Geeky Gal Birth Advocate

Giselle Rackley

February 17, 2020

Evaluation and management of Hip Pain During Pregnancy

1. Key Clinical Information: Hip pain is usually caused by the loosening of the ligaments holding
together the sacroiliac joints, which connect your spine to your pelvis. Approximately 20% of all pregnant
people will experience some sort of hip pain. The hormone relaxin increases during pregnancy, causing
the relaxation of the tissues that connect your bones throughout the body. While this joint and ligament
relaxation helps with the birthing process, it can cause pain in your hips and other joints as the weight of
your uterus bears down on your loosened bones and joints. It can result in inflammation, misalignment
or bones grinding against bones.
2. Assessment
i. Risk Factors
1. Weight gain
2. Poor posture
3. Transient osteoporosis
4. Side sleeping
ii. Subjective Symptoms
1. Discomfort
2. Pressure
3. Dull or Sharp Pain
4. Gradual or Sudden onset
5. spasms a the hip or groin
iii. Objective Signs
1. Round ligament pain
2. Sciatica
iv. Clinical Test Considerations
1. Visual examination
2. Consider and rule out other, more serious conditions with similar presentations
3. Management plan
i. Therapeutic measures to consider
1. Tylenol (Acetaminophen)
2. Advil (Ibuprofen)
ii. Complementary measures to consider
1. Side sleeping with a pillow under the belly and another between the knees.
2. Use a heating pad for pain
3. Taking a hot bath.
4. Daily exercising and stretches.
5. Yoga.
6. Activity modification as necessary.
 7. Pregnancy support garments
iii. Considerations for pregnancy, delivery and breastfeeding
1. Usually resolves after birth over time.
iv. Client and family education
1. Common in pregnancy
2. Education on support garments, activity management, and exercises.
3. Client handout: Hip Pain in Pregnancy
v. Follow-up
1. Monitoring for decreases/increases in pain during prenatal appointments
4. Indications for Consult, Collaboration or Referral
1. Severe pain or pain that limits normal daily functioning should be referred to the midwife or
primary care provider as soon as possible
2. Further referrals to chiropractor care or physical therapy may be necessary.
3. Any cramping, bleeding/spotty, fever, or nausea/vomiting with hip pain could be an indication of
a more serious issues and the client should contact their midwife immediately.
4. Referrals to other medical professionals as desired by the client.
5.References
Benvegnu, M. (2019, June 10). 7 Tips for Relief from Hip Pain and Pelvic Pain During Pregnancy. Retrieved
from https://www.upspringbaby.com/blogs/pre-natal/tips-for-relief-from-hip-pain-pelvic-pain-
during-pregnancy
Chavanelle, N. (2017, July 28). 10 Moves to Ease Hip Pain During Pregnancy. Retrieved from
https://www.activekids.com/prenatal-fitness/articles/10-moves-to-ease-hip-pain-during-
pregnancy
Hip Pain During Pregnancy. (2019, October 9). Retrieved from
https://americanpregnancy.org/pregnancy-complications/hip-pain-during-pregnancy/
Marcin, A. (2018, August 15). How to Relieve and Prevent Hip Pain During Pregnancy. Retrieved from
https://www.healthline.com/health/pregnancy/pregnancy-hip-pan#prevention