Back Pain During Pregnancy
Back pain during pregnancy is a common and unpleasant symptom. It is more likely to occur towards the end of the pregnancy but can occur at any stage. The pain can be in the upper, mid or most commonly lower back.
Lower back pain is a very common problem for those who have given birth.
Possible causes of Lower Back Pain
There are a number of reasons why you could be suffering an increased amount of back pain during pregnancy, including:
- Increased laxity in Ligaments and Joints
- Abdominal Muscle Strain
- Diastasis Recti (Abdominal Separation)
- Weakened Deep Core Muscles Including Pelvic Floor & Deep Abs (TVA)
- Spinal Muscles Overworking
Increased Laxity In Ligaments And Joints
When you are pregnant there are increases of certain hormones such as relaxin (early part of pregnancy), oestrogen and progesterone that made your ligaments and joints more lax than they are normally this can lead to very slight increases in movement around the joints which in some people can make them more susceptible to sprains and strains. This is very true around the spine, especially at the lumbar section and the pelvis as the baby grows and gets larger.
Abdominal Muscle Strain
The abdominal muscles are under a great amount of pressure just supporting your bump everyday especially in the final stages of the pregnancy.
Diastasis Recti (Abdominal Separation)
This happens to everyone in pregnancy by the last trimester but it may start earlier with some especially if you have been pregnant before. The abdominal separation affects how your core muscles work and how they work together.
Weakened Deep Core Muscles Including Pelvic Floor & Deep Abs (TVA)
You can find a lot more detail about the core muscles and how they form the powerhouse of our bodies in EDUCATION. If these deep core muscles are weak which is common then there is not a strong core centre meaning that joints, other soft tissues and muscles take the strain and this can lead to pain.
Spinal Muscles Overworking
As your pregnancy develops your tummy muscles will naturally turn off, a common compensation for this is for the back muscles to work harder to make up for this. This can make them ache and feel very fatigued and if pushed too far can lead to spasm and pain.
It is expected that between fifty and eighty percent of pregnant women will have some level of back discomfort during their pregnancy.
It might range from a dull ache that is brought on by a certain activity to a severe pain that turns into a chronic condition.
Roughly ten percent of the time, the discomfort will grow so severe that it will prevent the pregnant woman from being able to work or carry out typical activities during the pregnancy.
According to a number of studies, the most common time for a woman to have lower back pain during pregnancy is between the fifth and seventh months of carrying the baby, but it can start as early as eight to 12 weeks.
Back pain is more likely to develop in pregnant women who have had lower back problems in the past, and these women may have back pain early on in their pregnancies.
It is common for a woman to have lumbar pain during pregnancy. This type of back pain is often felt around or above the waist, in the middle of the back, and it may be accompanied by discomfort that extends down one or both legs.
In pregnant women, discomfort in the posterior pelvis (in the rear of the pelvis) is four times more common than pain in the lumbar region of the back. It is characterised by a severe ache that might be localised below the waistline, on one or both sides, or all the way across the tailbone.
Increase of hormones — In preparation for the process of giving birth, hormones are secreted throughout pregnancy that allow the pelvic area’s ligaments to relax and joints to become more mobile. Because of this alteration, the support that your back typically receives may be affected.
Center of gravity — Your centre of gravity will progressively shift forward as your uterus and baby continue to develop throughout pregnancy, which will cause a change in your posture.
Additional weight — As your pregnancy progresses and your baby grows, there will be an increase in the amount of weight that your back must support.
Posture or position — Poor posture, prolonged standing, and bending over can all cause or worsen back pain.
Stress – Weak points in the body are where stress is most likely to build up. As your pelvic region undergoes change, you may notice an increase in back discomfort, especially during times of increased stress.
Lower Back Pain in Pregnancy
Common causes of lower back discomfort during pregnancy include mechanical instability of the lumbar spine (lower back) and pelvis.
- The lumbar spine goes through a process called compensatory lordosis, which is an increase in the reverse C-shaped curvature. This results in an excessive amount of strain being placed on the lumbar joints, muscles, and ligaments.
- Because of the compensatory lordosis, the psoas muscle in the hip, which aids in hip and leg movements and stabilises the spine, is shortened. This shortening of the muscle contributes to the worsening of the symptoms of lower back pain.
