Low back and pelvic pain in pregnant women is such a common phenomenon that it is often considered a normal part of pregnancy. Pregnancy-related low back pain can be divided into 3 categories, based on location: lumbar spine pain, posterior pelvic pain, or a combination of the two. The high prevalence of this problem and the effect that it has on quality of life, suggests that it be taken seriously by health care providers. Women who experience low back pain during pregnancy will often have the same problem after giving birth.
Many mothers will tell you that the muscle strains of pregnancy are real and are more than just an annoyance. Studies have found that about half of all expectant mothers will develop low-back pain at some point during pregnancy. This is especially true during the third trimester, when the baby’s head presses down on a woman’s back, legs, and buttocks, potentially irritating her sciatic nerve. A high percentage of pregnant patients with low back pain or pelvic pain, who have undergone chiropractic treatment, report clinically relevant improvement in their symptoms; at all-time points up to 1 year. Another recent study, conducted by Logan Chiropractic College and Washington University Medical School, one of the top medical schools in the nation, compared standard obstetric care for low back pain to a multimodal approach performed by a chiropractor. The research concluded that a combination of manual therapy, exercise and patient education reduces pain and disability when applied at 24-33 weeks gestation. Patients perceived less pain and disability, increased range of motion, stability, and less irritation at the lumbar and pelvic joints and an overall global improvement in daily activities. Notably, no adverse effects were reported either.
Most causes of low back pain in pregnancy can be linked to weight gain, postural changes, hormonal changes, muscle separation and stress. The average weight gain of 25 to 35 pounds, combined with the increased stress placed on the body by the baby, can result in moderate to severe discomfort. Women who already suffer from low-back pain may experience worse symptoms. During pregnancy, a woman’s center of gravity quickly begins to shift forward to the front of her pelvis. Although the pelvis has enough depth to enable her to carry a baby, the displaced weight still increases the stress on her joints. As the baby continues to grow in size, the woman’s weight is projected even farther forward and the curvature of her lower back is increased, placing extra stress on the spinal disc and facet joints. In compensation, the normal curvature of the upper spine increases as well.
What can you do to prevent, or reduce, low back pain during pregnancy? 1) Try exercising at least three times a week, gently stretching before and after exercise. If you weren’t active before your pregnancy, check with your doctor before starting or continuing any exercise. Walking, swimming, and stationary cycling are relatively safe cardiovascular exercises for pregnant women because they do not require jerking or bouncing movements. Your heart rate should not exceed 140 beats per minute during exercise. Strenuous activity should last no more than 15 minutes at a time. Stop exercising immediately if you notice any unusual symptoms, such as bleeding, dizziness, nausea, weakness, blurred vision, increased swelling, or heart palpitations. 2) Wear flat shoes. High heels can exacerbate postural imbalances, especially as your pregnancy progresses. 3) When picking up children, bend from the knees, not the waist. Avoid picking up heavy objects, if possible. 5) Get plenty of rest. Sleep on your side with a pillow between your knees, to take pressure off your lower back. Full-length “body pillows” or “pregnancy wedges” may be helpful. Lying on your left side allows unobstructed blood flow and helps your kidneys flush waste from your body. 6) If you have to sit at a computer for long hours, make your workstation ergonomically correct. 7) Eat small meals or snacks every four to five hours, rather than the usual three large meals. This helps to prevent nausea or extreme hunger. 8) Supplementing with at least 400 micrograms of folic acid a day, before and during pregnancy, has been shown to decrease the risk of neural tube birth defects, such as spina bifida. Check with your doctor before taking any vitamin or herbal supplement to make sure it’s safe for you and the baby