For many women, pregnancy is a wonderful experience. There are, however, many changes and challenges the mom-to-be can expect, and back pain is one of them.
The development of back pain during pregnancy primarily relates to the weight gain associated with the growing fetus. The extra weight gained adds stress to the pregnant woman’s spine.
The discs or cushions within the spine serve as effective shock absorbers but can fail due to weight gain. A pregnant woman may experience low back pain depending on either the amount or intensity of activity she is undertaking.
The next common cause of low back pain is weakening of the abdominal muscles that results from the growing uterus. The abdominal muscles (core muscles) tend to thin out or separate, giving the pregnant woman less abdominal strength. These muscles are what hold us upright and in a vertical position, so once they are weakened or separated a necessary support structure is lost, and the back muscles, discs, and bones have to work overtime. Pain is most recognized with moving and activity and is relieved when resting.
As the baby grows during pregnancy, a pregnant woman may notice her posture changing, particularly the back flexing forward as her center of gravity shifts — this is not normal for spinal alignment. Ideally, the spine is balanced, but a flexed forward spine, also known as kyphosis, is well known to cause low back pain. Kyphosis is common in the aging spine but occurs in a pregnant woman from the constraints placed on her from her growing baby.
The third major cause of low back pain in pregnant women is hormonal changes. To prepare for the passage of the baby through the birth canal, a hormone relaxes the ligaments in the joints of the pelvis. These changing hormones can cause the ligaments to become lax or weaker. Ligaments hold the bones from moving too much, and their weakening may result in back pain.
Lastly, an often overlooked cause for pain in the low back is stress. With effective management, limiting stress as much as possible may relieve or lessen the pain.
How can a pregnant woman ease her back pain? Chiropractors, physical therapists, and acupuncturists play a role in treatment of pregnant women with back pain.
Pregnant women should talk with their doctor if their back pain persists and should never take pain medications unless advised by a doctor. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil or Motrin) and narcotics are not usually recommended.
Re-printed from an article by Matt Ammerman, MD, neurosurgeon.