How to deal with pregnancy hip pain

Hip pain during pregnancy is common, especially in the second and third trimesters (the last three to six months of your pregnancy). The most common cause of pregnancy hip pain and discomfort in your hips is pelvic girdle pain (PGP), formally known as symphysis pubis dysfunction (SPD).

PGP doesn’t harm your baby, but it can cause discomfort and make certain activities harder during your pregnancy, for example sleeping and moving around.

The condition is common and affects around one in five women during pregnancy. You have a higher risk of developing PGP if you have previously injured your pelvis, if you suffer from back pain, or if have a condition called hypermobility syndrome.

Today, we’ll look at what causes hip pain during pregnancy, what you can do to relieve symptoms yourself, and when to see a doctor.

What are the symptoms of hip pain during pregnancy?

The main symptom of PGP is pain. Pain may be different for everyone. It can range from mild to severe and may be dull or sharp. It may start as discomfort and gradually become painful, or you may have a sudden onset. You may have pain all the time, or it may come and go.

You may feel pain:

• At the front of your hips, around your pubic bone
• In your lower back (on one or both sides)
• Between your vagina and anus (perineum)
• In your knees or thighs

You may also experience:

• Clicking or grinding in the hips
• Worsening pain during certain activities, such as:

• Going up or down stairs
• Walking, especially over long distances or on uneven surfaces
• Moving your legs apart, for example, when getting out of the car
• Standing on one leg, such as when getting dressed
• Turning over in bed
• During sex

What causes hip pain during pregnancy?

Pelvic girdle pain

The pelvis (or pelvic girdle) is a ring of bone that connects the upper half of your body (your torso) to the lower half (your legs). As mentioned above, pelvic girdle pain (PGP) is the most common cause of hip pain in pregnancy.

The pelvic girdle contains three joints; two sacroiliac joints on either side of your spine at the back, and one symphysis pubis joint at the front. Normally, these joints work together and only move slightly, but various changes during pregnancy can cause them to move unevenly, causing pain. These changes include:

Hormonal changes

During pregnancy, your body produces increasing amounts of a hormone called relaxin. This hormone softens the tendons and ligaments (connective tissues that connect your bones and muscles).This helps your pelvis expand to make room for your growing baby, but it also increases pressure on the muscles and joints and may cause pain. Towards the end of the third trimester, relaxin causes the baby to drop lower in the pelvis to prepare for birth. This puts more pressure on your lower back, hips and pelvis, and can make hip pain worse.

Changes in your posture

As your baby grows, your body’s centre of gravity changes, and weight is redistributed around your middle. This can affect your posture when you stand, walk, and sleep, which increases pressure on your joints and may cause hip pain.

Weight gain

Increased weight from your growing baby and pregnancy weight gain is another factor that increases pressure on the muscles and joints and makes hip pain worse.

Other possible causes of hip pain during pregnancy

Apart from PGP, some other causes of hip pain during pregnancy include:

Transient osteoporosis (TOP)

Transient osteoporosis is a rare condition where your bones lose minerals and weaken during the last few months of pregnancy, making them more likely to fracture (break). TOP usually resolves once your baby is born.

Round ligament pain

Round ligament pain is a common condition that normally affects women in the second trimester of pregnancy. It is caused by the hormone relaxin loosening the round ligaments (the ligaments that hold the uterus in place). Round ligament pain usually causes a sharp, stabbing pain, or a pulling sensation around the hips, groin, and abdomen (tummy). Pain may be worse during sudden movements such as standing up quickly, coughing, sneezing, or laughing.

Sciatica

The sciatic nerve is the main nerve to the legs. Pressure on this nerve can cause a painful condition called sciatica. The condition normally affects older people and is commonly caused by problems with the spine, but your growing baby can also put pressure on the sciatic nerve during pregnancy. Sciatica normally resolves once the baby is born.

Urinary tract infection (UTI)

Infections in the urinary tract, bladder or kidneys occur when bacteria enter the urinary tract. UTIs are more common during pregnancy due to pregnancy hormones and weakened bladder muscles that make it harder to fully empty your bladder. UTIs can cause irritation in the surrounding tissues, which include the muscles and joints in your hips.

Other symptoms of a UTI include:

• Pain low in your pelvis (lower abdomen)
• Needing to pee urgently
• Peeing more often than usual (this is common during pregnancy and may not indicate a UTI)
• Pain or a burning sensation when peeing
• Strong-smelling pee
• Fever (a temperature above 38C) 

Can I treat my pregnancy hip pain at home?

Most hip pain during pregnancy can be helped by home treatments. These may include:

Sleeping position

It can be hard to find a comfortable sleeping position as your baby grows. A good sleeping position can relieve pressure on your hips and improve the amount and quality of your sleep, which is important for your overall health and wellbeing.

Some tips for finding a comfortable sleeping position include:

• Sleeping on your side. This is recommended during the later stages of pregnancy as it reduces the weight of your uterus on your back and spine, relieves pressure on your organs and blood vessels, and allows for better circulation
• Bending your knees when sleeping on your side
• Using a pregnancy pillow (a special pillow designed to support your body during pregnancy)
• Placing pillows behind your back and under your belly to provide extra support

Maintaining a good posture

Keeping a good posture when pregnant can help to reduce pressure on your hips. Stand with your back straight, tuck your bottom in and distribute your weight equally between both feet.

