Pelvic Pain, Sciatica or Round Ligament Pain? How to Tell the Difference in Pregnancy
Back, hip and belly pain in pregnancy often get lumped together as “normal,” but they are not the same thing. Round ligament pain, pelvic girdle pain and sciatica each have a different pattern, a different cause and a different plan. Here is how to tell them apart, with the caveat that only a provider who examines you can say for sure.
Round ligament pain
- Where: the lower pelvis or groin, on one or both sides.
- What it feels like: an ache, cramp or spasm, or a sharp, stabbing or pulling feeling that usually lasts only seconds to minutes.
- When it shows up: most often in the second trimester, according to Cleveland Clinic’s guide to round ligament pain.
- What sets it off: sudden movements such as standing up quickly, rolling over in bed, sneezing, coughing, laughing or exercising.
- What often helps: slower movements, supporting your belly when you sneeze or cough, gentle stretching, rest, a warm (not hot) bath, or an elastic belly band.
Pelvic girdle pain
- Where: over the pubic bone at the front, across one or both sides of the lower back, or between the vagina and anus, and sometimes spreading to the thighs, according to the NHS page on pelvic pain in pregnancy.
- What it feels like: pain, sometimes with clicking or grinding in the pelvis, linked to pelvic joints that are stiff or moving unevenly.
- What sets it off: walking, climbing stairs, standing on one leg, turning over in bed, or moving your legs apart.
- What often helps: staying active while avoiding what hurts, supportive shoes, keeping your knees together when getting in and out of a car, avoiding long stretches of sitting or standing, and physiotherapy exercises. The NHS also mentions support belts or crutches in some cases.
The NHS suggests contacting your midwife or doctor if it is hard to move around, it hurts to get out of a car, or stairs are painful.
Sciatica
- Where: typically starts in the low back or buttock and travels down the back of one leg.
- What it feels like: shooting or burning pain, often with tingling, numbness or pins and needles.
- What sets it off: it varies, but long stretches of sitting, certain positions and some movements can aggravate it.
- What often helps: position changes, gentle movement, and an evaluation to find out what is irritating the nerve.
Sciatica-type symptoms are worth mentioning to your OB or midwife. If you lose feeling in a leg, your buttocks or your genital area, or have trouble controlling your bladder or bowels, get emergency care right away. The NHS guide to back pain in pregnancy lists loss of feeling in those areas alongside back pain as an emergency.
Why the difference matters
The three can overlap, and all of them can be mistaken for plain muscle strain in the low back. Treating the wrong problem wastes time and can leave you hurting longer than you need to. That is why we start with an evaluation: your history, how you move, and when appropriate a CLA INSiGHT scan, before we recommend anything. If what you describe sounds like it belongs with your OB or midwife, we will say so. If you are still deciding whether chiropractic is an option at all, our article on whether chiropractic care is safe during pregnancy lays out what the research does and does not show.
Call your OB or midwife right away if…
Abdominal or pelvic pain with any of these needs prompt medical attention:
- Vaginal bleeding, or fluid leaking.
- Regular contractions or belly tightening, or a constant low, dull backache before 37 weeks. These can be signs of preterm labor, and March of Dimes covers them in its preterm labor warning signs guide.
- Fever or chills.
- Severe or persistent pain.
- Changes in vaginal discharge, or burning when you urinate.
- Nausea or vomiting that is not your usual morning sickness.
Where chiropractic may fit
After your OB has ruled out anything urgent, chiropractic care may be an option for pelvic and low back pain linked to how your joints and muscles are working. The research is limited, and we will not promise a result. We can tell you whether we think an evaluation is worthwhile for what you are feeling.
If the ache is mostly on the outer hip, see how we approach hip pain during pregnancy. If your pain sits mostly in the low back, our page on back pain during pregnancy goes deeper. If it matches the sciatica pattern, see how we handle back pain and sciatica in Colleyville. And if any of these are keeping you up, try our tips on sleeping with back pain during pregnancy. For care through each trimester, start with prenatal chiropractic at Radiant.
Not sure which one you have?
An evaluation is the fastest way to sort it out, and we will tell you plainly if it belongs with another provider.
Sources
This article is for general education and is not medical advice. For questions about your own health or your child’s, talk with your doctor, OB, midwife or pediatrician.
From the team at Radiant Chiropractic, 8090 Precinct Line Rd, Ste 101, Colleyville, TX.
About the Author
Dr. Cameron Williams, DC
Founder of Radiant Chiropractic in Colleyville, TX
Webster Certified (ICPA)CLA INSiGHT Scanning
Dr. Williams found chiropractic in college, after nearly a year of migraines nothing else had touched. He holds a B.S. in Kinesiology from the University of Arkansas and his Doctor of Chiropractic from Parker University, and guides every care plan with CLA INSiGHT nervous system scans.
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