Don’t let pregnancy be a pain, in your back

Back pain during pregnancy is no laughing matter, as any mom-to-be with back pain can attest.

Many pregnant women are told not to worry and that the pain will eventually pass, which it sometimes does without intervention. However, while it may be common to have low back pain during pregnancy, it doesn’t mean it should be accepted when there are ways to manage or improve the pain.

Some sobering statistics:

— 49-76 percent of women will experience low back pain during pregnancy

— There is strong evidence that a woman is at a higher risk of having low back pain during pregnancy if she has a prior history of low back pain or prior trauma to the pelvis

— Women with low back pain during pregnancy have greater risk for low back pain postpartum with 37 percent reporting pain at 18 months postpartum

For the sake of simplicity, “low back pain” will refer to pain in the lumbar spine, sacroiliac joints and/or buttocks (in physical therapy we often make a distinction between low back pain and pelvic girdle pain).

Risk factors for developing back pain during pregnancy according to the journal Spine include:

— history of previous low back pain

— previous trauma to the pelvis

— high work load

— having given birth 2 or more times

— higher body mass index

— history of hypermobility (increased range of motion of joints; joint laxity)

— amenorrhea (history of absence of menstrual periods)

There are many ways to treat low back pain in pregnancy.

One approach is to tough it out and hope that the pain will disappear after delivering the baby. I know few professionals or pregnant women who are comfortable with that approach. Most professionals would recommend determining the cause(s) of the pain and developing a custom-made intervention plan to address each woman’s specific issues. There are many different potential treatments for low back pain, including:

— over the counter analgesics (consult with your OB/physician)

— use of heat or ice to the painful area for 10-15 minutes

— exercise (prenatal exercise classes, water exercise, prenatal yoga with specially trained instructors. If pain persists, physical therapy will customize the exercise program based on the individual)

— manual techniques such as massage, joint mobilizations, stretching (via specially trained

professionals)

— improved posture and body mechanics

— supports, braces, orthotics or taping

In the years that I have worked with pregnant women in physical therapy or in my prenatal exercise class, I see a common theme – women don’t want to do anything “wrong” that could potentially compromise the health of their child. This is why it’s very important to treat every pregnant woman with back pain individually vs. having them guess on their own ways to decrease their pain.

When a referral is made to a physical therapist, the woman sits down with a therapist and discusses her history and concerns and then receives a comprehensive evaluation and treatment plan. The physical therapist will then provide her with direction in how to manage her back pain.

It may take just a few visits for a woman who is experiencing back pain for the first time. For those pregnant women who have had back pain prior to pregnancy, they may need more visits and intervention to get to the point that they feel they can manage their pain if it is still present.

Another fact that can’t be ignored is the 37 percent or more that still have back pain postpartum. Managing or eliminating back pain during pregnancy should have an effect on reducing postpartum pain. Yet some women will need to return to PT to work on this in the postpartum period (in addition to the abdominals and pelvic floor muscles).

In conclusion, while low back pain can be common during pregnancy, there is often a way to manage or resolve the source of the problem. Consultation with a physical therapist can go a long way towards minimizing your back pain and maximizing your mobility.

Taking control of the pain will hopefully allow you to focus on what you should be doing — enjoying your pregnancy.