Antenatal and postnatal MSK conditions

Physiotherapy assessment and management for women experiencing pregnancy related musculoskeletal conditions during pregnancy and in the early post partum period. This support is provided by the Women’s Health Physiotherapist based at the BGH, alongside local Musculoskeletal Physiotherapists in the community to allow women to receive physiotherapy input closer to where they live, as appropriate. Local MSK physiotherapists can escalate patients to the Women’s Health Physiotherapist when appropriate.

1. Antenatal conditions may include:

Lower back pain
Pelvic Girdle Pain
Diastasis of the rectus abdominis

2. Postnatal conditions may include:

New presentation of pelvic girdle pain.
Persisting lower back pain that began in pregnancy and is ongoing.
Persisting pelvic girdle pain that began in pregnancy and is ongoing.
Diastasis of the rectus abdominis muscle.

Who to refer, who not to refer, how to refer

Who to refer

Antenatal patients from 12 weeks gestation; lower back pain, pelvic girdle pain
Postnatal patients up to 3 months post partum; new presentation of pelvic girdle pain, persisting lower back pain or pelvic girdle pain from during pregnancy, diastasis of the rectus abdominus muscles.
Patients struggling with mobility/pain secondary to underlying health conditions present prior to pregnancy eg MS, hypermobility, Ehlers-Danlos Syndrome.
Patients expecting multiples eg twins will usually be escalated to the women’s health physiotherapist.

NB: this list is not exhaustive and individual cases can be discussed. Contact via email or phone above.

Who not to refer

Carpal tunnel syndrome in pregnancy; please signpost to information below and provide wrist splint from stock within health centre if appropriate.
Rib pain; please signpost to information below in the first instance.
Pelvic floor dysfunction; please refer to Bladder Bowel and Pelvic Floor Service if appropriate.
Red flag presentations; see more information on msk physio page about red flags in relation to lower back pain.

How to Refer

SCI Gateway

Badgernet

Self referral using this form

Microsoft Word - Self Referral to Obstetric Form 2 _3_.doc.pdf

Primary care management

Check for the presence of red flags
Provide and signpost to relevant self management advice. There are ample resources on the NHS Borders website under “Pregnancy Physiotherapy” with advice and signposting to resources. They are divided into antenatal resources (including management of rib pain and carpal tunnel syndrom) and postnatal resources. The link is: https://www.nhsborders.scot.nhs.uk/patients-and-visitors/our-services/allied-health-professionals/physiotherapy/pregnancy-physiotherapy/
In the case of antenatal lower back or pelvic girdle pain consider encouraging the patient to try conservative measures (resources in link above and in section below) and if their symptoms are not improving after trying conservative measures to signpost the patient to self refer.

Resources and links

NHS Borders Pregnancy Physiotherapy Webpage has resources for antenatal period, advice for labour and the post natal period.

The Pelvic Obstetric a nd Gynaecological Physiotherapy website contains many patient information leaflets including the following:

Pelvic Girdle Pain and other common conditions in pregnancy

The Active Pregnancy Foundation has guidance for both the antenatal and postnatal patients with guidance about safe exercise during pregnancy and resources support self management.

This Mum Moves sits within the active pregnancy foundation and has specific advice regarding safe levels of activity during pregnancy and even includes free online workouts.

Local service details

bor.physiotherapyadmin@borders.scot.nhs.uk

Physio.WH@borders.scot.nhs.uk

Women’s Health Physiotherapist

Borders General Hospital

01896 826548

Last reviewed: 25/10/2025

Next review date: 25/10/2027

Author(s): Gillian Cockburn.

Author email(s): gillian.cockburn@borders.scot.nhs.uk.