• Danielle Labuschagne

Lower back pain during pregnancy - 9 months of torture?


… It does not have to be…


Lower back pain is one of the most common complaints during pregnancy with 50 – 80% of women reporting LBP while pregnant. The discomfort most commonly occurs during the third trimester, between the fifth and the seventh month of pregnancy. This is due to the increase in body weight and postural changes that occur in your body.

Pregnancy induced lower back pain is a musculoskeletal type pain that can manifest itself in the lumbar (lower back) region and can radiate to the buttocks and posterior thigh. Unlike nerve type lower back pain, this LBP usually does not radiate below the knee.

Associated symptoms, other than lower back pain, include stiffness and limited motion of the back and legs. This pain and stiffness could be constant or only occur with certain positions or after extended activity. LBP due to pregnancy will resolve itself quickly after partum and rarely causes any lasting issues.


Risk Factors:


The following factors have shown an increased likelihood of developing LBP during pregnancy.


⦁ Previous existing lumbar problems or chronic back pain conditions

⦁ Lower back pain experienced with a previous pregnancy

⦁ Sedentary lifestyles

⦁ Extremely active lifestyle

⦁ Physically demanding occupations

⦁ Increased body mass index

⦁ History of hypermobility


Why does lower back pain occur with pregnancy?


Pregnancy induced lower back pain is believed to be caused by a number of factors.


Mechanical:

  • Due to the growing baby and the additional weight, your body’s center of gravity shifts more anteriorly which increases the forces applied to your lumbar spine.

  • In order to balance this anterior shift, the natural inwards curve of your lower spine increases (your lower back becomes more hollow), which applies more stress on your back.

  • The additional loading on your back causes a decreased height in die discs and increased compression of the spine.

  • Your abdominal muscles stretch to accommodate the growing baby and loose their ability to maintain body posture and support the back.

Hormonal:

  • Some women report LBP during the first trimester, when the above-mentioned mechanical changes have not yet occurred. This could be explained by hormonal changes causing inflammation and LBP.

  • During pregnancy there is a 10x increase in the concentration of a hormone named Relaxin. This hormone softens collagen and causes ligament laxity. The ligaments around the pelvic girdle and sacroiliac joint become lax / loose and causes a decrease in the stability of the pelvic girdle and lower back area. This results in a potential strain and discomfort of the lower back and pelvic area.

Circulatory:

  • As the baby grows, the expanding uterus can press on the vena cava when the mother is lying down. This causes pain that is severe enough to wake the mother during the night.


Turning pregnancy pain into pregnancy JOY:


The majority of treatment for LBP during pregnancy focuses on prevention strategies since treatment at a later stage may be difficult to implement.


1. Exercise:



  • Exercise before and early in the pregnancy can help to strengthen the back, abdominal and pelvic floor muscles. This will help with maintaining proper posture and improves your body’s weight bearing ability.

  • Low intensity exercise was shown to alleviate pain once it develops.

  • Exercises such as pelvic tilts, straight leg raising and lateral straight leg raising, curl up, knee pull and Kegel exercises were shown to be successful in relieving lower back pain in pregnant women.



  • Water aerobics are very relaxing and controlled exercises and relieves LBP during pregnancy. The water has a soothing effect on the muscles and gives some resistance for maintaining strength.


2. Massage:

  • This helps to relieve pain caused by the increased demand on the muscles surrounding the lower back and pelvic area. Due to the laxity of ligaments and decreased stability of the lumbar spine and pelvis, the muscles have to work harder to regain some stability and control. This results in strained muscles and muscle spasms.


3. Dry Needling

  • This is also used to treat muscle spasms and trigger points formed by the overworked muscles. Furthermore, it improves local blood circulation and decrease in inflammation.


4. Manual Therapy:

  • Manual therapy performed by a physiotherapist can decrease the inflammation between the lower back vertebrae, increase the mobility where motion is restricted and decrease pain

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5. Heat

  • Heating pads and beanbags has been effective in relieving LBP.


6. Relaxation Stretches


7. Chiropractic procedures


8. Pelvic girdle support belts

  • This was shown to be effective in relieving lower back pain in pregnant women. The support belt provides stability to the sacroiliac joints and decrease laxity in the pelvis by pressing the articular surfaces together.



Having a baby does not have to be a pain in the back for 9 months, get some help and enjoy the miracle of pregnancy…



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Danielle Labuschagne Physiotherapy; Paarl Physiotherapy

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