This is the most amazing thing to happen to you! Congratulations! Few things will change your life more than having a child. It’s a joyful time for you, filled with anxious excitement and planning. While you relish this 9 months and the anticipation of your baby, there was one thing you weren’t planing on: pregnancy back pain! Ugh!
Pregnancy related back pain is an extremely common complication of pregnancy. Some estimates place as many as 61% of women as experiencing low back pain while carrying their child. That being said, there are many practical conservative solutions to the stress on the low back that occurs while pregnant.
So, why does a woman develop low back pain? Well there is the obvious answer that with added weight, comes added pressure on the joints. True, the average woman, in a healthy pregnancy, gains 25-35 pounds on average. However, there is more the back pain it than a simply weight gain.
Many women describe pregnancy related low back pain as back pressure, pain across the back, or pain in the hips. Additionally, they may report achiness, stabbing, burning, or instability in the low back. Regardless of the description, the causes of pregnancy related low back pain are many and include:
- Increased weight gain – as your body increases in weight, increased stress is applied to the joints. Gaining the typical 25-35 pounds in a period of 9 months is a relative rapid weight gain, and change your body may have difficulty adapting to. Generally, the impact of weight gain will be affected by general health going into the pregnancy and other factors such as core strength and exercise levels. While healthy weight gain should not generally be discouraged, there are ways to get the body to adapt better to the increased weight, minimizing stress to the joints and maintaining full function of the back through the duration of your pregnancy.
- Changes in weight bearing – Generally, most of the weight gain during pregnancy is in the stomach causing the center of gravity to shift forward. While non-pregnant individuals will generally have a center of gravity that is somewhere over the mid-pelvis, pregnancy causes trunk weight to shift forward. This forward weight bearing can cause an increase in the curvature of the low back leading to cramping as the back muscles struggle to support the weight of the abdomen. Additionally, forward weight bearing stress the sacroiliac joints, those tailbone joints that work with the pelvis, to cause sacroiliitis.
- Changes in hormones – As your body approaches its due date, your body will start to produce hormones which will increase flexibility. While the hormones do allow for increased motion in the pelvis to allow for birthing, they also make it more difficult for the pelvis and low back to stay in proper alignment, leading to increased instability and pain. Pain may come and go as the pelvis and low back shift and move more easily, resulting in low back irritation and pain.
So, you have low back pain from your pregnancy, what can you do? There are a lot of conservative interventions available to help your deal with your back pain. Some can be accomplished on your own, others require the help and intervention of others. Here are a few suggestions:
- Weight bearing exercise – A moderate amount of walking will help keep postural muscles strong and improve circulation to affected tissues. Additionally, walking will help improve motion in the pelvis which should, in turn, decrease the likelihood of joint instability, asymmetry, and misalignment of the pelvis.
- Stretching – Later in pregnancy, your body does produce hormones that increase joint flexibility and make birthing possible. However the degree to which flexibility improves often depends on pre-pregnancy range of motion. It’s been my experience that many women have developed such muscle tightness before pregnancy that the relaxing hormones can’t even get those individuals to normal ranges of motion. Your body is designed to have a certain level of flexibility that we lose due to life circumstances. Maintaining and improving that flexibility will help decrease the stress on your low back and pelvis. Often, stretching areas you would not associate with your back can even help, such as hamstrings, upper back, and hips. Sitting on an exercise ball and rolling the hips or laying on your back and using the ball to roll the hips back and forth are great exercises for improving your back pain. There are also yoga programs for pregnancy that are available. True, you may not be able to do every pose, but working on your range of motion is generally a good idea.
- Improved diet – Of, course, it should go without saying that you should be eating well during your pregnancy, and I’m not talking about volume but quality. After all, you are eating for two now. You should be eating whole foods free of artificial ingredients. Not only will you be healthier for it but your baby will thank you. Improved nutrition will increase nutrient supply for the muscles, ligaments, and tendons of the back. Good food will decrease the likelihood of muscle spasms due to nutritional deficiency. Avoid excessive carbs/sugars because they can be pro-inflammatory and contribute to inflammation in the joints. Also, watch your water intake. Dehydration can also lead to muscle spasming and soreness in the soft tissues. Finally, a whole food pre-natal vitamin should be part of any regimen to help fill the holes in your diet, not to mention prevent possible birth defects.
- Stress management – Mental stress causes physical distress. True, your low back pain is most likely due to the physiologic changes you’re experiencing with your pregnancy but mental stress can take a physical problem and make it that much worse. Pregnancy in and of itself can be a trying time mentally, especially for single or first time mothers. Finding an outlet or your stress, such as exercise or even counseling will help your body adapt better.
