What to know about back pain in pregnancy

What to know about back pain in pregnancy

By Jamie Eske   

Reviewed by Holly Ernst, PA-C

First trimester | Second and
third trimesters | Pain relief Prevention | When to see a doctor | Outlook

Along with nausea, fatigue,
and swollen feet, most women experience back pain at some points during
pregnancy. Pregnancy-related back pain typically affects the lower back.

According to one review that
looked into the complaint, low-back pain affects more than two-thirds of women
during pregnancy.
Back pain can also arise near
the center of the back when doctors call it lumbar pain, or the tailbone when
they refer to it as posterior pelvic pain.
Many factors, including
hormonal and postural changes, contribute to back pain during pregnancy. The
causes vary between women and may depend on the stage of pregnancy.
This article discusses the
reasons for pregnancy-related back pain, and ways to treat and prevent this
discomfort.
Causes in the first trimester

Factors that can lead to back
pain during the first trimester include hormonal changes and stress, as we
discuss below.
Hormone changes

During the first trimester,
levels of progesterone in the body increase rapidly. High levels of this
hormone help relax the muscles and ligaments near the pelvis, which can affect
the stability and alignment of the joints.
Another hormone that doctors
call relaxin helps the egg to implant in the uterus wall, and also prevents
contractions during the early stages of pregnancy. As labor nears, relaxin
stimulates the cervix to soften and open in preparation for delivery.
Furthermore, relaxin relaxes
the ligaments and joints in the pelvic region so that the birth canal can
expand during delivery.
Finally, relaxin affects the
ligaments that stabilize the spine, which can cause instability, postural
shifting, and low-back pain.
Stress

Although many consider pregnancy
an exciting life event full of changes, it also introduces new sources of
stress.
Stress affects more than a
person’s mood or psychological state of being. Stress can cause physical
symptoms, such as fatigue, headaches, stiffness, and muscle pain.
Causes in the second and third
trimesters

During the second and third
trimesters, the uterus continues expanding as the fetus grows rapidly.
Postural changes, weight gain,
and muscle separation all contribute to back pain in the later stages of pregnancies,
as we discuss below:
Leaning backwards

A woman’s center of gravity
shifts to the front of the body as the baby grows in weight.
Some women may lean back to
regain balance. Leaning backward puts extra strain on the back muscles that can
lead to low-back pain and muscle stiffness.
Weight gain

Weight a person gains during
pregnancy can contribute to low-back and joint pain.
The amount of weight a woman
puts on during pregnancy can impact her and her baby’s overall health.
The Centers for Disease
Control and Prevention (CDC) recommend that women carrying a single fetus gain
the following amount of weight, according to their pre-pregnancy weight:
  • 28–40 pounds (lb) if
    underweight
  • 25–35 lb if a healthy weight
  • 15–25 lb if overweight
  • 11–20 lb if obese

Muscle separation

The abdomen consists of two
parallel bands of muscles that connect in the middle of the abdomen. These
muscles help to stabilize the spine and support the back.
During pregnancy, the growing
fetus pushes against the abdominal muscles, causing them to stretch and, in
some cases, separate. This pressure can result in a condition called diastasis
recti.
During the second and third
trimesters, some women may develop a bulge or “pooch” in their
stomach. This is a sign that their abdominal muscles are separating to allow
room for the growing uterus.
As the abdominal muscles
stretch, they become weaker. This can increase a woman’s risk of injuring her
back or developing low-back or pelvic pain.
How to relieve pain

At times, it may seem like
back pain is inevitable during pregnancy. However, there are ways to relieve
back pain both during and after pregnancy.
Ways to relieve back pain
during pregnancy include:
  • regularly stretching the lower
    back
  • sleeping on the side with a
    pillow between the legs and below the abdomen
  • using a warm compress to relax
    tight muscles or reduce inflammation
  • making postural changes, such
    as standing and sitting upright, so the back is straight and shoulders square
  • wearing a maternity belt for
    extra abdominal and back support
  • using a lumbar pillow for
    additional back support while sitting
  • getting prenatal massages to
    relax tight muscles, improve range of motion, and relieve stress
  • using alternative treatments,
    such as acupuncture and chiropractic services, with a practitioner who
    specializes in pregnancy.
  • reducing stress through
    meditation, prenatal yoga, and other mindfulness techniques
  • getting enough sleep

Tips for preventing and
avoiding pain

There are several effective
ways to avoid back pain during pregnancy, including:
  • strengthening the back muscles
    with pregnancy-friendly exercises
  • maintaining a healthy weight
    throughout pregnancy
  • doing gentle exercise
    regularly, with a doctor’s approval
  • wearing flat- or low-heeled
    shoes with arch supports
  • avoiding standing for long
    periods
  • avoiding lifting too much
    weight
  • practicing proper lifting
    techniques by squatting down and using the legs instead of the back
  • practicing good posture
  • avoiding sleeping on the
    abdomen

When to see a doctor

Women who experience back pain
during pregnancy should contact their obstetrician or other healthcare
providers if they experience the following symptoms:
  • severe pain
  • pain that lasts more than 2
    weeks
  • cramps that occur at regular
    intervals and gradually intensify
  • difficulty or pain when
    urinating
  • a tingling sensation in the
    limbs
  • vaginal bleeding
  • irregular vaginal discharge
  • fever

Sciatica occurs as a result of
an injury or irritation to the sciatic nerve. Sciatica during pregnancy occurs
when the growing fetus puts pressure on the sciatic nerve.
One symptom of sciatica is
low-back pain that radiates through the buttocks and down the leg.
Women who suffer from severe
back pain that persists longer than 2 weeks should discuss treatment options
with their healthcare provider.
Women who are pregnant should
speak with their healthcare provider before starting any new medications,
supplements, or naturopathic treatments.
Outlook

Back pain is a common part of
pregnancy. Several factors can cause back pain during pregnancy, including:
  • increase in hormone levels
  • postural changes
  • weight gain
  • muscle separation
  • stress on the body

Pregnancy-related back pain
usually resolves on its own after giving birth. Severe back pain that lasts
longer than 2 weeks may require medical treatment or physical therapy.
Women should speak with their
healthcare provider before starting any new medications or treatments while
they are pregnant.
SOURCE: MEDICAL NEWS TODAY
Kayode Ojo
Kayode Emmanuel Ojo is the Co-Founder and Managing Director at SHEFFA Limited. He is presently studying Computer Science at the National Open University, Victoria Island, Lagos.