Round ligament pain is an uncomfortable sensation you may feel in your abdomen, hips or groin during pregnancy. Your round ligaments are two rope-like bands on each side of your uterus. Each one is about 10 to 12 centimeters long. They connect your uterus to your lower abdominal wall through your groin. During pregnancy, the round ligaments are placed under tension as they support your growing uterus. This tension can cause pain, especially when you move suddenly.
Understanding round ligament pain
Round ligament pain is a common and normal symptom of pregnancy. There’s no cause for worry. Talk to your pregnancy care provider if you experience round ligament pain and don’t find relief from resting or changing positions, or if the pain comes with vaginal bleeding or contractions.
What does round ligament pain feel like?
Round ligament pain usually occurs during the second trimester of pregnancy (weeks 14 through 27). But it can appear earlier or later in pregnancy. It usually happens with sudden movements. Women often describe round ligament pain as:
- Aches.
- Cramps.
- Spasms.
- Sharp, stabbing or pulling sensation.
Where do you feel round ligament pain?
The pain may occur on the lower part of your pelvis or in your groin area. It can occur on both sides or just one side. It typically lasts only a few seconds or minutes. It often happens repeatedly during the second trimester when your uterus begins to grow more quickly. If pain in your round ligament doesn’t go away after a few hours, call your healthcare provider.
Possible Causes
What causes round ligament pain?
As your uterus expands during pregnancy, your round ligaments get longer and wider because they’re supporting your growing belly. This places tension on the ligaments and can cause them to ache. Additionally, your round ligaments typically contract and loosen slowly. So, when they’re already stretching, and you move suddenly, you’re making the round ligaments move and contract faster than they can.
Round ligament pain typically occurs when your uterus is enlarged, most commonly in pregnancy. But round ligament pain may also occur in women who aren’t pregnant. This could be a sign of endometriosis, when your uterine lining grows outside your uterus.
Some of the more common triggers of round ligament pain occur when you move suddenly or abruptly. Understanding what triggers your round ligament pain and avoiding those movements can go a long way in feeling better.
Common triggers include:
- Changing positions (like standing up too quickly).
- Rolling over in bed or getting out of bed.
- Sneezing, coughing or laughing.
- Exercising.
Care and Treatment
What relieves round ligament pain?
There are several things you can do to ease any discomfort you feel due to round ligament pain. Some of those are:
- Wear an elastic belly band to support your belly.
- Stretch or do yoga to stretch the ligaments gently.
- Rest.
- Hold your belly or flex your hips when you sneeze, cough or laugh.
- Take acetaminophen for severe pain.
- Take a warm bath (not hot).
- Avoid positions that worsen the pain.
While round ligament pain is usually harmless, it’s best to tell your provider about your symptoms so they can make sure it’s not something more serious.
How can I prevent round ligament pain?
It’s not always possible to prevent round ligament pain. But you may be able to reduce the sudden movements that sometimes cause the pain such as:
- Avoid lifting heavy objects and standing for long periods of time during pregnancy. This will help lessen the stress on your round ligaments.
- If you think you’re about to laugh, sneeze or cough, try leaning forward first. Try placing your hands under or over your belly for support.
- Move slowly when changing positions. Try to avoid standing, sitting or rolling over suddenly.
- Try bending and flexing your hips throughout the day. Or try this floor stretch daily: Put your hands and knees on the floor. Lower your head toward the floor. Keep your butt in the air.
Additionally, you can ask your provider if yoga or other gentle exercises could help you.
Does round ligament pain go away?
Yes, it goes away. Some women say round ligament pain subsides by about the third trimester. Others don’t experience complete relief until after delivery when hormone levels drop and your uterus returns to its pre-pregnancy size.
Seek medical attention right away if you have abdominal pain and other symptoms, such as:
- Bleeding.
- Contractions.
- Chills.
- Fever.
- Nausea or vomiting not related to morning sickness.
- Pain or pressure in your lower back, another sign of labor.
- Severe pain that doesn’t go away.
- Vaginal discharge (any substance leaking from your vagina).
- Blood in your pee or pain when you pee.
It’s common for round ligament pain to keep you from getting comfortable at night during pregnancy. Healthcare providers typically recommend lying on your side, with your legs drawn up and a pillow between your knees. You should try lying on the opposite side to where you feel the pain the most. Sometimes, placing a second pillow underneath your belly also helps.
