Pregnancy and birth may be a miraculous, special time, but rapid changes in a woman’s body can cause unexpected pain issues. While back pain may get the most press when it comes to the side effects of these changes, hip pain during pregnancy is more common than people think. Sometimes referred to in research as pelvic girdle pain, pregnancy hip pain can range in severity from mildly uncomfortable to completely incapacitating.
Contrary to some other pain conditions which may be a result of our modern way of living, hip pain in pregnancy was recorded by Hippocrates as early as 4 B.C.E. In pelvic girdle pain syndrome, pain originates in one of three joints in the hips. At its most extreme, it can result in the inability to complete daily activities like getting out of bed or climbing stairs.
Other types of hip pain can be located in various places across the hips, including:
- Around the lower back
- The top of the hip joints
- The top of the femur bone
- On the sides of the hips themselves
A small study of hip pain during pregnancy found that just over 20% of women reported substantial hip pain in their 33rd week of pregnancy, but it is possible that the rate is much higher.
What are the risk factors for pregnancy hip pain?
While no one risk factor for hip pain is clear, a 2006 study found that a collection of risk factors were more likely to produce hip pain that was impactful. These risk factors include:
- Low job satisfaction
- High levels of stress
- Earlier trauma to the back or pelvis
- Having a previous pregnancy
What causes hip pain during pregnancy?
While the most common cause of hip pain in general is arthritis, the causes of hip pain in pregnancy are distinct in each trimester.
Hip pain in early pregnancy
Hip pain in early pregnancy is arguably the least impactful symptom of the first trimester, but pregnancy hip pain at any stage is possible. When a woman becomes pregnant, the body begins to release the hormone relaxin. Relaxin allows tendons and ligaments to stretch to allow the pelvis to open for birth.
While relaxin itself is not the cause of pain, towards the end of the first trimester, the relaxed ligaments and tendons may allow weight distribution to change. This can cause hip pain in early pregnancy.
Towards the end of the first trimester, pregnant women may experience hip pain if they are sleeping exclusively on their backs. Weight gain in general can pull the pelvis into an anterior (forward) tilt, causing stress on the lower back. This can also result in pain.
Second trimester pregnancy hip pain
As the baby grows, pregnancy hip pain may grow with it.
In addition to hip pain caused by the uneven distribution of weight and the additional weight that naturally occurs as the baby develops, hip pain can also be caused by the baby itself. The growing baby may press on the sciatic nerve as the uterus expands. The sciatic nerve is the longest nerve in the body. It runs from the lower back, across the hip, and down the leg to the feet. When the nerve is compressed by a growing baby, pregnant women can experience dull and aching or sharp and sudden pain.
Between the 18th and 24th week of pregnancy, pregnancy hip pain may also be caused by stretching muscles as a woman’s belly becomes more pronounced.
Third trimester pregnancy hip pain
In the third trimester, all of the previous pain-causing symptoms can intensify. The baby is bigger, weight gain is more pronounced, and the stress on ligaments increases. Because of this, hip pain in the third trimester may be more intense.
Even if you have been pain-free in the first two trimesters, the third trimester may see an increase in hip pain. Round ligament pain is a throbbing pain in the hip and groin area that changes as the baby moves. This is completely normal but can be very uncomfortable in the last weeks of pregnancy.
Another condition called transient osteoporosis can develop. Transient osteoporosis can cause a temporary thinning of the upper femur bone. In extreme cases this can lead to hip fracture. This condition is diagnosed using an MRI.
For all stages of pregnancy, but often most frequently in the final trimester, changes in posture can be a very common cause of hip pain in pregnancy. A woman of average weight may gain between 25 and 35 pounds during pregnancy, with the bulk of that weight in the front of the abdomen. As the abdomen grows it can be difficult to maintain a natural gentle curve in the lower back. As the curve becomes more pronounced and the lumbar vertebrae compress, back and hip pain can result.
Pregnancy hip pain…after birth?
While many women experience near immediate relief of hip pain after birth, some may find that their hip pain is still present after their child is born. While birth is a completely natural process in a woman’s body, the stress of both pregnancy and childbirth does require a period of healing. The ligaments and tendons that were stretched do not return immediately back to their former shape, and only some of the baby weight goes away when the baby is born. Some residual pain may be present as the body heals.
Rarely, women may develop piriformis syndrome after cesarean delivery. This type of hip pain may be attributed to prolonged sitting after the procedure that leads to pressure on the piriformis muscle.
How to relieve hip pain during pregnancy
Hip pain in early pregnancy, late pregnancy, and even after birth may be common, but there are ways to relieve (and prevent) pain. Here are ten steps to prevent and manage mild to moderate hip pain during pregnancy.
- Stay active
- Stand tall
- Use supportive props
- Try exercise
- Get chiropractic care
- Investigate complementary and alternative medicines
- Get in water
- Book a therapeutic massage
- Eat well
- Get support
Step 1: Stay active
While you may have your hands full keeping food down and staying awake in early pregnancy, when it comes to preventing pregnancy hip pain, activity is good. Daily walking will improve overall health and mood. Specific pregnancy exercises like pelvic tilts can keep the abdominal muscles strong.
