10 ways to manage pelvic pain when lying down at night

You’re pregnant, you’re exhausted, and all you want is a good night’s sleep. But sometimes pelvic pain when lying down at night makes that almost impossible!

But why exactly is that? 

And more importantly, what can you do about it?

In this post, we’ll discuss:

• Why you’ve got pelvic pain when lying down at night during pregnancy
• At what stage in pregnancy do most women feel pelvic pain when lying down at night?
• Will having pelvic pain affect labour or my birth choices?
• How is pelvic pain diagnosed?
• How is pelvic pain treated?
• 10 ways to help manage pelvic pain when lying down at night
• When will pelvic pain when lying down at night go away?

Related: Learn how pelvic girdle pain (PGP) is diagnosed and managed

Hormonal Fluctuations:

Levels of the hormones involved in inflammation fluctuate at night. 

Some increase, and some decrease, but the overall effect is that inflammation levels are often higher at night. 

So, any inflamed areas of your body are more likely to be sensitive to pain at night. 

This applies to any areas of inflammation in your body. Other common sites of inflammation during pregnancy are your wrists and legs.

Body shape changes:

From the moment you conceive, your body starts to make changes to make room for your growing baby. 

This can mean you start to feel “different” or uncomfortable from very early on in your pregnancy. 

Changes to the shape of your pelvis can make it more likely that you’ll suffer from pain in the hips when laying down at night. 

Most women also gain somewhere between 5-18kgs during pregnancy. 

This added weight alone can put extra pressure on joints such as hips and shoulders. 

Wondering how much weight is considered “ideal” to gain during pregnancy?

The table below outlines the numbers to shoot for.

Related: 4 Ways to get Pregnancy Hip Pain Relief

Stress and anxiety help keep you awake

Pregnancy can be a wonderful time as you prepare for the birth of a new child.

However, there are a number of possible reasons why some women can find it stressful or anxiety-inducing. 

Things like:

• An unplanned or unwanted pregnancy
• Worries about how you will care for this child- physically, financially, emotionally
• Concerns around how you’ll give birth
• Wondering how this child will fit in with your existing family dynamics

… can all keep you awake at night. 

When you’re already awake and your brain is ticking over, you may feel pelvic pain when lying down that you wouldn’t otherwise notice if you were able to get some sleep. 

If you’re wondering how to sleep with pelvic pain during pregnancy, here are 10 ways that can help.

Use a pregnancy pillow

A pregnancy pillow can be your best friend to help manage pelvic pain when lying down.

Finding the right one for you really can help you get that much-needed comfortable sleep.

Without a doubt, the Victostar pregnancy pillow is one of the most popular choices. 

If you’d like help deciding which pregnancy pillow is best for you, I’ve discussed a range of options here. 

Keep your knees together at all times

Opening your legs can put more strain on inflamed pelvic joints, which can increase your pain.

While moving around throughout the day, try to keep your legs together as much as possible. This is especially important with tasks such as getting in and out of the car or going up and down stairs. 

At night time, actively squeeze your knees together when you have to roll over or get out of bed. 

Keep your knees together and place both feed on the floor before standing up from bed. 

These moves require some planning and getting used to, as they’re not the same way you’d likely normally move. 

Thankfully, women usually adapt to these changes quite quickly, so even when you’re half asleep you’ll remember the best way to move. 

Release your pelvic area muscles before laying down

The muscles in the back of your pelvis are working overtime to try to support your ever-growing belly.

Taking some tension out of them before laying down at night can help minimise pelvic pain. 

There are a number of ways you can do this. 

One simple way is to use a spiky ball on the fleshy parts of your gluteal muscles for 1 or 2 minutes. You can do this while leaning against a wall, or while laying on your back or sides. 

Using a spiky ball can be a little uncomfortable, but most people find this to be a “good pain” that immediately feels like something beneficial is happening. 

You could also try some simple stretching. 

Below is a video of the top 4 stretches that will help your pelvic pain when lying down at night.

Wear silky pyjama bottoms

Silk pyjama bottoms can make it easier to slide when rolling over or getting out of bed. 

Do yourself a favour though, and try a genuine silk product, such as these ones. They’re genuine mulberry silk shorts- which means they’ll help you move your pelvis around, but won’t make you feel too hot!

Silk is a natural fibre which breathes easily, meaning you won’t get too hot while wearing it. There are many polyester varieties around, and they’re usually a lot cheaper, but they don’t breathe as well. 

Most pregnant women’s body temperatures are usually on the warm side. The last thing you need is a synthetic fabric that holds all that heat in. 

Pure silk has both the slide factor and breathability that you need. 

You could pair these with a nursing-friendly singlet top, which will allow you to continue to wear your shorts after your baby is born. 

I wore singlet tops just like these while feeding both of my girls. 

The oldest was born during Summer, so this was all I needed to wear on top. 

The youngest was a Winter baby, so I also wore another top. But having the nursing singlet on meant my belly was warm on those chilly Winter nights!