Pregnant women tend to begin feeling round ligament pain in the second trimester (from about 14 to 27 weeks) because your uterus is growing rapidly during this time. The exact time when it feels the worst varies from person to person.
Acupuncture for Round Ligament Pain in Tokyo: A Gentle Approach to Pregnancy Comfort
Pregnancy is a time of profound physical and emotional changes, but it can also bring discomforts like round ligament pain—a common issue that affects many expectant mothers, particularly in the second trimester. As the body adapts to support a growing baby, some women seek natural, non-invasive ways to manage this pain. Acupuncture, a cornerstone of traditional Oriental medicine (TOM), is gaining attention as a holistic option to ease round ligament pain.
Understanding Acupuncture’s Role
Acupuncture involves inserting thin, sterile needles into specific points on the body, called acupoints, to balance the flow energy along meridians. For round ligament pain, acupuncture aims to reduce discomfort by targeting acupoints related to the pelvic region, lower abdomen, and musculoskeletal system. Practitioners may also address factors like stress or muscle tension, which can amplify pain perception during pregnancy. The treatment is customized to each woman’s experience, taking into account her stage of pregnancy, pain patterns, and overall health.
Acupuncture’s appeal lies in its gentle approach, making it suitable for pregnancy when many medications are off-limits. It offers a drug-free way to manage pain while potentially improving relaxation and emotional well-being—benefits that resonate with many expectant mothers navigating the physical demands of pregnancy.
Potential Mechanisms Behind Acupuncture’s Effects
While TOM explains acupuncture’s benefits through the lens of energy balance, modern science suggests several physiological mechanisms that may help relieve round ligament pain:
- Pain Signal Modulation
Acupuncture stimulates the release of endorphins and other natural pain-relieving compounds, which can dampen the sharp or aching sensations associated with round ligament stretching. This effect may reduce the intensity of discomfort in the abdominal and pelvic areas. - Muscle Relaxation
The round ligaments are surrounded by pelvic and abdominal muscles that can tense up in response to pain or postural changes in pregnancy. Acupuncture may relax these muscles by deactivating trigger points and improving local blood flow, easing strain on the ligaments. - Improved Circulation
Enhanced blood flow to the pelvic region can support tissue health and reduce inflammation around the stretched ligaments. Better circulation may also alleviate feelings of tightness or pressure in the lower abdomen. - Stress and Tension Reduction
Pregnancy can bring emotional and physical stress, which may heighten pain sensitivity. Acupuncture activates the parasympathetic nervous system, promoting relaxation and lowering stress hormones like cortisol, potentially making round ligament pain feel less intense. - Hormonal Balance
Pregnancy involves significant hormonal shifts, including elevated levels of relaxin, which loosens ligaments to prepare for childbirth. Acupuncture may help regulate the body’s response to these changes, minimizing discomfort caused by ligament laxity.
These mechanisms align with TOM’s holistic focus and Western medicine’s emphasis on measurable outcomes, offering a complementary approach to managing round ligament pain.
What Does the Research Say?
Research on acupuncture specifically for round ligament pain is limited, as studies often focus on broader pregnancy-related discomforts like low back pain, pelvic girdle pain, or nausea. However, evidence from related areas suggests acupuncture’s potential for addressing ligament-related discomfort.
A 2015 systematic review in BJOG: An International Journal of Obstetrics and Gynaecology found that acupuncture significantly reduced pelvic and low back pain in pregnant women compared to standard care or sham acupuncture. Since round ligament pain shares similarities with these conditions—often involving musculoskeletal strain and pelvic changes—these findings are relevant. Another study, published in Acupuncture in Medicine in 2018, showed that acupuncture improved mobility and reduced pain in pregnant women with pelvic girdle pain, suggesting it could help with ligament-related discomfort.
Clinical reports and smaller trials also support acupuncture’s role. A 2021 pilot study in Journal of Integrative Medicine observed that pregnant women receiving acupuncture for abdominal or pelvic pain reported lower pain scores and less need for analgesics. While not exclusive to round ligament pain, these results highlight acupuncture’s promise for pregnancy-specific discomforts.
