Pregnancy is a very exciting time for a woman. However, it can come with many physical changes that can cause back pain. It is estimated that 50 percent of pregnant women will experience an episode of back pain during pregnancy.
The rapid changes in a woman's body over a relatively short amount of time during pregnancy causes changes in hormones, changes in mechanical forces on the ligaments, and changes within the body as it accommodates the fetus. These changes, along with added weight gain, contribute to the possibility of back pain.
Relaxin is a hormone that is essential throughout pregnancy. Relaxin levels are highest in the first trimester and it acts on the uterus and blood vessels to better support the pregnancy. At the end of the pregnancy, relaxin plays a role in preparing for delivery. It acts on the ligaments to loosen and increase their flexibility. The flexibility in a woman’s spine increases the lumbar curvature, called lordosis, to shift the center of gravity forward, keeping it over the pelvis. This prevents her from falling forward as the fetus grows. This increase in lordosis also helps minimize the force acting on the muscles and ligaments. Due to the extra mobility in the ligaments, a woman is more likely to have a hyper-mobile spine and pelvis. This can also be more common after having multiple children and it increases the probability of back pain.
Spinal Pain and Pregnancy
Spinal pain can be divided into two categories: Pelvic Girdle Pain and Lumbar Pain. Pelvic girdle pain arises from the back (sacroiliac joints) and front (pubic symphysis joint) of the pelvis. Lumbar pain occurs from the five lower vertebrae. Pain commonly arises with rolling over in bed, climbing stairs and walking. If one has back pain in their first pregnancy, their chances of back pain in subsequent pregnancies increases. There is also evidence that weakness in the gluteus medius muscles will predispose to pregnancy related low back pain.
Pregnancy-related back pain and pelvic girdle pain are often exacerbated with movement and activity, and improve with rest for short periods. If you are experiencing severe back pain, or it is ongoing for more than two weeks, or it does not subside with rest, then consultation with your medical professional is important.
Early intervention can be helpful in preventing and managing discomfort. Seeking conservative care with someone who specializes in the treatment of pregnant women will be helpful in addressing any imbalances with the bones, muscles and ligaments. There is no reason to have to put up with this pain through pregnancy when there are health care providers available.
Postural changes and exercise can be helpful to prevent and manage back pain. Try the following:
* Make sure that you are walking daily.
* Avoid prolonged sitting. Move around frequently
* When sitting, keep your knees below your hips, with an angle greater then 90 degrees in your hip joints.
* Sit backwards on a kitchen chair.
* When on an exercise ball, keep your knees below your hips.
* When seated, keep your back upright, not leaning backwards.
* When standing, swing your hips in a figure-of-eight motion.
* Avoid carrying another toddler on your hip.
These postural habit changes may also help support the positioning of baby to facilitate less potential for painful back labor, or necessity for birth interventions.
It is very important to maintain cardiovascular and strength conditioning activities. If you were exercising regularly prior to pregnancy, you should be able to continue moderate intensity exercise. Moderate intensity exercise is classified as being able to maintain a conversation while exercising. If you are not able to maintain a conversation, you are working too hard. If you were running before pregnancy, you should be able to continue running while pregnant. Pregnancy is not the time to take up running. You should avoid exercises that have the risk of falling, contact sports, heavy resistance training and exercises that require lying on the back after the first trimester. (https://www.myvmc.com/pregnancy/exercises-to-do-and-avoid-during-pregnancy/). Studies of women who maintain exercise throughout pregnancy have decreased risk of gestational diabetes, decreased Cesarean section rates, and improved postpartum recovery time. If you are experiencing low back pain or pelvic girdle pain, water exercise is great alternative.
Activity Fact: Studies show that by the third trimester, the baby moves about 30 times each hour! Babies know before they are born how important it is to move!
(This article was written by: Dr. Melendy from the Neepawa Chiropractic Centre)