve pain [3].

4. Sleep Position and Posture

Improving your sleep position is one of the simplest yet most effective ways to manage pelvic and joint pain. Sleeping on your left side with a pillow between your knees can help align your pelvis and spine, reducing pressure on your joints and easing discomfort. Additionally, using a body pillow to support your abdomen and lower back can further relieve pressure on the pelvis and provide better alignment for the spine.

It may also be helpful to avoid lying on your back, as this can place extra pressure on the uterus and increase pain in the pelvic area. If you experience pain when getting in and out of bed, try rolling onto your side slowly and using your arms to push yourself up.

5. Anticipating and Managing the Impact of Weight Gain

While weight gain during pregnancy is essential for your baby’s growth and development, it can exacerbate pelvic and joint pain. One way to manage this is by wearing proper support garments, such as a maternity belt or pelvic support band, which can help distribute the weight of your growing belly and alleviate pressure on your joints.

Maintaining a healthy weight gain through proper nutrition and exercise will also support your overall well-being. However, it’s important to approach exercise with caution, particularly if you experience pain. Always consult with your healthcare provider before engaging in any new physical activity to ensure it is safe for you and your baby.

6. Antenatal Appointments and Checkups

Regular antenatal checkups are essential for monitoring your health during pregnancy and addressing any concerns related to pelvic or joint pain. Your midwife or doctor can assess your symptoms, provide advice on managing discomfort, and recommend appropriate treatments or interventions, such as physiotherapy or specific exercises.

In some cases, physical therapy or chiropractic care may be suggested to help realign the pelvis and alleviate pain. Always ensure that the healthcare provider is experienced in prenatal care, as certain techniques may not be safe during pregnancy.

Conclusion

Pelvic and joint pain in late pregnancy is a common issue, but it doesn’t have to stop you from staying active. By incorporating gentle exercise, such as antenatal yoga, water aerobics, and prenatal massage, you can reduce discomfort and maintain your physical health during pregnancy. It’s also essential to focus on sleep posture and consult your antenatal care provider for guidance on managing your symptoms.

By staying active and seeking the right support, you can ease pelvic and joint pain, improve your quality of sleep, and prepare your body for the challenges of labour and delivery. Always listen to your body, and don’t hesitate to seek professional advice if you have concerns about your symptoms.

References:

NHS. Pelvic Girdle Pain in Pregnancy.

American Pregnancy Association. Prenatal Yoga Benefits.

Field, T. Pregnancy Massage Benefits.