Pregnancy Back Pain
Research shows that 50-70% of women experience back pain during or after pregnancy. The last few months of pregnancy when the baby’s weight begins to increase dramatically are usually the most common period where pain begins. There are several reasons why back pain can occur, such as center of gravity changes, additional weight, postural changes, and hormonal changes.
As a baby grows in uterus the female’s center of gravity shifts anteriorly (forward), forcing the mother to change her posture to compensate. This change in center of gravity forces postural changes that the mother may have never experienced before, and causes increased strain on muscles and joints. For example if the mother’s center of gravity shifts forward her trunk and back must extend somewhat, causing shortening of lumbar extensors leading to increased fatigue in this group. If these muscles fatigue from increased use there could in turn be less core support for the lumbar spine which exposes the mother to increased possibilities of injury.
Another issue leading to low back pain is additional body weight. Additional body weight comes from the weight of the baby as well as through adipose tissue and milk production. An increase in weight causes increased load on the lumbar (lower) spine and discs causing abnormal pressure within the discs. Increased pressure within the disc causes increased potential for the disc to be injured, thereby causing back pain through a disc protrusion or extrusion.
The final significant factor for the cause of low back pain with pregnancy is an increased amount of hormone production. A chemical called relaxin is produced during pregnancy that acts to relax ligaments and joints especially in regards to the sacroiliac joint (SI Joint). SI mobility then allows the pelvis to open through which the infant passes during birth. Relaxin can cause the SI joint to become less stable and can result in SI instability where the joint can rotate anteriorly, posteriorly, shift up, or shift down.
How can physical therapy combat back pain with pregnancy?
Postural changes discussed earlier can be corrected through postural restoration exercises provided by your therapist. For example, stretching the pec major and minor groups with concurrent strengthening of scapular stabilizers can be used to square rounded shoulders resulting in a more military-like erect posture which results in less spinal pain. Core stabilizers coupled with stretches to restore movement of the spine can result in better support of the lumbar spine and less low back pain.
Education on the benefits of cardiovascular exercise by the therapist can also help control extra weight gain during pregnancy. It also doesn’t hurt that muscle burns more calories than fat and is already being produced with the addition of strengthening core and scapula stabilizers. A side benefit is cosmetics. A fit mother looks more like she did pre-pregnancy after giving birth than a mother who gains more weight than the prescribed 18-20 pounds.
A physical therapist can also educate the mother on proper biomechanics such as bending and lifting in the correct way, avoiding improper footwear such as high heels, using the healthiest position to sleep, and using pelvic support belts to stabilize the lumbar spine. Using a support pillow between the knees while sleeping and using modalities such as ice and heat for pain relief also can be useful.
Lastly in order to counteract pelvis laxity, SI stabilization exercises can be issued during pregnancy. These exercises can ensure that laxity needed for healthy childbirth doesn’t lead to instability of the SI joint. SI instability can result in chronic low back pain and must be corrected by manual SI mobilization as well as stabilization exercises to keep the joint in normal healthy alignment.
In summary there are a variety of reasons why back pain occurs during pregnancy. A consultation with a skilled physical therapist will reduce potential of back pain both during and after pregnancy. Post-pregnancy therapy can be implemented to correct abnormalities caused by pregnancy. Whether it be pre, mid or post-pregnancy, the physical therapists at Peak Physical Therapy are trained to combat pregnancy related back pain and will reduce pain related issues for a better and less painful pregnancy before, during, or after.
For more information on pregnancy related back pain contact Orofino Physical Therapy!
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