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- Low back Pain and Pregnancy 08/22/2017
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Low back Pain and Pregnancy
Some sources suggest as many as 90% of women experience some low back pain with pregnancy – but just because it’s common doesn’t mean it’s natural or necessary. Back pain is more likely as pregnancy progresses, starting between the 5th and 7th months, and can last into the postpartum period for some women.
What causes low back pain in pregnancy?
While no single, specific cause can be found for all women, low back pain is typically attributed to:
Hormonal changes: During pregnancy, your body releases a hormone, called relaxin, to soften your ligaments so that your pelvic cavity (and, in fact, your pelvis during birth) can expand to fit your growing baby.
A shifting center of gravity: As the weight of your baby and uterus increases, gravity pulls it forward, causing an exaggerated curve of the lower back. This shifts your center of gravity to keep you balanced, but can cause pain.
Is it just the low back, or something more?
Low back pain can aggravate – or may even be caused by – other, related conditions.
Sciatica: If the pain from your back radiates into your buttock and leg on one side, it may be that the sciatic nerve is affected. True sciatica – caused by a damaged vertebral disc – occurs only rarely. But the extra fluid and swelling associated with pregnancy can put pressure on this nerve, causing inflammation and pain
Pelvic Girdle Pain: This is a catch-all phrase for any pelvic pain during pregnancy. Experts think it may be caused by the release too much of the hormone, relaxin, weakening the ligaments supporting the pelvis. It may include symphysis pubis dysfunction, a painful misalignment of the pubic bones.
Diastasis recti: This separation of the abdominal muscles may happen as pregnancy progresses. Without the support of the strong core muscles, back pain is more likely.
How can it be treated?
Prevention may help limit the amount of back pain you have in pregnancy:
Maintain a healthy weight: You will inevitably gain weight during pregnancy – after all, you are growing a baby. But eating for two doesn’t really mean eating twice as much. If you were a healthy weight before pregnancy, you can expect to gain 25 to 30 pounds by birth (a little less if you were overweight, and a little more if you were underweight).
Stay active: Get some exercise every day. Obstetricians recommend 30 minutes of moderate exercise at least 5 times per week. You can break it into smaller chunks, but be sure you get your heart pumping each time.
Pay attention to posture: One of the simplest ways to alleviate some back pain is by practicing good posture. When standing, keep your shoulders back and your chest forward, avoid curving your lower back, tuck your abdomen and pelvis, and soften your knees. Many women are sedentary for long stretches – especially if you sit at a computer all day for work. If so, make sure your sitting posture is good. Keep your feet flat on the floor and don’t cross your legs. Knees and hips should be at right angles. Sit on your ‘sit bones’ (the lower points of the pelvic bone) and don’t curve your lower back.
Practice active stress management: Muscle pain can increase when you feel stressed or worried (which is another normal part of pregnancy). As often as possible, try some relaxation exercises to alleviate the build-up of tension in all your muscles, including those of the lower back.
Some practitioners might recommend exercises or physical therapy, rest, acupuncture, or chiropractic or other manipulative therapies. Other treatments you can try at home include warm baths, hot or cold compresses, sleeping with pillows for support, and massage. Some women wear a support belt specifically designed or pregnancy. Ask your provider before taking any over-the-counter pain medications.
What specific exercises might help?
Consider joining an exercise class designed specifically for pregnant moms, or work with an exercise physiologist or a physical therapist with experience working with prenatal moms who can teach you the correct way to move to avoid strain or injury.
Stretches: Most yoga poses are terrific for keeping your body in motion with gentle stretches. Try the following stretches to relieve back pain:
- Pigeon stretch: Fold one leg under your belly toward the opposite hip (as if your were going to sit cross legged on the floor) and extend the other leg straight back along the floor. Keep a slight arch to your lower back rather than tucking your hips. Gently push off the floor with your upper body. Hold for 10 seconds or so, then switch sides. You should feel a gentle stretch in your belly and low back.
- Triangle pose: With your feet wide apart, turn your right foot out and align the right heel with the arch of the left foot. Bend from the hips over the right leg, placing your right hand on your shin or ankle as you extend the opposite arm to the ceiling, turning your head to look at the ceiling, as well. Hold for 10 seconds, then repeat on the other side.
Pelvic tilts: These are a combination of stretching and working your core or abdominals. As pregnancy progresses, avoid lying flat on your back and instead do the hands and knees version or adapt the exercise while standing back against a wall.
- On your back: Rest with your hands near your hips and your knees bent. Slowly contract your abdominal muscles and tilt your pelvis so that your lower back touches the floor. Hold briefly and return to normal. (Later in pregnancy, this can be done while standing with your heels and back against a wall instead.)
- On your hands and knees: Kneel with your hands shoulder width apart and your knees slightly wider than your hips. Begin with your back level, and slowly arch your back while tucking your pelvis and contracting your abdominal muscles. Hold briefly. Slowly release and return to the neutral position without swaying your back toward the floor.
Core exercises: Many pregnant women worry about working their abdominal muscles during pregnancy. But, in fact, many of these core muscles support the back, too.
- Squats: Stand with fee shoulder-width apart and hold your hands straight out in front of you for balance (or hold onto something sturdy). Lower your bottom toward the floor while keeping your back straight, the weight on your heels and your knees aligned with your toes. Return to the starting position. Try to work up to 10 repetitions.
- Standing pelvic rock: With your feet hip-width apart and your hands near your ears, tuck your pelvis and crunch forward while contracting your abdominal muscles. Return to the starting position. Try several receptions. (Hard time figuring it out? Imagine the movements as they would be if you were lying on the floor on your back.)
- Side lying knee lifts: Lie on your right side with your right arm extended and pillowing your head. Use your left hand on the ground in front of you for support. With your knees bent and on top of one another, bring them slightly forward then lift them off the ground using your abdominal muscles. Release slowly. Try several repetitions on each side.
Kegels: Don’t underestimate the positive effects of good internal posture. Regular kegel exercises will not only prevent things like urinary incontinence, but can keep your core muscles and lower back strong.
- Basic kegels: contract and hold your pelvic floor muscles (the same muscles that stop your urine midstream) for 5 seconds, then slowly release. Repeat 4 to 5 times. Work up to 10 second contractions. *Note, if you experience contractions following Kegels discontinue them immediately.
Liddle SD, Pennick V. Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database of Systematic Reviews 2015, Issue 9. Art. No.: CD001139. DOI: 10.1002/14651858.CD001139.pub4.