As the belly grows,
So may your spine pain woes
Many pregnant women experience back pain. Because the connection between back pain and pregnancy is not fully understood, access to the right treatment can be a challenge.
Fortunately, pregnancy-related spine pain typically has a short life span—most cases go away shortly after your baby’s birth. Pregnancy-related back pain is often localized to a specific area of the spine and not widespread. Back pain tends to arise between the fifth and seventh months of pregnancy, though it can begin much earlier.
Pregnancy - Related Spine and Pelvic Pain
Women typically experience pregnancy-related pain in the lower spine—the low back, sacrum, and pelvic regions. Pain in the pelvic region for which a clear-cut diagnosis has not been made is called peripartum pelvic pain. Peripartum refers to the period surrounding childbirth—typically a few weeks before birth and a few weeks after birth.
Pain presents itself most commonly in the following areas:
- Sacroiliac joints at the posterior superior iliac spine – the bony part of your pelvis near your lower vertebrae
- The groin areas
Coccyx – The “tailbone” at the base of the spinal column
Pubic symphysis anteriorly – A joint that keeps the two bones of the pelvis together but becomes for flexible for childbirth
Occasionally, other areas of the pelvis and upper legs are affected, but rarely does pain occur below the knee. Pain tends to be influenced by posture and is associated with a waddling gait.
What Causes Spine Pain During Pregnancy?
The cause of pregnancy-related back pain is likely related to a combination of mechanical, metabolic, circulatory, and psychosocial contributing factors. However, most of the causes can be grouped into the following areas:
- Weight gain – Women typically gain between 20 and 40 pounds throughout pregnancy, which puts additional pressure on the spine. This added pressure may result in lower back pain.
- Shift in center of gravity – As you gain weight and your belly grows, your ability to maintain proper posture becomes challenged. Posture changes from pregnancy have been connected to lordosis and herniated discs, which may contribute to low back pain.
- Hormonal changes – While most women start experiencing back pain between during the fifth and seventh months, some report back pain in the first trimester. Since the baby isn’t large enough to cause any physical stress to the spine, it may be hormonal changes causing pain. Pregnant women produce relaxin, a hormone that relaxes spinal and pelvic ligaments and joints to facilitate childbirth. Relaxin may cause some spinal instability, and this can cause low back pain. In fact, certain hormones produced during pregnancy can cause sacroiliac joint dysfunction, a condition that causes low back pain.
Increased stress. Pregnancy is an exciting and special time for many women, but it can also be stressful. Stress can worsen back pain—or even cause it. Finding ways to manage stress during pregnancy may help ease your pain.
TREATMENT
Most treatments for pregnancy-related back pain involve lifestyle modifications, such as:
Avoiding excessive weight gain. A healthy diet is among the best ways to keep a healthy weight during pregnancy, and some foods have been linked to easing spinal inflammation (a common cause of low back pain). Eating five or more daily servings of fruits and vegetables will provide essential nutrients. Other good choices include nuts and fatty fish, such as salmon, which pack a healthy dose of omega-3 fatty acids to fight inflammation.
Exercising to strengthen the back and core muscles. In general, pregnant women should avoid the extremes when it comes to activity: Too much activity and too little can both cause an increase in back pain during pregnancy. Walking, swimming, and yoga are great ways to condition yourself throughout pregnancy, but always first talk to your doctor about how to safely exercise while pregnant.
Physical therapy with a therapist who specializes in women’s health. He or she can help you develop a plan and give you pregnancy-friendly stretches and exercises to relieve back pain.
Reducing stress. Finding ways to manage your stress throughout your pregnancy has physical as well as emotional benefits. A prenatal massage, relaxing with a heating pad against your low back, and getting plenty of rest are excellent ways to manage stress while helping your spine.
Maintaining correct posture. Talk to your doctor about ways you can keep good posture as your pregnancy progresses.
Investing in a pregnancy pillow to provide support during sleep. Sound sleep and pregnancy don’t always mix, but a supportive pillow may deliver more restful mornings.
