Back Pain During Pregnancy
About 50 to 80% of 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 groin areas
- pubic symphysis anteriorly
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 Influences Pain Intensity During Pregnancy?
While age and smoking status has been not been shown to increase pain levels, higher body mass, more pregnancies, a previous history of back pain, and a previous history of pain during pregnancy have been connected to an increase in peripartum pain.
Also, younger women tend to have more intense pain when compared to older women. Studies have reported that approximately 10% of women said back pain during pregnancy prevented them from working, and more than 80% said it affects their ability to do daily tasks.
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.
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 5 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.
- 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.
If your back pain is severe and doesn’t respond to conservative treatments, your doctor may recommend a prescription pelvic belt, medication, physical therapy, injection therapy, or bed rest.
Fortunately, pregnancy-related back pain tends to go away within 6 months after birth—allowing you to focus on the much more important addition to your life, your new baby. If your back pain doesn’t subside after your baby arrives, talk to your doctor about whether additional testing or treatment is an option for you.