- Improve your body positioning – Being conscious of your posture and taking active steps to alleviate the stresses on your back may improve your pain symptoms. This may include everything from sleeping on your side with a pillow between your legs to using pillows to support the back and legs while you’re sitting. Back supports may also help. Avoid standing or sitting in one position for too long and try to get moving as much as possible.
- Massage Therapy – Because much of the pain experienced during pregnancy is due to tension and stress on the muscles, soft tissue mobilization may help alleviate a portion of the pain. Massage therapy will help relax tightened muscles, improve circulation to the tissues, and promote a general sense of well-being.
- Heat or ice – While many sources will include hot baths for relieving pain, I will generally discourage that for my patients. In fact, many physiotherapy resources discourage the application of heat over the abdomen as a contraindication during pregnancy. I generally tell patients to use a regional warm pack over the back for no more than 15-20 minutes. It can be repeated but allow about an hour or so for re-application. I want the patient to avoid increasing their resting metabolize temperature and the goal isn’t to cook the tissues. A warm pack can often provide just as much effect as a hot pack, with less risk. A microwaveable heat pack or hot water bottle will generally suffice to ease tension in the low back without the danger of overheating the area. As a general rule, avoid placing heat or ice over the abdomen while you’re pregnant.
- Kinesiotaping – This is an athletic taping technique that has been gaining popularity in recent years. Kinesiotape is being increasingly used by professional and amateur athletes to help alleviate pain and improve tissue healing. It’s safe to use during pregnancy because it does not use any drugs and is strictly a cloth tape with a skin adhesive. In fact, there are specific taping regimens for pregnancy, to not only alleviate low back pain, but possible abdominal pain associated with carrying your baby. To be effective, though, the tape should be applied by an individual with training and experience in kinesiotaping. There is a certain art form to its application. It can, however, offer notable decrease in pain and improved stability in the back, hips, and abdomen.
- Proper spinal alignment – Arguably one of the most important aspects of decreasing pain in your back, I saved this for last. Proper alignment of the low back will decrease pressure on pain sensitive nerves, improve motion of the joints of the low back, decrease stress on the soft tissues, and improve overall function of the low back. Chiropractic care has been routinely shown to be safe and effective for relieving the back pain associated with pregnancy. Spinal adjusting has also been linked to improved labor and delivery. There are certain medical conditions that may be a contraindication to chiropractic care but, for most women, chiropractic care can be very effectively incorporated into a pain management regimen. In my office, I will frequently see pregnant patients on a weekly or biweekly basis for their pain and most women will see decreased pain immediately following their adjustment. They also will report improved ability to sleep, decrease generalized soreness, and an improved ability to function. In my opinion, chiropractic adjusting should be incorporated for most women with pregnancy related low back pain.
If you are struggling with pregnancy related low back pain, there are solutions out there for you. Perhaps the best place to consult about your back pain is with someone who sees a lot of back pain patients, like a chiropractor. Besides adjusting your spine, they can provide you with additional tips and tricks to alleviate your pain.
Has your doctor suggested pain medication to you? Always ask better questions. The decision to take pain medication while pregnant should be a thoughtful one made with your medical doctor. You need to know what research has been done on that medication and its effect on a developing fetus. Certain conditions like asthma and autism have risen to alarming rates, with little research done on the effects of oral medications on an undeveloped fetus. While there is little overt evidence to explain the remarkable rise in childhood illness, that is mostly the result of a lack of research. Just because there is not an established 1 to 1 relationship between a specific cause and disease does not discount an overall trend toward increasing illness due to an accumulation of exposures. I don’t think it’s an accident that autism rates have risen to 1 in 88 kids. Too much of the research focuses on, and debunks, a single specific cause like vaccination and I fear conditions like autism are not due to a solitary cause but a series of toxic exposures over time. Unfortunately, there is very little research on the effects of pre-pregnancy, intra-pregnancy, and post-pregnancy toxic exposure on the developing child. However, it reasons that the rises in childhood illness rates may be linked to the fact that our environment is as toxic as it’s ever been. Anything you put in your body that is not food is a potential toxin. That toxin can affect you and your baby. Pain medication is not food. Anything you feed your body while pregnant, your baby will respond to, either for good or bad. Try to remove as many toxins as possible from your diet and lifestyle. Turning to natural means for alleviation of your pain may make you and your baby a whole lot healthier and happier for a lifetime of wellness.