Low back pain is a common complaint in pregnancy. Low back pain in pregnancy can be the result of mechanical alterations. As the uterus expands with the growth of the baby, the belly shifts your center of gravity forward. In addition the weakening and stretching of the abdominal muscles, the postural change creates a straining force on the low back. When low back pain radiates into the buttocks and thighs, it’s usually resulting from the growing uterus pressing on the piriformis muscle (one of the pelvic floor muscles) and the sciatic nerve that runs beneath it. The piriformis muscle can also undergo strain due to widening of the pelvis and change in the gait pattern during pregnancy. Pain arising from the piriformis muscle is often under-diagnosed and under-treated, resulting in ongoing pain. When diagnosed early and with appropriate treatment, symptoms usually resolve successfully allowing normal pain free function.
The other factor that can contribute to low back pain in pregnancy is hormonal changes. Hormonal changes, particularly the release of the hormone relaxin can result in muscle and ligament relaxation, which can loosen your joints and ligaments that attach your pelvic bones to the spine (the sacroiliac (SI) joints). This can make you feel less stable and cause pain with prolonged standing, walking, rolling over in bed or getting up and down from a chair.
Who's most likely to have low back pain during pregnancy?
Not surprisingly, people who have experienced low back pain previously will likely have low back pain during pregnancy. You're also at higher risk if you've lead a very sedentary lifestyle and have poor flexibility and weak back and abdominal muscles.
What can I do to avoid back pain?
1. Start an exercise program to stretch and strengthen muscles that support the back and legs, including your abdominal muscles. Stretching gently and cautiously will prevent further strain joints which have been made looser by pregnancy.
2. Swimming is a great exercise option for pregnant women because it strengthens your abdominal and lower back muscles, and the buoyancy of the water takes the strain off your joints and ligaments.
3. If you sit all day, be sure to sit up straight and take frequent breaks from sitting. Get up and walk around at least every hour or so.
4. Avoiding prolonged standing is equally important. If you need to stand all day, try to take a midday break and rest lying on your side while supporting your upper leg and abdomen with pillows.
5. Wear comfortable shoes and avoid high heels. As your belly grows and your balance shifts, high heels will throw your posture even more out of whack and increase your chances of stumbling and falling.
6. Avoid lifting. If you do lift, always bend from your knees and lift things from a crouching position to minimize the stress on your back.
7. Listen to your body. If you find that a particular activity or exercise makes your back hurt, then avoid doing it!
What can I do to get relief?
1. Doctors of chiropractic can alleviate the uncomfortable symptoms arising from the muscular, ligamentous, and biomechanical stresses encountered during pregnancy. We accomplish this through the use of spinal manipulative therapy and myofasscial massage therapy.
2. Prenatal massage by a trained therapist may provide great relief.
3. Acupuncture can be extremely effective for acute pain relief.
4. Try heat or cold. If muscles or joints feel tender to the touch and has a sensation of being “hot.” Apply an ice pack to the affected area for 15 minutes every hour. If the muscles feel tense or deep aching sensation, apply a moist heating pad.
A study released in 2006 demonstrated that chiropractic care is safe during pregnancy and support the hypothesis that it may be effective for reducing pain intensity. Lisi, AJ. Chiropractic spinal manipulation for low back pain of pregnancy: a retrospective case series. J Midwifery Womens Health. 2006 Jan-Feb;51(1):e7-10.
