Round ligament pain is a sharp pain or jabbing feeling often felt in the lower belly or groin area on one or both sides. It is one of the most common complaints during pregnancy and is considered a normal part of pregnancy. It is most often felt during the second trimester.
Here is what you need to know about round ligament pain, including some tips to help you feel better.
Causes of Round Ligament Pain
Several thick ligaments surround and support your womb (uterus) as it grows during pregnancy. One of them is called the round ligament.
The round ligament connects the front part of the womb to your groin, the area where your legs attach to your pelvis. The round ligament normally tightens and relaxes slowly.
As your baby and womb grow, the round ligament stretches. That makes it more likely to become strained.
Sudden movements can cause the ligament to tighten quickly, like a rubber band snapping. This causes a sudden and quick jabbing feeling.
Symptoms of Round Ligament Pain
Round ligament pain can be concerning and uncomfortable. But it is considered normal as your body changes during pregnancy.
The symptoms of round ligament pain include a sharp, sudden spasm in the belly . It usually affects th e right side, but it may happen on both sides. The pain only lasts a few seconds.
Exercise may cause the pain, as will rapid movements such as:
Treatment of Round Ligament Pain
Here are some tips that may help reduce your discomfort:
Pain relief. Take over-the-counter acetaminophen for pain, if necessary. Ask your doctor if this is OK.
Exercise. Get plenty of exercise to keep your stomach (core) muscles strong. Doing stretching exercises or prenatal yoga can be helpful. Ask your doctor which exercises are safe for you and your baby.
A helpful exercise involves putting your hands and knees on the floor, lowering your head, and pushing your backside into the air.
Avoid sudden movements. Change positions slowly (such as standing up or sitting down) to avoid sudden movements that may cause stretching and pain.
Flex your hips. Bend and flex your hips before you cough, sneeze, or laugh to avoid pulling on the ligaments.
Apply warmth. A heating pad or warm bath may be helpful. Ask your doctor if this is OK. Extreme heat can be dangerous to the baby.
You should try to modify your daily activity level and avoid positions that may worsen the condition.
When to Call the Doctor
Always tell your doctor about any type of pain you have during pregnancy. Round ligament pain is quick and doesn’t last long.
Call your health care provider immediately if you have:
- severe pain
- pain that lasts for more than a few minutes
- pain on urination
- difficulty walking
Belly pain during pregnancy can be due to many different causes. It is important for your doctor to rule out more serious conditions, including pregnancy complications such as placenta abruption or non-pregnancy illnesses such as:
- inguinal hernia , liver, and kidney problems
Preterm labor pains may sometimes be mistaken for round ligament pain.
American Pregnancy Association web site: “Round Ligament Pain.”
Department of Health and Human Services Office on Women’s Health web site: “Pregnancy: Body Changes and Discomforts.”
Ratcliffe, S. Family Medicine Obstetrics, 3rd edition, Elsevier Mosby, 2008.
Ferri, F, Ferri’s Clinical Advisor 2013, 1st edition, Mosby Elsevier, 2012.
Marx, J. Rosen’s Emergency Medicine: Concepts and Clinical Practice, 7th edition, Mosby Elsevier, 2009.
When you’re pregnant, abdominal pain can be a scary yet normal part of pregnancy. It often happens because your body is changing to welcome a growing baby. One common cause of abdominal pain during pregnancy is a condition called round ligament pain.
Two large ligaments run from your uterus, the organ that feeds a developing baby, down to your groin. “They’re essentially holding the uterus in place,” says Harpreet Brar, MD, a board-certified OB-GYN at Detroit Medical Center’s Hutzel Women’s Hospital .
What causes round ligament pain?
These ligaments stretch as your uterus grows, irritating nearby nerve fibers and causing spasms, numbness, tingling, or other pain sensations. Sudden movements such as quickly standing, laughing, and coughing also rapidly contract and stretch the ligaments. All of these factors can contribute to lower abdomen pain.
“Round ligament pain is a sign that the uterus is growing and expanding, but unfortunately can be very uncomfortable,” says Raeonda Bullard, MD, a resident in the department of obstetrics & gynecology at the Medical College of Georgia at Augusta University .
This type of pain usually happens in the second trimester of pregnancy, into the third . It’s a common pregnancy symptom and other than being uncomfortable, it is not dangerous or permanent.
What does round ligament pain feel like?
Many times, round ligament pain causes discomfort that comes and goes on the right side of the abdomen, pelvis, or hip area. It can also happen on the left or even both sides of the body and radiate to the groin area.
“It is usually a sharp, shooting pain and often can range from moderate to severe in nature,” Dr. Bullard says.
Pain typically lasts for a few seconds at a time. It can also cause:
- Dull ache
- Cramping pain
- Muscle spasms
- Stretching or pulling sensation
Lots of pregnant women notice pain as they change positions, wake up and roll over in bed, or when they’re more active. Pain may also result from prolonged sitting, standing, or repetitive motion. Being active actually can reduce pain.There’s no diagnostic or lab test for round ligament pain. Providers diagnose it based on your symptoms and by excluding other possible causes of pain.
7 pregnancy-safe treatments for round ligament pain
Round ligament pain is common during pregnancy and treatable at home with lifestyle changes and over-the-counter medication.
“It is generally not a cause for concern and can be treated with conservative measures,” Dr. Brar says. To ease pain, experts recommend pregnant women:
- Try gentle stretches
- Change positions slowly, which helps to gently stretch ligaments
- Flex the hips before coughing, sneezing, or laughing to cut down on ligament strain
- Avoid prolonged sitting, standing, or inactivity
- Avoid rapid or repeated movements
- Take Tylenol ( acetaminophen ) with your healthcare provider’s approval
3 round ligament stretches
Special stretching exercises can also help to relieve round ligament pain. Be sure to go slowly and use a mat to make yourself more comfortable.
