Pregnancy Related Back Pain: What can you do?
Back pain is a common complaint among the general population. While there is a chance of low back pain as an adult, up to 50% of pregnant women experience low back pain during pregnancy or in the postpartum period. Unfortunately, back pain during pregnancy typically has a negative impact and can prevent women from completing day-to-day activities. Historically women have been told that the back pain is something that they will have to live with for the duration of their pregnancy. This advice is not only unhelpful it is wrong.
When looking at back pain in pregnancy here are some of the more typical signs and symptoms:
- Tightness or Pain in the low back
- Pain in the back of the pelvis
- Pain in the front of the pelvis
- Shooting pain into the glutes and down the leg
The presentation of these symptoms varies based on what is causing the symptoms. There are a large number of factors that contribute to an increased risk of low back pain in pregnancy.
Some factors that can contribute to the pain include:
- A change in pelvic tilt and position
- Flaring of the ribcage
- Increased weight gain
- Increased Abdominal diameter
- Shifting of the bodies center of gravity
- Hormone induced ligament laxity
- Stretching of the abdominal wall causing muscular fatigue
It is typically a combination of these factors that contribute to the increased risk of low back pain during and after pregnancy. While a majority of these risk factors cannot be completely altered, it’s important to address low back pain to help prevent future occurrences and decrease discomfort during pregnancy and labor. In order to treat pregnancy related back pain you must first diagnose which structures are causing the pain.
Treatment for pregnancy related low back pain is variable. Factors that determine the course of treatment can include the cause of the back pain, which trimester the woman is in, any pregnancy related risk factors and how well each intervention is tolerated.
Some treatment options available include:
- Activity modification
- Light cardiovascular exercise (including walking, swimming, yoga)
- Soft tissue therapy
- Chiropractic adjustments
- Support belts (SI belt)
- Posture and breath training
When the proper treatment options are combined not only can you decrease back pain but you can also help prevent it from interrupting day-to-day activities. One large factor to consider when deciding to treat back pain in pregnancy is the postpartum period. If pain is present during pregnancy there is a higher chance of pain in the postpartum period which can make it more challenging to care for newborns and have a negative effect on the mother’s mental health.
If you are pregnant or newly postpartum it’s important to address any back pain you may experience. While you cannot change the causative factors, the stronger you are the better prepared you are for the biomechanics changes of pregnancy. Below are three helpful strengthening exercises that can help decrease your risk of low back pain:
- Standing Glute Squeeze: Standing tall with relaxed shoulders, slowly and strongly squeeze your glute muscles and hold for 10-20 seconds. Repeat this 5 times
- Side Lying Leg Abduction: Lying on your side with your bottom leg bent and your top leg straight. Slowly lift the top leg off the ground about 4 inches and lower it back down. Repeat this 15-20 times per side.
- Breathing Exercises: Sitting tall in a chair, slowly take a full breath in allowing your ribs to expand and your stomach expand outward. As you exhale all of the air out, slowly pull your ribs in and your stomach up and in as far as possible. Repeat 10 times
Katonis P1 et al. Pregnancy-related low back pain, Hippokratia 2011, 15, 3:205-210