Round ligament pain (RLP) is known for the sharp, sudden jabbing sensation it causes in the lower abdomen and groin during pregnancy, occurring when the growing uterus stretches its supporting structures. It is possible to experience pain related to or mimicking RLP when not pregnant, though this is much less common and usually indicates a different underlying issue. While true ligament strain can happen, any sudden, intense pain in this region warrants careful evaluation.
The Round Ligament’s Location and Function
The round ligament is a pair of structures composed of connective tissue that helps maintain the position of the uterus. Each ligament originates at the upper side of the uterus and extends through the pelvis. The ligament then traverses the inguinal canal, a passage through the abdominal wall, before terminating in the tissue of the labia majora in the groin area.
In the non-pregnant body, the ligament is relatively firm and flexible, acting to hold the uterus forward in a slightly tilted position. Because the ligament is not under tension, quick movements typically do not cause the sharp, sudden spasms characteristic of RLP in pregnancy. Its path through the inguinal canal makes it a common site for pain from other sources to manifest in the lower abdomen and groin.
Non-Pregnant Causes of Ligament Strain
True pain originating from the round ligament when not pregnant is relatively rare but can occur due to mechanical stress or inflammatory conditions. Acute strain can happen during sudden, extreme physical movements such as a forceful twist, heavy lifting, or strenuous exercise. This movement can cause an acute, temporary strain or minor tear in the ligament’s fibers, resulting in brief soreness or a sharp sensation in the lower abdomen.
Chronic inflammation or masses along the ligament’s path can also cause discomfort. A specific, though rare, pathology is the development of a hydrocele in the Canal of Nuck, a small pouch that accompanies the round ligament through the inguinal canal. Endometriosis, where tissue similar to the uterine lining grows outside the uterus, can also implant directly onto the round ligaments and cause cyclical or chronic pain in the area.
Conditions That Feel Like Round Ligament Pain
Since the round ligament passes through the groin, numerous conditions causing sharp, sudden, or radiating pain in this region are frequently mistaken for RLP. One of the most common mimics is an inguinal or femoral hernia, where tissue or a portion of the intestine pushes through a weak spot in the abdominal wall near the groin. This can cause a sudden, sharp pain that worsens with straining, coughing, or standing, closely mimicking RLP.
Pain from the reproductive organs, particularly the ovaries, can also feel like RLP because of their proximity to the ligament’s origin. The sudden onset of intense pain may suggest an ovarian cyst rupture or ovarian torsion, where the ovary twists on its supporting ligaments, cutting off blood supply. These conditions cause severe, stabbing pain that requires immediate medical attention.
Conditions involving inflammation or infection in the pelvic region are common sources of misdiagnosed pain. Endometriosis can cause chronic pelvic pain that may radiate to the groin. A muscle strain in the lower abdominal wall or hip flexors can also produce a sharp, localized pain that is indistinguishable from true ligament strain. Pain from kidney stones can also radiate downward to the groin, presenting as a sudden spasm.
Guidance on Seeking Medical Care
Any person experiencing sharp, sudden, or persistent pain in the lower abdomen or groin should consult a healthcare provider for an accurate diagnosis. Since true RLP outside of pregnancy is rare, a medical professional must perform a thorough examination to rule out more serious causes. A pain that is severe and comes on suddenly, lasting for more than a few minutes, is a red flag that needs immediate assessment.
It is especially important to seek urgent medical care if the pain is accompanied by other systemic symptoms. These include fever, chills, nausea, vomiting, vaginal bleeding, or unusual discharge. Changes in urinary or bowel habits, or pain that is so intense it makes walking difficult, are also signs that the issue may indicate an infection, torsion, or other acute abdominal emergency.