There is no set period during pregnancy when symptoms of lower back discomfort first appear. It’s possible that these symptoms will feel like:
- A throbbing aching or an acute, searing pain in the region of the lower back.
- Symptoms include localised discomfort on the right or left side of the lower and/or middle back.
- Foot drop is a condition in which the affected individual is unable to elevate the front portion of their foot when walking.
Symptoms of sciatica often manifest themselves when a lower lumbar nerve root and/or an upper sacral nerve root is compressed in the lower spine as a result of a lumbar herniated disc, spondylolisthesis, facet joint disorder, or muscle strain and spasm.
Pain in the lower back during lying or sleeping
It is possible that the swelling of the uterus during pregnancy is to blame for the nighttime worsening of lower back pain, as this occurs when the vena cava is compressed by the growing uterus.
Pregnancy-related changes to the pelvis are necessary to provide room for the expanding uterus and pave the way for labour and delivery.
Different degrees of sacroiliac joint laxity exist in the right and left sacroiliac joints, which link the spine to the pelvis, in pregnant women who complain of pelvic discomfort. A high quantity of the hormone relaxin, which softens the connective tissues and joints, is the cause of this variation in joint laxity. The ilium, a portion of the pelvis that connects to the sacroiliac joint, may move if the sacroiliac joints are noticeably slack.
When the shifted ilium is moved in an unstable position, it causes stress on the tissues that are next to the area, which results in pain. The muscles inside or around the pelvis become stiff and pulled in as the body works to return the pelvis to its natural position. This can cause pain and discomfort. Severe discomfort could be experienced if tension develops in the muscles of the pelvic floor or the adductor muscles of the thigh, both of which are located in the groin and work to assist bringing the legs closer together.
Pain in the posterior region of the pelvis is rather prevalent during pregnancy and may affect as many as 76 percent of expecting mothers. Additionally, this discomfort may be sustained by anywhere from 5% to 8.5% of new moms for several years after giving birth. This discomfort may also be referred to as pelvic girdle pain or symphysis pubis dysfunction by medical professionals.
Treatments for Back Pain
There are a number of ways you can ease your lower back and hopefully even cure it.
Generally just moving helps lower back pain. Often for those who sit around it makes the back pain worse and if you do not exercise and move your body becomes deconditioned and then if you start trying to move again the back pain will start. There are certain exercises that can help lower back. Have a go at our Lower Back Pain Relief Workout (see main post video above) and try this workout once a day. Also try and walk more gradually increasing each time how far you walk.
Heat can be applied to the lower back and give relief. You can use a hot water bottle or there are heat packs that are available to heat up in the microwave. Pharmacys also offer a stick on heat patch which activates when you fold the patch before applying.
Pain Relief Patches
You can buy from pharmacies pain relief patches that you can stick over your lower back. Some people find these patches helpful. Remember to discuss your pregnancy with your pharmacist to ensure the patches are suitable.
Anti-inflammatories and Painkillers are fine to use when you have an acute flare up of lower back pain but we do not advise taking regularly long term as for one your body will become accustomised to the pain medication and need higher doses to take effect and there is always the risk of Pain medication addiction.
Help from Professionals
In Pregnancy it is best to seek advice from your Doctor or Obstetrician with regards to advising on any pain medication that you can take.
Physios And Osteopaths
There are a number of treatments they can offer to help. First they will take a thorough history of your complaint and medical history and then do a proper full physical assessment to diagnose what is causing your pain. They will then be able to carry out the best treatments they feel fit for your condition which can include:
- Manual Therapy where they work on the joints, soft tissues and muscles
- Acupuncture (depends on if they are qualified to offer this)
- Trigger Point Release (a trigger point is a specific painful point in a muscle and it can be released by certain techniques)
- Teaching movement, stretching and core muscle exercises
There are prenatal specialised chiropractors who are reported to help alleviate muscle & ligament pain as well as help with paving the way for a smoother labour. Some are trained in the Webster technique which is a technique created for use during pregnancy that focuses on the sacrum and pelvis as well as the surrounding muscles and ligaments.
Try Our Program for Pregnant Moms
Want to get started properly? Our Pregnancy Safe Exercise Program is a great starting place. Get guidance on the right types of exercises as well as exercises to avoid.
You’ll get access to online videos with exercises and educational content along with free online support from expert physios, and more. Try it today and enjoy exercising safely during your pregnancy.