The uterus which is surrounded by round ligaments tends to grow during pregnancy. As a result of that, the ligaments thicken and stretch to support and accommodate the uterus. This causes pain on either sides or one side of the hip or abdomen area. The pain generally occurs during 2nd trimester of pregnancy. The pain commonly occurs as a stabbing pain or as short jabbing feeling when the person tries to change position. Simple activities like getting off the bed, getting off the chair, or rolling in bed can cause this pain to happen. Some pregnant women also complain of pain in their groin areas. This is an internal pain and considered to be absolutely normal during pregnancy.
Factors Triggering in Round Ligament Pain
If a pregnant woman suddenly moves or jerks her body, it creates a spasm which can result in round ligament pain. Sudden movement of the body causes quick contraction of the ligaments which can produce painful cramps. When a woman is pregnant, the uterus automatically stretches and so does the ligaments. These sudden changes in the body cause a shooting or grabbing pain in the groin or abdomen area. The pain has also been described by some women as dull achiness around the groin or abdomen area.
Signs and Symptoms of Round Ligament Pain
As the pressure gets relieved from the bladder, pregnant women start experiencing abdominal as well as round ligament pain, mostly during the thirteenth week. The ligaments pull and stretch to support the uterus which can cause severe pain. The primary symptoms of such a condition are sudden sharp, spasm in belly with the pain lasting only for few seconds. Rapid movements like standing up quickly, rolling in bed, laughing, coughing, sneezing, etc all can cause quick contraction of the ligaments leading to extreme pain. Pregnant women often complain of heartburn during this period as the acids from the stomach cause irritation of the lining of stomach leading to heartburn. The breasts feel extremely sensitive mainly because of production of colostrum.
Tests and Examinations for Round Ligament Pain
When the condition arises to make a visit to emergency department, the doctor in charge quickly examines the pregnant woman to ensure that life-threatening conditions are non-existent. Basic examinations are carried out in case of abdomen pain in the lower part like pelvic, digital rectal and abdominal examination. Even though, the patient might feel a bit uncomfortable during these examinations but, it helps the doctor to properly assess the condition of the patient and order appropriate tests so as to advise a treatment plan.
Blood tests detecting possible infection or anaemia might be recommended by the doctor as during pregnancy women tend to be a little bit anaemic. There might be a surge in WBC count which is common during pregnancy. Apart from that, urine sample might be tested to detect infection in the urinary tract which can cause complications to the unborn baby. Extreme flank pain often gives indications of Kidney stone and the diagnosis is necessary to get a clear picture. Ultrasound or scan of pelvis is also recommended by doctors to assess certain conditions like:
- Ovarian Cysts
- Ectopic Pregnancy
- Bladder or Kidney stones
- Placental Abruption
Causes of Round Ligament Pain
The uterus of a woman’s body is supported with the help of thick ligament bands which run from groin up to abdomen side. With the growth of uterus during pregnancy, women tend to experience pain with the ligaments thinning out and stretching to accommodate increasing weight of the uterus. The increasing pressure can at times cause dull aches or/and sharp pains mostly, in the lower part of the abdomen. This pain increases considerably when the person tries to get up from bed quickly, change positions quickly and even while coughing. The pain is brief and stays only for few seconds. Till the time, the pain is occasional and not accompanied by other symptoms there is hardly anything to get worried of.
Prevention from Round Ligament Pain
Round Ligament pain occurs naturally during pregnancy as the body experiences different changes taking place. The sharp pain can be through slow movements during rolling over, sitting and standing. Girdle or maternity belts are also used by many women to get some relief from the severe surge of pain lasting momentarily. Shifting positions or slipping to a hot bath is also recommended by doctors when women it difficult to cope with the growing pain. However, the good part is that, the pain generally subsides by 3rd trimester and there are also women who never feel such pains during pregnancy.
Differential Diagnosis for Round Ligament Pain
Round ligament pain symptoms can get mistaken with specific medical conditions in women. This is why, differential diagnosis is always recommended by doctors when it comes to abdominal pain during pregnancy. The diagnosis of the patient is carried out to look for other conditions like ovarian cysts, appendicitis as well as abdominal cramps. Experienced doctors can easily differentiate such conditions with pregnancy and refer the patient for exams and tests to come up with a proper treatment plan.
Treatment for Round Ligament Pain
Pain Relief Tips
- Stretching of the ligaments can be avoided by bending and flexing at hips while laughing, coughing or sneezing.
- It is always better to avoid sitting or even standing for long time periods as it leads to increased pressure on stretching and growing ligaments.
- The body should be lifted slowly from all types of position which prevents the stretching of the ligaments and reduces pain.
- The Pelvic Tilt happens to be a recommended exercise for strengthening the ligament muscles and relieve the pain associated with it. The person should lie with hands at the side and legs straight with the feet straight up against the wall. The pelvis should be raised from the floor by exhaling and hold in that position for about five seconds. It should be repeated at least five times in a row.
- The kneeling exercise is also a good option for those suffering from round ligament pain. The person should kneel down with hands in front. The head should be lowered towards the floor by keeping the buttocks in air. This position should be maintained for nearly thirty seconds and repeated after relaxing.
- OTC medication like acetaminophen (Tylenol) may be prescribed by the doctor to offer the patient with some relief from the sudden surge of pain because of increasing pressure on ligaments around uterus.
Round Ligament Pain ICD-9 and ICD-10 Codes