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 would 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. Now there are two reasons why the lower back and these structures in particular are more affected and specifically in pregnancy. One is because as a mother’s abdomen grows outward, the center of gravity changes and the pull — the weight of the baby, of the fluid, of the amniotic sac – all those structures pulls 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) – and it's a fulcrum point, it’s a point of maximum - you know - leverage where the actual abdomen can pull forward as a lever arm and pull against the SI joint, cause pain in that area, pain and inflammation.
Now one of the important factors is that mothers they reduce, there’s certain they produce certain hormonal substances, there’s hormonal changes which are there to 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 actually 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 actual weight of the baby so 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 a core strengthening program before pregnancy. Exercise in pregnancy is extremely safe and even basically high levels of exercise are safe as long as the mother was doing these exercises before the pregnancy, as long as their body's 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, 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 exercise 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 the muscles surrounding the spine – can oftentimes be quite effective in treating pregnancy-related pain. A mother should maintain their activity level, do stretches, keep the 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.