DEMYSTIFYING ROUND LIGAMENT PAIN IN PREGNANCY: A NARRATIVE REVIEW

Abstract

Background: Round ligament pain (RLP) is a common yet often misunderstood musculoskeletal discomfort during pregnancy, affecting 10–30% of women, particularly in the second trimester. It results from stretching of the round ligaments due to uterine
enlargement. Hormones such as relaxin, estrogen, and progesterone increase ligament laxity by altering collagen structure, reducing tissue stability and increasing pain susceptibility. Despite being benign, RLP is often confused with serious conditions, requiring proper
clinical understanding.

Purpose: This narrative review aims to demystify RLP by exploring its anatomy, pathophysiology, clinical presentation, differential diagnosis, management, and prognosis, while emphasizing the role of physiotherapy in improving maternal quality of life.

Methods and Materials: This review synthesizes existing literature on RLP, focusing on anatomical and physiological changes, hormonal influences, clinical features, diagnostic considerations, and conservative management. Emphasis was placed on non-invasive, physiotherapy-led interventions.

Results: The result of this study shows RLP commonly presents as unilateral or bilateral sharp or dull pain in the groin-to-hip region, often triggered by sudden movements. It may temporarily impair function. Differential diagnosis is essential to rule out conditions such as ectopic pregnancy, ovarian torsion, varicosities, or hematoma, especially with symptoms like fever or bleeding. Evidence supports physiotherapy interventions including pelvic tilts, hip stretching, core stabilization, postural education, kinesio taping, and support belts, with heat and rest as adjuncts.

Conclusion: RLP is a self-limiting condition with excellent prognosis, resolving postpartum. Physiotherapy plays a key role in pain reduction and functional improvement. Early education helps prevent exacerbations, though further randomized controlled trials are needed to strengthen evidence.