In this episode of the Morley Physiotherapy Centre Podcast, owner Tony talks about how to reduce pregnancy back pain.
Is there a cure for pregnancy back pain? Listen now or read on to find out the reason and cause for back pain in pregnancy and understand how to cure back problems as they occur.
Full transcript below!
Tony: Good morning, it’s Tony Pullella speaking, I’m a musculoskeletal physiotherapist, and I work for Morley Physiotherapy Centre. Today I’m going to help discuss with you some of the reasons why women get back pain in pregnancy, what are some of the causes of that and of course how to understand ways of preventing and curing those problems as they occur. So in my experience over the last 35 years as a physiotherapist, I’ve met quite a few women in the clinic who’ve come in with back pain related to their pregnancy and also my wife and I have six children, so I’ve actually experienced day to day what it’s like living with a pregnant women, and I must admit and I did have some problems back in those pregnancies, and I did help her get over those. So maybe I can also help you understand what you can do too.
So whether you are pregnant right now, or you are planning to get pregnant, you should probably understand how back pain can affect you and this is quite a common problem that 45 to 55 percent of all pregnancies associated with variant degree of lower back pain. So lower back pain is quite a natural occurrence in pregnancy and obviously most of those problems are mild but in about ten percent of women, the pain can become severe, and it interfere with the ability to work or carry out normal activities and in those cases, those women are the ones coming in looking for treatment.
Two common types of back problems
So with pregnancy, there are two common types of back problems, one is associated with the lower back, which is in the small of your back, and the other one is more of a pelvic pain, which is also known as sacroiliac joint pain, which is in the buttock or glute area between the hip and the spine. Most of the problems are more severe in the third trimester, which is roughly from around 30 weeks of gestation and so that’s about ten, eleven week period between about six and nine months of pregnancy. The sacroiliac area is one of the common areas that we look at in pregnant women and that’s the area we call the bony ring, which connects your hips to your spine. It’s a very important functional unit of the body that is the core of your pelvic area that allows normal patterns of movement during walking. So often when those joints don’t work, and those ligaments don’t work properly, it’s in the walking and standing department that you get most of the pain.
Causes of back pain during pregnancy
So what are some of the causes of natural back pain in pregnancy? I guess the most obvious one is in pregnancy, from the early stages there are hormonal changes that are occurring in the body and natural hormone changes cause the joint support structures or ligaments in the pelvis to loosen and relax. The hormone is known as relaxant and it’s obviously its name describe what it does in the body, it actually causes the ligaments in your pelvis to start loosening so that when you deliver the baby, your ligaments can allow that pelvic ring to open up and allow the delivery. So that lack of joint support not only affects your pelvis, but it affects every other joint in your body, so there is a possibly of joint strains in pregnancy, which wouldn’t normally happen.
A second cause of back pain in pregnancy is to do with the natural weight gain that occurs and in some women that weight gain can be quite large, up to ten to thirteen kilos, up to 25 percent of the body weight and this increase in weight causes a lot of loading on the weight bearing structures and it usually causes a lot of leg cramping and tightness as well.
The third area that is normally looked at is the spinal posture or alignment of the spine that changes. As the baby grows inside the womb, there is an increase change of the center of gravity of the body. The center of gravity moves forwards as the baby pulls the spine towards the front and this changes the line of curve, it increases the arch of the lower back, and it’s call the lordosis, and it also can cause a change in the pelvic tilt, which tends to tilt down towards the floor. This in itself changes the alignment of the spine, the discs and changes the tension on the ligament and the tension on the muscles.
Another area that we should discuss too is stress, there is a lot of emotional strains on women when they get pregnant. It’s obviously a joyful time but there’s a lot of … it can become an emotional roller coaster, it can become a physical roller coaster, so that can be one of the areas that affects the ability of the body to handle pain, and that’s one of the stress hormones that are released make us more open receiving pain signals from the body.
Posture loading or strains are quite easily brought on by too much sitting, standing for too long or walking for long distances. As the body is changing shape, as the body is becoming more affected by hormone changes, if you sit, stand or walk for too long, the back starts to ache. And often it’s worse towards the end of the day and with a bit of a heat pad, or a rub like a massage and a bit of a stretch, it usually eases away, but it’s quite interesting how that is a very common factor, and the body at this time is also liable to get strains from bending, lifting and twisting movements much as it can happen in other stages of life. So your ability to handle prolonged sitting, standing, and walking or lifting and twisting strains can be affected by the pregnancy.
