We’ve all seen those classic images of a pregnant woman, hands on her lower back, arching rearward, her face to the sky. As if foreshadowing the challenges that lay ahead for a mother-to-be, a certain degree of pain—in the back and elsewhere—seems to come with the territory.
Is it a necessary experience for a mother-to-be? And if so, how is it treated?
According to Brigham and Women’s Hospital in Boston, studies have indicated that 47-49 percent of pregnant women experience some form of back pain during their pregnancies. Both body chemistry and physical changes to the body are responsible for causing discomfort to pregnant patients.
“Throughout pregnancy, hormones affect a woman’s muscles and joints. The hormones relaxin and progesterone relax muscles and loosen ligaments and joints, especially in the pelvic area,” says an article entitled “Work and Pregnancy” in the online Johns Hopkins Medicine Health Library. “The extra weight and body changes in pregnancy along with these loosened joints and ligaments can cause discomfort and even lead to injury.”
The potential injury to the back increases with the growth of the fetus, the article explains. “As your uterus grows and becomes heavier, your center of gravity changes; this can lead to problems with balance and the potential for falls. The weight of your baby and weakening of abdominal muscles pulls your lower spine forward, adding strain to back muscles. Many women respond by leaning back in an awkward posture. This increases back strain and pain.”
Most studies estimate that 50 percent of pregnant women will suffer from lower back pain at some point, and one-third will suffer from severe pain, according to Johns Hopkins.
But why do some moms-to-be complain more than others of baby “getting on their last nerve”? Not all back pain is alike, and different origins of discomfort have distinct causes.
One complaint is called pelvic girdle pain (PGP), a specific lower back pain that may radiate in the posterior thigh and can occur with symphysiolysis, another type of back pain caused by a misaligned pelvis. PGP has an incidence of 20 percent in the pregnant population, says Hopkins.
Contributing factors to women suffering from pelvic girdle dysfunction include a history of previous low back pain and trauma to the back or pelvis, say Albert, Godskesen, Korsholm and Westergaard, authors of an article in the online U.S. National Library of Medicine. They also add that the subjects with PGP had a relatively higher weight, a higher level of self-reported stress and stressful jobs. Symphysiolysis was found more often in patients who weighed more and were smokers.
Two other types of pain, according to the authors, involve the sacroiliac region. Pain in the sacroiliac (SI) joint causes pain in the lower back and buttocks, sometimes with sciatic leg pain and numbness. The study concluded that one-sided sacroiliac syndrome was more likely to occur in women who had vocational training or a professional education and were either stressed, had a bad experience when giving birth previously, had a poorer experience of previous delivery, or back trauma. Double-sided SI syndrome was found more often in women who had previous back or pelvis trauma, a poor relationship with a spouse, or were less satisfied with their jobs.
Eighty percent of women suffering from lower back pain claim that it affects their daily routine and 10 percent of them report they are unable to work, say doctors at Johns Hopkins. They also suggest that changes can be made to reduce a woman’s back pain during pregnancy.
“Your ability to continue working depends on your overall health, the health of the fetus, and what sort of work you do,” according to the article in the Hopkins online journal. “Many jobs are safe to continue through the beginning of pregnancy. But later in pregnancy, some duties may need to be changed or stopped. As your body and posture change, back, neck, and shoulder strain may also become an issue if you sit all day.”
Some of the suggestions from Hopkins for women who work at a computer include:
- Take frequent breaks.
- Get up and walk around to improve blood flow and reduce swelling.
- Use a pillow or cushion for lower back support.
- Use correct hand and arm positions when using a computer.
- Use a wrist rest if you use a keyboard and mouse.
- Use a phone headset to relieve neck and shoulder strain.
- Don’t cross your legs or feet.
Jobs that require standing for long periods can reduce the blood flow to the fetus and slow the baby’s growth. It is also a big contributor to a pregnant woman’s back and leg pain.
Doctors at Hopkins offer the following suggestions for women who stand at their places of employment:
- Prop a foot on a short stool or box to help relieve back pain.
- Ask if you can sit on a tall stool rather than stand.
- Take breaks often and sit down with your feet up if possible.
- Wear good, comfortable, well-fitted and low-heeled shoes.
What about jobs that require heavy lifting?
“If you have a job that often requires heavy lifting, pulling, pushing, or other physical labor, talk with your healthcare provider about whether it is safe to continue,” says the Hopkins article. “Pregnancy symptoms, like dizziness … make some physical jobs dangerous. As your center of gravity changes, your sense of balance may suffer, making you more likely to fall.”
Treatment for a pregnant patient’s back pain varies, depending on the origin. The conditions require different treatment, so she needs to seek the advice of a seasoned medical professional.
“Low back pain could present as either a pelvic girdle pain between the posterior iliac crest and the gluteal fold or as a lumbar pain over and around the lumbar spine. The source of the pain should be diagnosed and differentiated early,” says The Hippokratia Quarterly Medical Journal, a peer reviewed publication found in the NIH U.S. National Library of Medicine.
With an average weight gain of 25-35 pounds during pregnancy, says the American Chiropractic Association, pain can be significant, especially during the final trimester, when the baby’s head presses against a woman’s back, sometimes causing sciatic nerve issues.
Some of the agency’s suggestions include wearing flat-soled shoes, sleeping on your side with a pillow between the knees, and using a footstool under your feet when sitting at a desk or computer.
Even before becoming pregnant, it is wise for women to have a health assessment by a chiropractor, where they can check for imbalances in the pelvis or elsewhere, says the ACA. From nutrition to ergonomics, patients can become more informed, which generally leads to healthier decisions.
A postpartum chiropractic visit is a way to address joint problems that occurred as a result of pregnancy. The earlier the better, as treatment before ligaments return to their pre-pregnancy state can mitigate the onset of shoulder pain, headaches and other chronic issues.
This article is made available for general, entertainment and educational purposes only. The opinions expressed herein do not necessarily reflect those of The Joint Corp (or its franchisees and affiliates). You should always seek the advice of a licensed healthcare professional.