Groin pain, experienced as discomfort in the lower abdomen, inner thighs, or pubic bone area, is common during pregnancy. This discomfort, often referred to as pelvic girdle pain, typically begins in the second trimester and intensifies as the body prepares for birth. While the pain can be disruptive, safe and practical measures exist to manage symptoms and provide relief. Understanding the physical changes driving this pain is the initial step toward effective management.
Identifying the Sources of Groin Pain
Groin pain during pregnancy stems from two distinct causes, each with different sensations and triggers. The first is Round Ligament Pain (RLP), which results from the stretching of the two thick, cord-like ligaments supporting the uterus. As the uterus expands, these ligaments pull taut, causing a sudden, sharp, and brief jabbing sensation. This pain is often felt on the right side and is provoked by quick movements, such as a cough, sneeze, or rolling over in bed.
The second cause is Pelvic Girdle Pain (PGP), historically known as Symphysis Pubis Dysfunction (SPD), which affects up to 20% of pregnant people. PGP is a chronic, dull ache concentrated at the pubic symphysis—the joint where the two halves of the pelvis meet. Hormonal changes soften pelvic ligaments, leading to uneven movement and instability in the pelvic joints. This instability causes pain that worsens with single-leg activities, such as climbing stairs, walking long distances, or getting dressed while standing.
Immediate Adjustments for Daily Relief
Managing movement patterns is an effective first line of defense against both RLP and PGP. When getting in or out of a car, pivot the body and keep both knees pressed together to prevent joint separation. When getting out of bed, use “log rolling,” a technique that maintains pelvic alignment by moving the torso and legs simultaneously.
Avoiding activities that require standing on one leg significantly reduces pain caused by pelvic instability. Sit down to put on pants or socks rather than attempting to balance while standing. Taking smaller steps while walking minimizes the shearing force placed on the pubic symphysis. Reducing the distance walked and breaking up large chores into smaller tasks can lessen pelvic strain.
Simple home remedies provide immediate, localized comfort. Applying a cold pack wrapped in a towel to the area of maximum pain for 20 to 30 minutes can help reduce inflammation and dull discomfort. For sleeping, placing a firm pillow between the knees and ankles helps maintain neutral hip and pelvic alignment.
Utilizing External Support and Physical Therapy
External supportive devices offer mechanical stability to the pelvic structure, compensating for loosened ligaments. A sacroiliac (SI) belt, often recommended for PGP, wraps low around the hips and stabilizes the sacroiliac joints. This bracing limits excessive movement in the pelvis during periods of increased activity.
The SI belt focuses on compressing and stabilizing the pelvic ring, unlike abdominal belly bands that lift the weight of the uterus. Wear the belt only during necessary activities, such as walking or standing for long periods. This prevents stabilizing muscles from becoming overly reliant on external support and reduces the intensity of pain flares.
Consulting a pelvic floor physical therapist (PT) provides a targeted, long-term approach to managing groin pain. A PT can accurately diagnose the source and prescribe strengthening and stabilization exercises. These exercises focus on activating the deep core muscles, gluteal muscles, and pelvic floor, which support the pelvis.
PT-recommended exercises include gentle pelvic tilts, which improve mobility and awareness of pelvic position. Strengthening exercises like glute bridges and clamshells help stabilize the hip and pelvic joints. Performing a gentle adductor squeeze, such as pressing a small ball between the knees, helps recruit stabilizing muscles without causing excessive pain.
Warning Signs and When to Consult a Doctor
While most groin pain during pregnancy is benign and manageable, certain symptoms indicate a need for immediate medical attention. Severe pain that is sudden, consistently worsening, or not relieved by rest or conservative measures should be evaluated by a healthcare provider. Unilateral pain that is sharp and debilitating, especially if it makes walking nearly impossible, may signal a more serious musculoskeletal issue.
Monitor for signs beyond typical musculoskeletal discomfort. Groin pain accompanied by a fever, chills, or vaginal bleeding requires prompt medical consultation, as these may indicate an infection or complication. If the pain is associated with new difficulty urinating, bowel changes, or significant swelling, a doctor should be notified immediately.