What Is Round Ligament Pain and Can a Chiropractor Help?

Round ligament pain is a sharp, pulling or cramping pain in the lower belly or groin caused by the ligaments that support the uterus stretching as it grows. Cleveland Clinic describes it as most common in the second trimester, weeks 14 through 27, and says an episode usually lasts only a few seconds or minutes. Cleveland Clinic calls it "a common and normal symptom of pregnancy."

The research on hands-on care in pregnancy is about low back and pelvic pain, not round ligament pain by name, so nobody can promise a result for this symptom. A 2015 Cochrane review of 34 randomized trials involving 5,121 pregnant women found that a multi-modal approach of manual therapy, exercise and education "may be of benefit" for that pain, and the review also described the evidence for exercise as low quality. This post explains what the round ligaments are, why they hurt, what you can do at home, where gentle chiropractic care fits, and which symptoms mean you should call your provider instead.

What Are the Round Ligaments?

The round ligaments are two rope-like bands, one on each side of the uterus, that connect the uterus to the lower abdominal wall through the groin. Cleveland Clinic puts them at about 10 to 12 centimeters long.

As the uterus expands, the round ligaments get longer and wider because they are supporting a growing belly. They handle slow, steady stretch well. A sudden movement asks them to move and contract faster than they can, and that is the jab you feel.

What Does Round Ligament Pain Feel Like?

Most women describe an ache, a cramp, a spasm, or a sharp, stabbing or pulling feeling low in the pelvis or in the groin. It can show up on one side or both.

The pain tends to arrive with movement. Common triggers listed by Cleveland Clinic include:

• Changing positions quickly, such as standing up from a chair

• Rolling over in bed

• Sneezing, coughing or laughing

• Exercise

Round ligament pain comes and goes. If the pain is constant, keeps building, or comes with other symptoms, treat it as something else until your provider says otherwise.

What Helps Round Ligament Pain at Home?

Small changes in how you move usually make the biggest difference, because the pain is set off by sudden stretch.

• Slow down transitions. Roll to your side and push up with your arms when you get out of bed.

• Try an elastic belly band. Cleveland Clinic lists it as one of the first things to try.

• Rest and change position when an episode starts.

• Use warmth. A warm bath can ease the ache.

• Ask your provider before taking any medicine. Cleveland Clinic mentions acetaminophen for stronger pain, and that is a decision to make with your own doctor or midwife.

Gentle stretching is on Cleveland Clinic's list too, including a daily floor stretch on hands and knees with the head lowered toward the floor, and bending and flexing the hips through the day. Keep every stretch slow, and stop if it brings on the sharp pull.

Can a Chiropractor Help With Round Ligament Pain?

A chiropractor cannot shorten or "fix" a stretching ligament, and the stretching itself is a normal part of pregnancy. What prenatal chiropractic care works on is the area around those ligaments: the pelvis, the lower back and the muscles that attach to them.

During pregnancy your center of gravity moves forward and the pelvic joints loosen. When the pelvis and lower back are stiff or moving unevenly, the tissues attached to them can end up under uneven tension. Gentle adjustments and soft tissue work aim to keep the pelvis moving well so those tissues are not pulled harder on one side than the other.

On the research side, the 2015 Cochrane review is a fair summary. It covered low back and pelvic pain in pregnancy, not round ligament pain by name. It found that manual therapy combined with exercise and education may be of benefit, that the evidence for exercise was low quality, and that when side effects were reported, there were no lasting ones in any study. Many expecting mothers at our office report easier movement and less discomfort with care. That makes it a reasonable thing to try, and it is not a guarantee.

If you are new to care during pregnancy, our post on whether prenatal chiropractic is safe during pregnancy covers positioning, pressure and what a visit looks like.

How Does Prenatal Chiropractic Care Work at Our Office?

At Barto Family Chiropractic, prenatal chiropractic care in Monroeville uses gentle techniques and positioning made for a pregnant body. Dr. Stephanie Parrish is certified in the Webster Technique, a specific way of evaluating and adjusting the pelvis during pregnancy that includes the soft tissues connecting the uterus to the pelvis.

For the lower back of pregnant patients she recommends a handheld instrument called an Activator, which delivers a quick, low-force adjustment. You can read how the method works in our guide to the Webster Technique in prenatal care.

Chiropractic care sits alongside your prenatal care. It does not replace your OB or midwife, and we want them to know what you are feeling.

When Is Belly Pain in Pregnancy Something Else?

Round ligament pain is brief and tied to movement. Pain that does not fit that pattern needs a call to your provider.

Cleveland Clinic advises contacting your provider if the pain comes with bleeding, contractions, chills or fever, or if you have severe pain that does not go away.

The CDC's Hear Her campaign lists urgent maternal warning signs that call for immediate medical care during pregnancy and in the year after delivery. Several involve the belly or pelvis:

• Severe belly pain that is sharp, stabbing or cramp-like and does not go away

• Vaginal bleeding or fluid leaking during pregnancy

• Your baby's movement stopping or slowing

• A fever of 100.4°F or higher

• Severe nausea and vomiting

If you are unsure which kind of pain you have, call your OB or midwife first. A chiropractor is the right visit after a medical cause has been ruled out, not before.

FAQ

When does round ligament pain start?

It usually starts in the second trimester, between weeks 14 and 27, according to Cleveland Clinic. Some women feel it earlier or later.

How long does round ligament pain last?

A single episode usually lasts only a few seconds or minutes. The episodes can come and go through the second trimester. Pain that lasts for hours is not typical and is worth a call to your provider.

Which side does round ligament pain happen on?

Either side, or both. Cleveland Clinic notes it can occur on both sides or just one.

Is round ligament pain dangerous for the baby?

Cleveland Clinic describes it as a common and normal symptom of pregnancy and says there is no cause for worry. Providers still ask about it to make sure the pain is not coming from something else.

Does a belly band help round ligament pain?

It can. An elastic belly band supports the weight of the belly and is on Cleveland Clinic's list of relief measures. Wear it during the parts of the day when you are on your feet, and ask your provider how long to keep it on.

Is it safe to see a chiropractor while pregnant?

Many women do throughout pregnancy. Choose a chiropractor with specific prenatal training, tell them how far along you are, and keep your OB or midwife in the loop. Our article on how often you should see a chiropractor explains how visit schedules are set.

What happens at a first prenatal chiropractic visit?

You will talk through your pregnancy and your symptoms, then have a gentle exam of your spine and pelvis before any adjustment. Our walkthrough of what to expect at your first chiropractic visit has the details.

Prenatal Chiropractic Care in Monroeville, PA

Dr. Stephanie Parrish has focused on prenatal and pediatric care since starting her practice in 2014, and she holds Webster certification through the International Chiropractic Pediatric Association. She is a mom herself, and the office is at 1000 Infinity Dr Ste 310 in Monroeville.

If round ligament pain, back pain or hip discomfort is making pregnancy harder than it needs to be, we are glad to take a look and tell you plainly whether we think we can help.

Visit Barto Family Chiropractic or call 412-793-3300 today. Contact us for more information.