- Wearing sensible shoes. Footwear and spine care are connected. Avoid high heels and flip flops, and purchase new footwear if your shoe size changes during pregnancy.
- Pregnancy Abdominal support garment. The daily pressure of an expanding belly is often centered around the lumbar spine. Abdominal support garments help to redistribute this pressure off the spine and across the larger surface area of the low back and hips. Many support garments are adjustable for use throughout pregnancy and are even beneficial for alleviating pain and pressure post-delivery.
- Massage therapy. Massages may help relieve muscle tension, improve blood flow, and reduce joint stress. Massages are considered safe throughout pregnancy, though there are a few exceptions. Massage may not be safe in the first trimester or for those who have chronic health issues such as uncontrolled high blood pressure, congenital heart disease, preeclampsia, recent injuries or surgeries, bleeding, pregnancy complications, or a recent organ transplant. Before scheduling your first appointment with a certified prenatal massage therapist, be sure to discuss massage with your health care provider.
- Stretching. Stretching is one of the best ways to target muscles, ligaments, and tendons that are working daily to adapt to your ever-changing center of gravity during pregnancy. Stretching improves blood flow, strengthens muscles, increases range of motion of the spine, expands flexibility, and relieves tension.
TIPS TO HELP WITH
PREGNANCY BACKPAIN
Tip #1: It’s Imperative to strengthen the abdominals and glutes
Often, when your back hurts during pregnancy, it’s because you are not utilizing the stronger muscle groups that help stabilize your body’s frame. As you gain pregnancy weight, the discomfort may worsen. When my Pilates instructor gave me deep core strengthening and glute exercises that I could do at home, I found the exercises immediately helped to alleviate my back discomfort. In many ways, the exercises reminded those muscle groups to wake up. So, instead of my back doing all the work, these muscles could take over when I needed them.
My favorites?
Bridges with a good bum squeeze at the top and pelvic tilts that gently wake up the transverse abdominals.
Tip #2: Side Stretching Helps the Back to Open
Stretching the sides of your body opens space between the ribs. It not only helps to alleviate back discomfort, but can improve breathing. As your pregnancy advances, the middle region of your body may feel tighter. It’s one of the reasons why you may feel out of breath. My massage therapist shared a body stretch that helps to open up the space between the ribs. My favorite stretch can help open up the left and right sides of your body.
Sit cross-legged and reach both arms up toward the ceiling. Move your right hand down and, with your left hand, reach over toward the right side of the room. Repeat on the opposite side. The key is to reach up and over to improve breathing. Hang out there and take deep luxurious breaths.
Tip #3: Place Your Legs Up a Wall
As pregnancy progresses, your legs, knees, and feet begin to feel the effects of greater body weight and pressure. Here is another favorite movement of mine— especially during pregnancy—that I discovered through my yoga practice.
This restorative yoga pose involves simply placing a yoga mat or blanket as a back cushion near a wall. Make sure it is level and smooth. Lie on the floor with your bottom against the wall and allow your legs to climb straight up the wall.
Stretch your arms outward and turn your palms up. Take deep breaths. It feels so good to reverse the blood flow and give your joints a break. Hang out for a few minutes and enjoy. If the back of your legs feel like this is too much of a stretch, you can always bring the soles of your feet together and let the knees butterfly to the side.
Tip #4: Commit Daily
It’s tough to make a personal commitment to doing daily stretches and exercises, especially as life becomes busier and busier. But making that daily commitment is key to make your home exercises effective. It’s best to get into the habit now to make your personal self- and body-care a priority. Life with kids will attempt to take over—but you need to make your wellness No. 1. Living with back pain is no walk in the park—nurture that discomfort now so you can enjoy your pregnancy journey toward motherhood even more.
Note: Many women experience back pain during pregnancy. However, it should be understood that back and neck pain can be caused by other conditions or disorders. Always seek the advice of your doctor or other qualified health care provider with any questions you may have about back or neck pain. Before starting an exercise program or other health care regimen, speak with your doctor or provider first.