Back Pain During Pregnancy: Causes, Relief Tips, and Care Instructions

Pregnancy is a beautiful journey however, it doesn’t come without its physical challenges. Pain into the lower back and pelvis is common and we see a higher prevalence of it during pregnancy, affecting nearly 50-80% of all pregnant women. A combination of hormonal changes and a growing belly can lead to increased strain on the low back and cause increased discomfort for expecting mothers, particularly in their second to third trimesters. We understand the frustration that pain may can cause during this particularly vulnerable time and we want you to know that there are many ways to help manage it and provide you with some relief.

What Causes Back or Pelvic Pain During Pregnancy?

You might be wondering why you are experiencing backache during pregnancy? Well, there the are several contributing factors that can lead to this discomfort. Let’s dive into the anatomical changes first – as your body grows to accommodate for your baby, the extra weight during pregnancy causes your centre of gravity to shift forward and upwards leading to a natural change in posture that can add strain to the spine. Additionally, as your abdominal muscles stretch, their ability to contract to support the trunk and maintain body posture becomes more challenging leading to the spine picking up more of the slack to support the weight of the torso.

With pregnancy also comes hormonal changes such as the release of the hormone relaxin which causes a loosening of the ligaments around the pelvis making the body more vulnerable to pelvic or low back pain. Other contributing factors such as age, lifestyle, stress, sleep, and physical activity level can impact the severity of these symptoms. Women with pre-existing lower back pain are also at higher risk of experiencing it during pregnancy. Given the higher prevalence of this condition in pre-natal women, it is important to be able to recognize when you may be experiencing signs of a more serious issue and when to ask your healthcare provider for help.

Why is back pain so common in pregnancy?

Think about our spine as a thick branch from a tree – it is both strong and flexible. As we place a progressively heavier load onto a segment of that tree branch, it is forced to accommodate to that weight by bending and even straining as it attempts to remain stable. This is similar to how our spine naturally adapts with pregnancy and a common reason why we can see discomfort or pain develop behind your back or into the pelvic area.

5 Treatments to Ease Back Pain in Pregnancy

Fortunately, there are both self-treatment and physio-led options, that can help to prevent or ease back pain. Here are 5 different options that you can explore as treatments for pain into the pelvic girdle or back muscles.

1. Exercise & Stretching

Exercising is beneficial in both the prevention and treatment of back pain in pregnancy therefore incorporating low-impact activities such as walking and water exercises like swimming can serve to help improve your cardiovascular endurance, strengthen your core, and support the spine as your pregnancy progresses. Mobility and stretching exercises like the pelvic tilts or practicing pre-natal yoga can also help take stress off the back by promoting gentle movement into the lower spine.

A physiotherapist can help you design a specific regimen of recommended exercises that is safe during pregnancy and works to strengthen the pelvic floor, abdominals, and other key muscles. Having a guided and individualized program to follow that is tailored to your specific goals and abilities can help ensure you are optimizing your time while also keeping you safe and feeling supported!

2. Heat and Cold Therapy

Heat? Cold? Which one should you do? Both a cold compress or a heating pad have been shown to offer quick pain management for a variety of conditions, including low back pain. Our current evidence does not show one method being more superior than the other therefore it’s up to you in deciding which modality feels the most comfortable and effective! In order to protect your safety, limit use of these modalities to 15-20 minutes a few times a day.

3. Positional changes

One thing we know is that our backs like movement! Frequent changes in position and making small adjustments to how we’re positioned on the couch or in bed can take stress of your back and help provide relief. Using a small pillow behind your lower back to provide back support or side-lying with a pillow between your knees can help ensure optimal spine alignment to minimize stress on the muscles in the back. Taking the time to change positions when you’re seated for prolonged periods by taking breaks to learn back, bend forward, or roll your shoulders back allows for an easy breakup of postures. As much as you’re able to, try to avoid sitting for prolonged periods or having to stand for a long time and generally think about keeping your back moving as this will take stress off your back and help your pain.

4. Manual Therapy

Physiotherapists can provide hands-on techniques such as soft tissue massage, spinal mobilization, and other manual therapy approaches to relieve back pain. These techniques aim to reduce tension in the muscles and joints and promote healing. Manual therapy creates neurophysiological changes all the way up into our brain which lead to descending pain suppression from the spinal cord to ease pain. The mechanism behind how this works is called the “Pain Gate Theory”. With weekly manual therapy sessions we can see noticeable improvement within 4-6 weeks.

5. Kinesio taping (KT)

When Should You Seek Support from a Physical Therapist?

Although pain into the pelvis and back can be a normal part of pregnancy, there are symptoms you should look out for that indicate it may be time to consult a physiotherapist or ask your doctor for more information. Symptoms such as persistent severe back pain radiating down into your legs, weakness, or numbness may indicate nerve compression, which requires professional intervention and can be assessed and diagnosed by a physiotherapist.

Back pain can also occur as a result of a urinary tract infection. If you are experiencing pain into the uterus or a burning sensation during urination, increased frequency of urination, cloudy or dark urine, blood into the urine, pain into the pelvis or lower abdomen, or fever call your doctor right away.

Symptoms such as sudden, intense pain, cramping, or back pain accompanied by contractions should be taken seriously as these can be a symptom of preterm labor. In such cases or if your symptoms are severe, immediate and emergency medical attention is essential.

To conclude…

Early intervention is key for expecting mothers dealing with back or pelvic pain. For more information, book an appointment at REP Physio at one of our two Edmonton locations and be seen by a professional physiotherapist who can work with you to help diagnose and treat the pain you are experiencing to achieve optimal results!