And if the person has got preexisting lower back pain or problems, poor flexibility or poor strength together with poor level of fitness, that’s another factor can predispose women that are pregnant to having lower back pain. So what are some of things that we can encourage you to look at in your pregnancy. Everyone knows the health benefits of exercise and I think that things like heart disease, cardiovascular disease, getting blood sugars down, preventing diabetes is obviously a very well known medical fact now that but the physical effect and mental effect of exercise is amazing in pregnancy.
How to reduce back pain
A lot of women think they have avoid exercise and protect their baby that’s growing inside them but really your baby is well supported and well managed in your womb and you can become an active person as long as your activities are not too extreme or too vigorous, your body can handle a wide range of gentle, moderate activity during pregnancy.
Also, this helps to boost energy levels, which is a very important thing as well, as very important benefit and relaxation. So the physical effect and mental effects of exercise are really important for you to consider. What exercise could you consider? Well, first of all, for cardiovascular or aerobic benefit, anything that it involves low to medium intensity exercise is ideal, particularly throughout your pregnancy. Things like walking, cycling, and swimming are really good exercise to consider. Obviously walking activities can become a bit strained towards the end of second trimester but in the early stages, walking and also water exercise, like walking in water and hydrotherapy is very good exercise to do and if this can be maintained for twenty minutes to forty minutes, three to five times a week, you’re getting a very good general workout for your body.
If you want more specific exercises that includes stretching, routines and strengthening, lot of women prefer yoga and Pilates because these are gentle and moderate and often allow the body to stretch gently and they’ve done it in a way that tends to strengthen also the core and pelvic areas of the body, so done with supervision and professional help, yoga, Pilates and stretching and strengthening exercises are well-suited for you.
If you can improve your posture, that’s also a very important thing for you, in sitting it’s really important to choose your chair properly, avoid sitting low chairs, soft, low couches because that’s the area that will give you the least amount of back support, so avoid slouching and avoid slumping and try to get a chair with an adequate back support that isn’t too low. When we’re standing, try to avoid slumping the shoulders forward and arching the lower back, this is one of the areas that women tend to do when their baby’s getting really large and is dragging them forward, so just pull the belly button in and try tilting the pelvis back as if you’re trying to flatten your back.
Interestingly, pregnant women find a lot of difficulty lying in bed for long, you think that will give them so rest but usually lying on their back is very uncomfortable, they’re more comfortable lying on their sides with their knees slightly bent and a pillow between their knees. Often sleep is disturbed or interrupted when they move, they find it very difficult to roll from side to side, so that’s one area that will be challenged in the later months but if we keep our spinal area strong and supported, that helps us get our posture sorted out during the night sleep.
If the walking is becoming a bit difficult, I will normally recommend a woman look at getting a pelvic support or a sacroiliac belt. These are easily available from physiotherapists and they’re not too expensive and they are applied in the day time when they’re getting a bit tired. ‘Cause one of the things that you’ll find is that you get a lot of fatigue and the muscle fatigue is one of the things that really affect the posture and movement control of the body. So far, we’ve discussed some of factors that are involved in lower back pain in pregnancy, we understand it’s a natural thing, we understand there’s a lot of stresses on the body and on the emotion as well as we’re pregnant and that we need to look after the way we sit, the way we stand and the way we walk, particularly with the posture of the body as we’re getting larger.
So, let’s see if we can give you some encouragement now to get out and get moving. That’s one of important things about pregnancy is not to stay in one position for too long and you can get some help from your physiotherapist, they can prescribe exercises for you. Many physiotherapists have got a fit ball exercise program for pregnant women that they can do at home. So a lot of the exercises can be home based, they’re very convenient and keep the exercise going throughout the pregnancy and don’t do anything that’s too extreme or too strenuous for you to handle. So I hope this information is giving you some understanding of back pain and how to prevent it, how to understand it and if you’re not able cope when things are getting a bit unmanageable, I encourage you to ring your physiotherapist. They’re always happy help you to understand how you can get these problems sorted out.
I wish you all the very best and remember – Feel well, Move well, Live well!
Contact Us
Morley Physiotherapy Centre Website
Phone: 08 9375 3900
Email: admin@morleyphysio.com.au