Back and Pelvic Pain During Pregnancy
March 29, 2019
As pregnancy progresses into the second and third trimesters, many women experience back and pelvic pain. Such discomfort can have a big impact on life during pregnancy. While it’s not always avoidable, there are some factors that increase the likelihood that an expecting mother may have to deal with this sort of pain.
Body mass index (BMI) is a measure of body fat based on height and weight.1 According to the National Institutes of Health, a healthy BMI for an adult woman pre-pregnancy is 18.5 to 24.9.1 Research suggests that pregnancy-related pelvic pain may increase with a higher pre- pregnancy BMI.2 This finding highlights the importance of implementing healthy habits before pregnancy. Women who are thinking about becoming pregnant and have a BMI that classifies them as overweight or obese should talk to their health care provider.
As women progress through pregnancy and their babies develop, they begin to gain weight, particularly in the second and third trimesters. Back pain most commonly starts between the fifth and seventh month of pregnancy.3 Research suggests that activity level may be related to the onset of back pain during pregnancy.3 A sedentary lifestyle brings an increased risk of back pain compared to a more active lifestyle.3 Strengthening the abdominal, back and pelvic muscles before and during pregnancy may provide better support to the spine, improve posture and increase weight bearing ability.3
During pregnancy women experience changes to the thoracic and lumbar regions of the spine.4 The thoracic region runs from the base of the neck down to the abdomen. It connects to the lumbar region, which refers to the part of the lower back where the spine curves inward. A study that examined pain intensity, spinal curvature, and balance and gait ability found that there were significant differences between non-pregnant women and women in their second or third trimesters of pregnancy.4 As the spinal curvature increased from the second to third trimester, pain intensity in the lower back and pelvis increased.4
Pregnancy hormones may be another factor in back or pelvic pain. To prepare for the passage of the baby through the birth canal, the hormone relaxin is released that relaxes the ligaments in the joints of the pelvis.5 This loosening is a way for the body to naturally prepare for labor and delivery, as it allows the joints to become more flexible.5 Unfortunately, it may cause back pain if the joints become too mobile.5
Muscle Weakness, Strain and Separation
The main cause of back pain during pregnancy is strain on the back muscles.5 As a baby develops during pregnancy, the uterus becomes heavier. The increased weight, which is carried in the front, causes pregnant women to naturally bend forward.5 Because of the shift in their center of gravity, women adjust their posture to maintain their balance. They may find themselves leaning backward, which makes the back muscles work harder. This extra strain can lead to pain, soreness and stiffness.5
Similarly, weakened abdominal muscles may also play a role in back pain during pregnancy.5 The abdominal muscles support the spine, but during pregnancy these muscles become stretched and may weaken.5 These changes also can increase the risk of back injury during exercise.5
Support for a Healthy Pregnancy
If you have severe pain in the back or pelvis, or pain that persists for more than two weeks, talk to your health care provider. It may be a symptom of preterm labor or an underlying health issue, such as a urinary tract infection.5
Once any serious causes are ruled out, your health care provider may recommend low-impact exercise, pillows to support the spine, or use of a heating pad to help with back or pelvic pain.5 Wearing shoes with good arch support and using chairs with good back support may help prevent back pain during pregnancy.5 Side sleeping with a pillow support between the legs or sleeping on a firm mattress may also help.5
The majority of treatment strategies center on pain prevention because treatment late into pregnancy is often too difficult to implement.3 This is why it’s so important to implement healthy habits, such as regular exercise and eating a well-balanced diet, before pregnancy.
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