Breathe

I know, it sounds obvious that you need to breathe. 

But when did you last stop to think about how you’re breathing?

There are a few different reasons why many of us don’t breathe in the best possible way, even when we’re not pregnant. 

However, during pregnancy, our breathing often changes because:

• The pressure of a growing belly and the effect this has on your ribs and diaphragm has a direct physical effect on our breathing
• The stress and anxiety that can sometimes go along with becoming a mother leads us to breathe in a more shallow way
• Pain states like PGP also often mean that we tend to breathe less deeply than we otherwise would. 

Both of these factors can mean that breathing is significantly changed in pregnancy.

But why do breathing changes in pregnancy matter?

• Shallow breathing uses more of the muscles around your neck and shoulders. This can contribute to feelings of neck pain and tension in this area
• Shallow breathing doesn’t stretch out your middle back in the way that deeper breathing does. This can contribute to feeling tighter or stiffer in this area. This can also have a flow on effect to your lower back and pelvis, as gravity pulls the pressure of your breath downwards.
• Your breath doesn’t flow all the way down to your pelvic floor like it should. This can increase the tightness in these muscles, which can further aggravate your pain and mean these muscle find it hard to relax while you’re in labour. 

So, what can you do about it?

It’s as simple as consciously practicing deep breathing.

Think about your entire chest and abdomen expanding 360 degrees with each breath in, and then coming back together with your breath out. ‘

Don’t just think about “belly breathing” like some experts will tell you to do, as this can increase your risk of abdominal separation, and doesn’t do much for back expansion or your pelvic floor. Picture your entire rib cage- front and back- moving in all directions with each breath. 

Make it a practice to quietly sit and do this for a few minutes each day. 

Notice the effect this has on your body- pain levels, any feelings of anxiety, feelings of breathlessness, etc. 

This truly is a practice that you’ll find beneficial even long after pregnancy. 

Use meditations, affirmations and thought-stopping

Your mind is your most powerful tool.

We all talk to ourselves constantly throughout the day.

Those nagging thoughts of “I can’t do this anymore” or “am I the only woman who feels like this?” reinforce the pain you’re experiencing, and make it hard for you to see the positive aspects of your life.

Try to switch up the negative self-talk and replace or reframe it with more positive statements.  

Training your brain to believe you’re a strong woman who is becoming a strong mother can do wonders to your experience of pain.  

You’ll find something that works for you, but some examples might be:

• using a mantra such as “I am strong and I’ll get through this”, or 
• taking a minute to focus on the miracle that is growing inside you, 

… can help make even the toughest days possible.

You’ve got this, mama.

Try water aerobics

Exercising in water has been found to have a beneficial effect on lower back and pelvic girdle pain in pregnancy. 

Women in this study were asked to complete unsupervised exercise in the water between 20 and 32 weeks of pregnancy. The sessions took around 30 minutes, and were completed twice a week.

The study found a significant reduction in lower back pain in the participants than women who didn’t exercise in water.

So it actually works!

The theory is that water helps support your body weight, while gentle exercise helps maintain strength and stability. 

Do you need any more excuses not to hit the pool this week?

Use Kinesio tape

Also known as “Rock Tape”, Kinesio tape can give you just the hint of added support you might not have realised you needed. 

This stretchy tape can be used around your pelvis and belly to provide gentle support, but still allow you to move freely. 

You can purchase your own Kinesio tape here, and learn how to use it with this document from the manufacturers here. 

Ice your inflamed joints

This is an oldie but a goodie. 

Simply applying ice to a tender pubic or tail bone can feel like heaven after a few hours on your feet when you’ve got PGP. 

The best way to do this is to wrap an ice pack or bag of frozen peas in a thin cloth, then cycle through 5 minutes on, 5 minutes off for 30-45 minutes while you rest. 

Ice is a great way to minimise pain and inflammation, and provided that you wrap the ice pack to minimise the risk of ice burns, there’s no significant risks associated with it. 

Try the “Apple Picking” exercise

No, I haven’t lost my marbles.

I know that picking fruit is probably the last thing you feel like doing right now. 

But what if I told you that the action of picking fruit is actually great for your pelvic pain?

The reaching action with your arms can help increase middle back and rib mobility. 

This can help decrease downward pressure onto your pelvis, which can really help your pain levels.

Watch the very dorky apple picking video below!

Related: 12 Pregnancy Sleep Hacks

Pelvic pain when lying down at night- the takeaway message:

Pelvic pain when lying down at night is extremely common during pregnancy.

It often begins during the second trimester, and doesn’t usually have a significant impact on your birth choices or positions.

Pelvic pain can be treated by an Osteopath or Physical Therapist with training in treating pregnant women. 

There are a number of ways you can adapt your everyday activities to help minimise pelvic pain when lying down at night, and in the majority of cases it will ease quite soon after you give birth. 

Have you given these tips a try? 

How did you go?

Leave me a comment below, and don’t forget to share this post with your pregnant friends who could use some decent sleep!