Prenatal yoga is also a great way to prepare the body and mind for birth. If you are already an active person, you can continue with your regular routines throughout the first trimester (but talk to your doctor!). If you haven’t been active, aim for some amount of daily physical activity that works the whole body (e.g. walking, biking, or swimming). Bonus points for activity in nature – walking outside can lower anxiety and combat hormone-related depression.
Step 2: Stand tall
As pregnancy progresses, it becomes more important to practice correct posture. Learning proper alignment for standing and sitting is crucial and will help you keep your spine healthy (and hips pain-free) throughout your pregnancy.
Step 3: Use props
As pregnancy progresses, sleeping and even sitting for long periods of time may become difficult. Invest in a body pillow for sleeping, and experiment with different positions to find what supports your growing belly the best. You may also want to re-evaluate your mattress. Even if you normally prefer a firm mattress, pregnant bodies may like a little softness at night. Consider a memory or egg crate foam mattress topper as an affordable way to add some padding.
For sitting, using a lumbar pillow and making sure your chair allows both feet to rest flat on the ground can help tendons in the front and sides of the hips to relax. Getting up to stretch at least once or twice an hour can also help hips feel more comfortable.
Step 4: Try exercises for pregnancy hip pain
You’re walking, you’re swimming, but you still have hip pain?
There are specific exercises for hip pain that can help. Many of these exercises can be done in just a few minutes and can greatly improve your quality of life every day. Treat these as a relaxing form of self-care, not a strenuous workout.
After the hard work of childbirth and the newness of parenting an infant, the last thing you might want to do is exercise. However, moving your body as much as possible postpartum is one of the best things you can do for hip pain after pregnancy. You needn’t exercise strenuously or for long periods of time. Exercise in the weeks after childbirth can be as simple as parking the car far away from the entrance to stores or strolling around the block with your baby. Postnatal yoga is also a gentle way to stabilize joints and rebuild muscles, particularly in the pelvic region.
Step 5: Get chiropractic care
Chiropractic care can make a big difference in hip pain during pregnancy.
The additional weight and its attendant changes in posture during the ten months of pregnancy can wreak havoc on the spine. Regular chiropractic care from a doctor who specializes in treating pregnant women can help to realign the spine and support pregnancy health.
Step 6: Investigate complementary and alternative medicines
There are a host of complementary and alternative medicines with positive, research-based results in pain relief.
Acupuncture is one that is gaining widespread acceptance. Traditionally practiced for over 3,000 years, this ancient Chinese medicine places hair-thin needles into specific energy points in the body. While it is unclear how these needles work, acupuncture is a proven pain reliever in late pregnancy.
Another complementary medicine that has been showing positive effects in the research is mindfulness meditation. Mindfulness meditation is the practice of noticing discomfort and stress, and then breathing and letting it go. While the practice sounds simple, the effects can be profound. Four recent studies on mindfulness meditation in pregnancy found overwhelmingly that this practice:
- Reduces stress
- Increases positive feelings
- Contributes to pain management
All of these benefits, with no side effects!
Step 7: Get in water
While hot tubs are generally not recommended in the final months of pregnancy, immersing yourself in water can provide relief for all types of pain as you near your due date. Heading to a swimming pool for some slow laps or even to just bob up and down on a floatie. Both can help provide some lift and relieve the pressure on your hips, pelvis, and low back.
Head towards the deep end with a flotation device and allow your lower body to relax down to feel length in your spine and across your hips.
Step 8: Book a therapeutic massage
Pregnancy massage can help release tension in the hips and back. It also confers the benefit of deep relaxation to a tired, pregnant person.
Step 9: Eat well
Pregnancy cravings are not a myth, but try hard to maintain a (mostly) healthy diet of whole grains, fresh fruits and vegetables, and proteins, including those high in brain-healthy omega-3 fatty acids.
Foods high in fat, sugar, and salt can increase fatigue and affect sleep. That frosting covered pickle may sound like a good idea, but take care to eat well throughout your pregnancy.
Step 10: Get support
Childbirth and parenting are two of the toughest jobs on earth, and there is often no rest for the weary. If you are overwhelmed and stressed with your newborn (or yourself), or you are feeling significant pain and fatigue, reach out and get help.
Postpartum depression affects one in seven women, but the other six often experience difficult feelings after birth, too. Emotional challenges can increase the perception of pain. Find a support network of moms, family members, or friends to help you through those first challenging months.
When is hip pain during pregnancy an emergency?
While many cases of mild to moderate hip pain can be treated at home, severe hip pain during pregnancy should be immediately evaluated by a doctor.
Hip pain before the 37th week of pregnancy that radiates towards the thighs and is accompanied by abdominal cramping, back pain, or vaginal discharge may be a sign of early labor. If you have any concerns about hip pain during pregnancy, talk to your doctor.
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