Anecdotal evidence further bolsters its case. Many pregnant women describe reduced pain, better sleep, and a greater sense of calm after acupuncture sessions. While larger, targeted studies are needed, the combination of preliminary research and patient experiences makes acupuncture a compelling option for round ligament pain.
What to Expect from Acupuncture Treatment
If you’re considering acupuncture for round ligament pain, understanding the process can help you feel confident and at ease, especially during pregnancy. Here’s what to expect:
- Initial Consultation: The acupuncturist will discuss your pregnancy, pain patterns, and overall health, including sleep, stress, and any other symptoms. In TOM, they may assess your pulse or energy balance to tailor the treatment. Be sure to share your due date and any medical conditions.
- Acupoint Selection: Common points for round ligament pain include SP6 (Sanyinjiao, on the inner leg), ST36 (Zusanli, below the knee), and CV6 (Qihai, on the lower abdomen, used cautiously in pregnancy). Points on the lower back or hips may also be selected to support pelvic stability.
- The Session: You’ll rest comfortably, often on your side or seated, to accommodate your belly. The practitioner inserts fine needles, which typically cause minimal sensation—perhaps a slight tingling or warmth. Needles remain in place for 15–30 minutes, and many women feel relaxed during this time.
- Treatment Frequency: For round ligament pain, 1–2 sessions per week over 4–8 weeks may be recommended, depending on pain severity. Some notice relief sooner, while others benefit from ongoing sessions as pregnancy progresses.
- Monitoring Progress: Your acupuncturist will check in regularly, adjusting points or frequency based on your response. They may suggest lifestyle tips, like gentle stretches, to enhance results.
Choose a practitioner experienced in prenatal acupuncture, ideally certified by a body like the NCCAOM in the U.S. or equivalent, and verify they follow pregnancy-safe protocols, avoiding points contraindicated for expectant mothers.
Practical Considerations and Safety
Acupuncture is generally safe during pregnancy when performed by a trained professional, with side effects like mild soreness or fatigue occurring in less than 1% of cases. Key considerations include:
- Safety First: Ensure your acupuncturist is aware of your pregnancy and avoids points that could stimulate uterine contractions (e.g., LI4 or BL60 in certain contexts). Complications are rare but discuss any concerns with your obstetrician.
- Cost: Sessions range from $60–$150, depending on location and expertise. Some insurance plans cover acupuncture for pregnancy-related pain, so check your coverage.
- Time Commitment: Sessions last 45–60 minutes, and regular treatments may be needed for sustained relief. Plan around prenatal appointments and rest needs.
- Medical Clearance: If you have a high-risk pregnancy or conditions like preeclampsia, consult your doctor before starting acupuncture.
Integrating Acupuncture with Other Strategies
Acupuncture works best as part of a holistic plan for managing round ligament pain. Complementary approaches can enhance comfort:
- Gentle Movement: Prenatal yoga, pelvic tilts, or walking can improve circulation and reduce ligament strain. Avoid sudden movements that trigger pain.
- Support Gear: A maternity belt or belly band can stabilize the uterus, easing ligament stress.
- Heat Therapy: Warm (not hot) compresses on the lower abdomen may relax muscles and complement acupuncture’s effects.
- Rest and Positioning: Resting on your side or using pillows to support your belly can reduce pressure. Avoid prolonged standing.
- Hydration and Nutrition: Staying hydrated and eating nutrient-rich foods supports tissue health and overall pregnancy wellness.
Tracking pain patterns—when it occurs, what worsens or helps—can guide your acupuncturist and inform other care decisions.
Conclusion
Acupuncture offers a gentle, pregnancy-safe way to manage round ligament pain, blending ancient TOM principles with modern insights. Its potential to ease discomfort, reduce stress, and support pelvic health makes it a valuable tool for expectant mothers seeking natural relief. While research continues to evolve, the growing body of evidence and positive experiences underscore its promise.
If you’re intrigued, consult a prenatal-trained acupuncturist to discuss your needs and explore this approach. Paired with lifestyle adjustments and open communication with your healthcare team, acupuncture can help you navigate round ligament pain with greater ease, letting you focus on the joy of your pregnancy journey.
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- Address: 132-0031 Matsushima 1-chome, 21-14, Tokyo, Japan
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