Sitting position

Sit in a firm, supportive chair with your back straight. You can place a pillow behind your lower back for added support. When you sit or stand, do so slowly and use your legs rather than your back.

Heat packs

Using a heat pack or warm compress can reduce pain by increasing blood flow, relaxing muscles, and reducing muscle spasms. Heat packs come in the form of hot water bottles, gel-filled heat pads, wheat bags and heat wraps. Make sure you follow the instructions that come with your heat pack carefully and avoid placing anything too hot against your skin. It’s best to avoid placing heat packs directly onto your abdomen during pregnancy.

Warm baths

A warm bath can be relaxing at any time, but never more so than during pregnancy. The warm water supports your body, and the heat can relax your muscles and relieve pain. For extra comfort, lie on a padded bathmat and use a bath pillow to support your head and neck. Make sure the water is not too hot and avoid adding anything to your bath, such as bath salts, bubble baths or essential oils, as these can be harmful during pregnancy.

Pregnancy belt

A pregnancy belt, pelvic band, or maternity support belt is a flexible band that is worn around the lower abdomen during pregnancy. It can help reduce hip and pelvic pain by supporting your bump, reducing pressure on your pelvis, keeping your hips in alignment (the correct position), and restoring your centre of gravity.

Stretching

Gentle stretches and some yoga positions can be beneficial for hip pain in pregnancy. Stretching can help loosen your hips and reduce pain. Some yoga poses should be avoided during pregnancy, so be sure to tell your instructor that you are pregnant. If you want to learn some specific exercises that can help you with PGP and are safe during pregnancy, book a consultation with one of our physiotherapists.

Rest

It’s important for you and your baby that you get enough rest during all stages of your pregnancy. Avoid standing for long periods and overexerting yourself. Listen to your body and rest when you feel tired.

Gentle exercise

Along with plenty of rest, gentle exercise like walking and swimming is beneficial during pregnancy and may help to relieve symptoms of hip pain by building strength and flexibility.

Massage

Massage during pregnancy can help stimulate blood flow, relax your muscles, decrease stress and anxiety, and stimulate the release of ‘feel good’ hormones such as serotonin and dopamine.

Massage is considered safe during pregnancy after the first trimester, but we recommend that you get the go ahead from your healthcare provider first. Make sure you find a qualified practitioner and be sure to tell your massage therapist that you are pregnant.

Over-the-counter painkillers

Paracetamol is generally considered safe to take during pregnancy, but we recommend that you check with your healthcare provider before taking any medication during pregnancy. Even common painkillers such as ibuprofen are not safe to use while you are pregnant.

When should I see a doctor?

Sometimes, hip pain in pregnancy may be a sign of something more serious and may need medical treatment. Seek medical attention if you experience:

• Pain in the first three months (first trimester) of pregnancy
• Feeling dizzy
• Spotting (bleeding from your vagina)
• Difficulty standing (weight bearing) or walking
• Severe pain, pain that lasts for more than two weeks, or stops you from doing normal daily activities
• Abdominal pain, discomfort, or cramping, particularly in the lower abdomen
• Pain in your lower back that radiates to your front or sides and doesn’t get better when you change positions
• Regular contractions (abdominal cramps 5 to 10 minutes apart that last for between 60 and 90 seconds), especially when unexpected or before your due date
• Unusual vaginal discharge that is clear, pink, green, or brown, or has a strong, unpleasant smell

How is hip pain in pregnancy treated?

How hip pain in pregnancy is treated depends on what is causing the pain. Your doctor will examine you and ask you some questions about your symptoms, as well as your pregnancy, general health, and medical history. They may order some tests, such as a blood test to check for underlying medical conditions, or an ultrasound scan to check the status of your baby.

Providing no serious cause can be found, your doctor may treat your hip pain with:

Painkillers

Your doctor may prescribe a painkiller that is safe to take in pregnancy. Always follow your doctor’s instructions carefully when taking any medication and ask your doctor or pharmacist if you have any questions.

Physiotherapy

A physiotherapist can help treat your hip pain by teaching you exercises you can do at home to strengthen and build flexibility in your hips. They can also advise you on which positions are best to relieve pressure on your hips when standing, walking, or sleeping. Your physiotherapist may also use techniques such as manual (hands-on) therapy, hydrotherapy, and acupuncture.

Preventing hip pain during pregnancy

Sometimes, hip pain in pregnancy can’t be avoided, but there are some things you can do to reduce the risk, including:

• Avoid activities that make hip pain worse, such as heavy lifting, going up and down stairs, sitting and standing for long periods
• Stay active during your pregnancy — gentle, low-impact exercise such as walking, yoga, Pilates, swimming, and cycling are best
• Keep an eye on your weight — while it’s normal to gain weight in pregnancy, excessive weight gain can increase pressure on your hips and make hip pain worse
• Wear flat, supportive shoes
• Get enough rest and stay off your feet as much as possible when experiencing pain

Summary

Many women see hip pain as a normal part of pregnancy, and something they have to put up with until their baby is born. Though common, hip pain in pregnancy is not something you have to endure, and there are many things you can do yourself to relieve hip pain. If you are worried about your hip pain, or it isn’t improving with home treatments, call us today to make an appointment to see a physiotherapist or a consultant.