Hip pain is a common experience during pregnancy. Up to 70% of pregnant people experience some form of pelvic or lower back pain, often including the hips. This discomfort is a normal consequence of the numerous physiological changes the body undergoes to prepare for childbirth and accommodate a growing fetus. Understanding the causes behind this pain can help in managing the discomfort.
Understanding the Physiological Causes
The body prepares for birth by releasing the hormone relaxin, which increases throughout pregnancy. Relaxin softens and loosens the ligaments and connective tissues surrounding the joints, especially in the pelvis, allowing for necessary expansion during delivery. This increased flexibility, however, can lead to instability in the pelvic girdle joints, stressing surrounding muscles and causing generalized hip soreness.
As pregnancy progresses, the increasing weight shifts the body’s center of gravity forward. This change forces the spine and pelvis to compensate, often resulting in an increased arch in the lower back, known as lumbar lordosis. This postural change, combined with the extra mechanical load from weight gain, places strain on the hip joints and stabilizing muscles. The resulting muscle imbalance and joint stress contribute directly to the dull, aching hip pain often felt in the second and third trimesters.
Recognizing Pelvic Girdle Pain (PGP)
Pelvic Girdle Pain (PGP) affects approximately one in five pregnant people. PGP is pain experienced in the joints that make up the pelvic ring, including the two sacroiliac joints at the back and the pubic symphysis at the front. The former term, Symphysis Pubis Dysfunction (SPD), refers specifically to pain in the pubic joint.
PGP is characterized by stiffness or uneven movement of these pelvic joints, leading to pain that can range from a mild ache to a sharp, shooting sensation. The pain is often felt over the pubic bone, in the lower back on one or both sides, and radiating down to the thighs. A defining feature of PGP is that the pain is often worsened by asymmetrical movements of the legs.
Activities that stress the pelvic joints, such as walking, climbing stairs, or turning over in bed, can intensify PGP symptoms. Standing on one leg while getting dressed is another common trigger. Some individuals may also feel or hear a clicking or grinding sensation in the pelvic area, indicating joint instability. While PGP is not harmful to the baby, it can significantly limit mobility and should be monitored by a healthcare provider.
Practical Strategies for Pain Management
Adjustments to daily habits can often provide relief for general hip soreness and mild PGP symptoms. When sitting, choose a supportive chair and maintain a straight back, ensuring knees are not higher than hips to keep the pelvis neutral. Practicing good posture while standing helps minimize the strain on the lower back and hip joints caused by the shifted center of gravity. A maternity support belt, or belly band, can also provide gentle compression and support to stabilize the joints during movement.
To alleviate pressure during rest, sleeping on your side is generally recommended, but this can sometimes worsen hip pain by placing direct weight on the joint. Placing a pillow between your knees while side-sleeping helps keep the hips and pelvis aligned, which reduces discomfort.
Gentle, low-impact movements like prenatal yoga or swimming are beneficial for strengthening supporting muscles without overstressing the joints. Avoid activities that involve standing on one leg for extended periods or separating the legs widely, such as lunges, to prevent exacerbating PGP. Applying a warm compress to the painful area for short intervals can encourage muscle relaxation and offer temporary relief from aches.
When to Contact a Healthcare Provider
While most hip pain during pregnancy is a normal consequence of bodily changes, certain symptoms warrant a prompt consultation with a healthcare professional. Contact your provider if the pain is sudden, severe, or prevents you from bearing weight or walking normally, as this suggests a more serious underlying issue.
Any pain that radiates down the leg and is accompanied by numbness, tingling, or a burning sensation could indicate pressure on the sciatic nerve, known as sciatica. Although sciatica is common in pregnancy, it still requires medical evaluation.
If hip or pelvic pain is accompanied by signs of preterm labor, seek medical attention immediately. These signs include abdominal cramping, persistent lower back ache, or changes in vaginal discharge before 37 weeks.