Causes of round ligament pain during pregnancy—and 7 pregnancy-safe treatments

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:

1. Try gentle stretches
2. Change positions slowly, which helps to gently stretch ligaments 
3. Flex the hips before coughing, sneezing, or laughing to cut down on ligament strain
4. Avoid prolonged sitting, standing, or inactivity
5. Avoid rapid or repeated movements
6. Rest
7. 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.

Cat-cow

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.

Pelvic tilts

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.

Savasana pose

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. 

RELATED: What medications are safe to take during pregnancy?

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 
• Sciatica

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)
• Fever
• Chills
• Nausea
• Vomiting
• 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.