Video Transcript

Back pain during pregnancy is quite common – approximately half of all pregnancies are complicated by back pain. In about ten percent of the time, the pain can become so severe that it interferes with the ability to work or carry out normal, everyday activities. Risk factors for back pain during pregnancy include a pregnant mother who has a physically strenuous job who’s continued working or perhaps is taking care of other children. Also, a history of low back pain prior to the pregnancy predisposes a pregnant mother to back pain during that pregnancy.

Common causes of back pain during pregnancy are typically related to two general structures of the lower back, that is the sacroiliac joint – the SI joint – as well as the lumbar spine. There are two reasons why the lower back and these structures in particular are more affected specifically in pregnancy. One is because as a mother’s abdomen grows outward, the center of gravity changes and the pull of the weight of the baby, of the fluid, of the amniotic sac – all those structures pull anteriorly, pulls towards the front, and increases the curvature of the lumbar spine. Also, the sacroiliac joints – or the joints that connect the sacrum to the ilium (to the pelvis) – are a fulcrum point, it’s a point of maximum leverage where the abdomen can pull forward as a lever arm and pull against the SI joint and cause pain in that area and painful inflammation.

One of the important is that mothers produce certain hormonal substances and have hormonal changes which allow the pelvic girdle to open up to allow the passage of the baby. Unfortunately, these hormonal changes aren’t specific for the pubic symphysis, which is where we like to see a little play to allow the passage of the baby’s head. The hormonal changes cause relaxation in multiple ligament structures, including the SI joint and the lower lumbar spine at its point where it’s most affected by the weight of the baby you have this compounding effect.

In order to treat low back pain in pregnancy, the first thing that should be done is it should be preemptively treated. That is a women who plans to get pregnant should work on core strengthening program before pregnancy. Exercise in pregnancy is extremely safe and even high levels of exercise are safe as long as the mother is doing these exercises before pregnancy, as long as their body is conditioned, and as long as they don’t exercise to exhaustion, then most likely the exercises are safe. So, if a mother has a strong core, strong abdominal musculature, a strong back, obliques – if the core is strong, then those muscles will help support the baby and support the spine so that there is not an exaggeration of that curvature of the spine and undue pressure placed on the sacroiliac joints.

During pregnancy, the exercises should be maintained and there are several different programs that someone can go to including Pilates or yoga or even physical therapy to teach someone who doesn’t know which exercises to do. Also, chiropractic manipulations as well as osteopathic manipulations – which are geared towards a healthcare practitioner applying certain forces and treating the actual curvature and muscles surrounding the spine – can oftentimes be quite effective in treating pregnancy-related pain. A mother should maintain their activity level, do stretches, and keep their core strong. Oftentimes a pelvic support belt – which can be purchased at a medical supply store with the guidance of your doctor – can be used as an additional support device to help with the relaxation of those joints in the lower back and pelvic area.