Pregnancy & back pain
Back pain is a common complaint during pregnancy. Chiropractor Dr. Robin Maris gives you some pointers on how to manage it.
If you are pregnant, you are no doubt coming to grips with the physical changes that are taking place in your body to accommodate your expectant bundle of joy.
During my wife’s pregnancy, I would tell her that she looked absolutely radiant with her relatively tiny tummy that was carrying our son. As the father, I truly felt this way and would beam with pride when her baby bump rounded the corner before she did. However, she did not echo my sentiments and would reply with a lengthy list of complaints that accompanied what she felt was her ever expanding belly.
We are all aware of the usual issues that come with pregnancy such as water retention and weight gain, but there is a very common problem that is often not properly highlighted until it is suddenly experienced during pregnancy: back pain.
Pregnant women often describe this type of back pain as dull or sharp and it is usually concentrated in the lower back region. In more severe cases this pain can develop into sciatica, which is a term to describe pain along the distribution of the sciatic nerve. This nerve radiates from the bum down the back of the leg and into the calf and foot. Numbness and tingling are also sometimes experienced in this area.
Causes of back pain in pregnancy
Back pain can affect pregnant women at any stage in their pregnancy and there are a few reasons why this condition is so common. One is hormone related. When you are pregnant, your body releases relaxin from the placenta, the linings of the uterus and the membranes that surround the baby. Towards the end of pregnancy, this hormone promotes the growth, opening and softening of the cervix and vagina to help in the process of childbirth and it relaxes the ligaments in the front of the pelvis to assist with delivery of the baby. During your first trimester of pregnancy, the body releases large amounts of relaxin, which causes the ligaments in the pelvis to relax. This can cause certain individuals to develop back pain as the baby starts to grow.
The growth of the baby brings with it another issue that can cause lower back pain, and that is the stretching and weakening of the abdominal muscles. Your abdominal muscles and your lower back muscles work together (along with other muscles) to maintain the stability of your lower back, but unfortunately the more weakened and stretched the abdominal muscles become, the greater the workload is for your lower back muscles as they need to compensate for this. As your tummy grows your centre of gravity also shifts forward, placing additional strain on the lower back.
Prevention of back pain in pregnancy
Prevention of the onset of lower back pain is always first prize, not only when it comes to pregnancy, but when dealing with back pain in general. I recommend a good core stability and stretching programme, which could either be provided by a biokineticist, chiropractor or physiotherapist. Doing Pilates at least once a week is also widely regarded as the gold standard when it comes to core strengthening.
If you have not been doing any of these types of exercises, I do not suggest that you take them up if you are already pregnant. Most gynaecologists encourage maintaining the training regimen that you were doing prior to falling pregnant, but are reluctant to add anything more strenuous because of possible strain that could adversely affect your pregnancy.
Heavy weight lifting is almost always discouraged during pregnancy. The strain involved leads to a dramatic increase in intra-abdominal pressure, which could place significant stress on the womb, resulting in premature labour or premature separation of the placenta.
Even though your feet and ankles may be swollen and you feel that a nice pair of heels will make them look prettier, do not do it. Wearing high heels causes an anterior tilt of your pelvis, which increases the curve of your lower back and leads to increased stress on the intervertebral discs and facet joints. Your centre of gravity is also forced further forward and when added to your weakened and stretched abdominal muscles, will almost always result in lower back pain.
Treatment of back pain when pregnant
If you start to suffer from back pain during pregnancy, it is wise to attend to it as soon as possible, because generally the longer you leave it untreated, the worse it becomes and the longer the treatment process will be.
Chiropractic treatment is considered safe for pregnant moms and is often administered from very early on in the pregnancy and sometimes all the way until full term. The maintenance of proper vertebral and pelvic alignment is said to allow for an easier delivery during natural childbirth.
In some instances when the pregnant mom has an extremely large tummy, supportive taping using kinesiotape across the stomach has been shown to provide additional support and decrease the severity of the lower back pain. Kinesiotape is hypoallergenic and does not contain any form of medication and is generally considered safe to use during pregnancy.
In very acute lower back pain in pregnancy, myofascial dry needling can also be used along with other trigger point therapies to help release muscle spasm. Special care must be taken to avoid any acupuncture/acupressure points that could cause any premature contractions.
Therapeutic massage can also be safely used although it will need to be administered with the pregnant patient lying on her side. However, it is best to avoid the type of deep tissue massage that leaves you feeling like you were run over by a small train. All of the abovementioned treatments should only be performed by a qualified chiropractor or physiotherapist.
In the third trimester at the stage when the baby descends into the pelvis, some pregnant moms are in the unfortunate situation where the baby’s head rests directly on the sciatic nerve. This results in tremendous and constant sciatica that is often aggravated by even the smallest movement, and these patients are often confined to bed rest. Sometimes the baby changes position slightly during this time and the pain disappears.
In the end, back pain is just a bump in the road on your pregnancy journey. You can take comfort in knowing that there are professionals around to help you if you need it.