Position yourself on your hands and knees with your shoulders over your wrists and hips over your knees. The tops of your feet should also be flat on the mat. For the cow position, take a deep breath in, let your belly fall toward the floor, arch your back, and look up a bit to the ceiling. Then for the cat position, breathe out, push your hands into the mat, round your back, and look down at your belly. Repeat this stretch three to five times.
Lay on your back with your knees bent and feet flat on the mat. Inhale and squeeze your stomach muscles. Hold, and then push the small of your back into the mat. Slowly breathe out while counting to five. Repeat this stretch three to five times.
Lay on the mat on your left side in a fetal position. Support your head with your arm or a pillow, and place a pillow in between your legs. Hold this position for several minutes.
Other activities that may help
Prenatal yoga and low-impact activities such as fast walking, swimming, or elliptical training may promote core strength, balance, and flexibility—which can reduce overall aches and pains during pregnancy. In addition, if your pain persists, you may benefit from working with a skilled physical therapist to improve your conditioning, posture, and functionality.
What to avoid
Pregnant women should avoid taking Advil or Motrin (ibuprofen), especially during the third trimester. It could cause a critical blood vessel, called the ductus arteriosus, to close while the baby is in the womb. This blood vessel supplies the baby with nutrients and oxygen.
You may also be tempted to use a heating pad to relieve pain. But, heat on the abdomen is harmful since it can raise the baby’s temperature. Heating pads are okay to use for back pain on low heat for no longer than 20 minutes at a time.
When to call your healthcare provider
Pregnant women should be aware that there are other causes of pain in the abdomen—some harmless and some serious such as:
- Gas and constipation
- Braxton Hicks contractions (known as “practice contractions”)
- Ectopic pregnancy, or when an egg implants outside of the uterus
- Placental abruption, a potentially deadly condition in which the placenta breaks away from the uterus while the baby is still in the womb
- Miscarriage, or the loss of a pregnancy
- Urinary tract infection (UTI)
- Preeclampsia, a condition that causes high blood pressure during pregnancy
Here are some symptoms to look out for that something could be wrong:
- Frequent or constant pain
- Sharp pain that feels like contractions (comes in waves)
- Pain that becomes more severe
- Vaginal discharge (bleeding or loss of fluid)
- Abnormal fetal movement
“If a woman feels any of those [symptoms], then it’s unlikely to be round ligament pain,” says Dr. Brar. Any time you’re concerned, don’t hesitate to contact your OB-GYN or physician.
This article was medically reviewed by Lacy Windham, MD. Dr. Windham is a board certified Obstetrician & Gynecologist in Tennessee. She attended medical school at the University of Tennessee Health Science Center in Memphis and completed her residency at the Eastern Virginia Medical School in 2010, where she was awarded the Most Outstanding Resident in Maternal Fetal Medicine, Most Outstanding Resident in Oncology, and Most Outstanding Resident Overall.
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Round ligament pain is a common, although painful, complaint of women who are pregnant. It typically begins in the second trimester of pregnancy as the uterus grows. The round ligaments in the uterus stretch, becoming thin and taut like stretched-out rubber bands, to provide support for the expanding uterus.  X Trustworthy Source Mayo Clinic Educational website from one of the world’s leading hospitals Go to source At times, the ligament contracts, or spasms, on its own, resulting in moderate to severe episodes of pain. There are things that you can do to minimize the round ligament pain and discomfort during your pregnancy.
If you have been pregnant you have probably experienced round ligament pain.
It can be a mild ache to a sharp stabbing pain.
What is the round ligament?
It is a cylindrical ligament that attaches from the uterus to the pelvis. It keeps the uterus from twisting or shifting too far out of place.
During pregnancy the round ligament needs to stretch as the uterus expands.
However, depending on how fast it stretches or how tight it is, it may cause pain.
Pain is usually felt in the lower half of the abdomen, near the hip.
It may only occur when you transition from sitting to standing, as the tissues in the front of the hip stretch.
Or it may last all day, lingering.
Even though your round ligament needs to stretch during pregnancy, it doesn’t need to be painful.
Remember, just because you are pregnant doesn’t mean you have to experience the common aches and pains associated with pregnancy.
So what can you do about round ligament pain?
Here are a few tips to ease the pain you may be experiencing as your uterus expands and stretches.
Using a warm heating pad or taking a warm bath can sooth the achey tissues. If you use a heating pad, avoid electric ones, just in case you fall asleep you don’t want to burn yourself.
Doing simple stretches like pelvic tilts, side bends and and lunge stretch can help length the tissues around the uterus that may be inhibiting the round ligament.
As always when you stretch during pregnancy, avoid extreme positions, modify as necessary and use props!
Being mindful of your posture during pregnancy is not only good practice for overall health, but will put less strain on the round ligament as it supports the uterus.
Using your core muscles properly and doing simple core exercises improve your support of the uterus. This reduces the amount of work the round ligament needs to do, so it can stretch with less forces on it.
If you are unable to provide enough muscular support, wearing a maternity brace that helps lift your tummy the way your abs are meant to can help relieve some discomfort.
If you are experiencing severe round ligament pain that is really inhibiting your way of life, seeing a specialist may be your best bet. A pelvic floor PT who specializes in maternal health can perform manual therapy to release tight tissues and ease discomfort, help you find good posture, give you stretches most appropriate for you, and guide your through strengthening exercises.
Don’t let round ligament pain get you down. Head over to The Bailey Birth Method to learn more ways to promote good posture during pregnancy, safe exercises and more.