Hip, knee, and foot pain during pregnancy and the postpartum period

Although much has been written about low back pain during pregnancy, there are few studies regarding leg, foot, and hip pain. The purpose of this study was to investigate the prevalence and characterize the nature of lower extremity pain in women of child-bearing age and to assess the impact of recent pregnancy on these symptoms.

In this case-control study, 107 consecutive postpartum women (case subjects) and 91 nulliparous women (controls) completed a questionnaire regarding hip, knee, and foot pain and potentially influencing factors.

Postpartum subjects had more symptoms of leg and foot pain than did the controls (56% vs 37%; odds ratio [OR]=2.3; 95% confidence interval [CI], 1.2 to 4.7). A significant majority of pain (82%, P<.05) began during the second and third trimesters. Postpartum subjects also had a significantly higher prevalence of hip pain (38% vs 23%; OR=3.2; 95% CI, 1.4 to 7.0) and foot pain (31% vs 22%; OR=2.2; CI, 1.1 to 4.5). History of previous pain complaints also were found to be risk factors for lower extremity pain during pregnancy for case subjects and in the past year for controls. There was a trend toward older age as a risk factor as well. Multiple pain complaints were more common among case subjects than among controls.

Lower extremity pain is common in women of childbearing age. Pregnant and postpartum women are more likely to develop new lower extremity symptoms than are nulliparous women. The timing of symptom onset in mid- to late pregnancy may suggest that biomechanical factors play a larger role than hormonal influences. Regular exercise appears to be neither protective against nor a risk factor for lower extremity pain during pregnancy.