Lower back pain during pregnancy

By Sally Ann Quirke, Chartered Physiotherapist | Filed under: Pregnancy and Back Pain

Published: 26 August 2015

Lower back pain during pregnancy is a very common complaint.

Pregnant women with lower back pain are referred to me for physiotherapy on a daily basis by their doctors.

But, why is low back pain so common in pregnancy?

The reasons for low back pain in pregnancy are most often related to your posture and the changes in that posture that occur when you are pregnant. The type of Lower back pain caused by posture in pregnancy is usually mild, causing you minimal problems with day to day life.

Also, when you’re pregnant the hormonal changes which occur can cause ligaments to become lax in your lower back and pelvis, placing more strain on your lower back, which may to be painful. More severe presentations of lower back pain related to pregnancy are conditions where your pelvis may be strained and joints in and around your pelvis go out of alignment.

These injuries are usually related to the sacro-iliac joint and the symphysis-pubis joints. When these joints move out of alignment the associated lower back pain can be very severe indeed.

Successful treatment of lower back pain during pregnancy

Treating lower back pain during pregnancy is very successful overall. Where posture is the cause your physiotherapist can teach you how to support your back with posture correction and advice. If you have a joint out of place, again, your Physiotherapist will correct it. Depending on the cause, they may also provide you with a pelvic brace for the remainder of your pregnancy that has been specifically designed for pregnant women. .

This will ease your pain and provide your pelvis with the support it needs to carry your baby! Failure to correct your alignment may make labour more difficult. So seek expert advice from the outset

Pregnancy Pilates is also very helpful in helping prevent back pain during pregnancy.

In my opinion, there does not appear to be any known or obvious reason for severe lower back pain in pregnancy. It may be genetically caused or it may be that you injured your back while working with a poor lifting technique for example. Although it is important to keep active throughout pregnancy you should avoid heavy activities which may pre-dispose you to injuries, especially if you have a history of lower back pain.

Lower back pain and pregnancy - Daisy’s Story

The most common lower back pain that I see in my practice is sacro-iliac dysfunctions. As your pregnancy progresses the hormones relating to pregnancy cause your pelvis to stretch and widen to adapt in size and shape for your baby to lie in and eventually travel through. It is due to this laxity combined with postural changes in pregnancy that your pelvis may become painful as strain is placed excessively on certain joints and ligaments. This looseness predisposes you to alignment problems during pregnancy.

I had a lady called Daisy in today who was 26 weeks pregnant. She complained of severe right-sided lower back pain. It had been present for 2 weeks and she had been told by her doctor that it may settle with time but that she had to get on with it!

On assessment she had what we call a “ight ilium up-slip”. This is where the large bone on the right side of Daisy’s pelvis known as the ilium had slipped upwards. Daily recalled the pain starting when she was reaching upwards to hang washing on the line. It is probable that as a result of the looseness of Daisy’s pelvis that this reaching activity resulted in her ilium bone moving upwards too far and it failed to return to its correct position.

Thankfully, Daisy’s pain was easily resolved. I simply corrected the position of her ilium using a specific Physiotherapy technique. Following this she had immediate relief. I advised daisy to wear a sacroiliac belt for the remainder of her pregnancy to help prevent her pelvic alignment from moving out of position again. I also educated her with regard to tummy and pelvic floor exercises to help maintain strength in her back and pelvic floor during the remainder of her pregnancy. Daisy was delighted!

Always seek advice before you settle with suffering with pain during pregnancy.