Up to 80% of all pregnant women suffer from back pain at some stage, and the symptoms can be severe.

As it is so common, back pain is often ignored and accepted by many pregnant women as “normal”. However, there is a lot you can do to reduce back pain, and it is certainly not an inevitable part of pregnancy.

What causes back pain in pregnancy?

There are two different types of back pain during pregnancy – Pelvic Girdle Pain, (PGP) and true Back Pain.

Pelvic Girdle Pain is caused when ligaments in the pelvis and spine relax to allow the baby to pass more easily through the birth canal. This is a completely natural process but in some women the hypermobile joints ‘lock’ causing joint asymmetry. This can cause pain over the pubic bone (symphysis pubis) and the joints at the back of the pelvis (the sacro-iliac joints). If you have had a previous trauma to the pelvis, (an accident, for example) or muscles around the pelvis and spine are weak you could be more susceptible to PGP. Symptoms of PGP include difficulty walking, getting in and out of a car or the bath, or standing briefly on one leg. Symptoms vary from mild to more severe and debilitating.

True Back Pain in Pregnancy
True back pain is caused by a response to the growing bump as many women lean backwards to compensate for the increased weight. Muscles, ligaments and spinal joints become strained, and your abdominal muscles become over stretched and weakened. Your back becomes more sensitive than normal.

How can we beat back pain to prevent it happening?

Stay Fit.
Fitness in pregnancy is all about gentle movements and consistency. Even if you were an athlete before you became pregnant, you want to avoid high impact activities such as aerobics or racquet sports as they can cause injury.

Swimming is a wonderful way to tone and strengthen your muscles, and you can enjoy the feeling of being weightless in the water. Aqua-natal, Antenatal Yoga and Antenatal Pilates are all very beneficial and designed especially for you. Even a short gentle walk every day will help. It is important to take time for your fitness, whether you are still working while you are pregnant, or are at home with your family.

Improve your Sitting Posture.
Soft couches and easy chairs with deep seats make you push on the tailbone and sacrum and can cause pain. Put a thick cushion behind your lower back to help you stay upright.

In the car you can adjust your seat to a less reclined position…and it is probably best to stay out of a sports car with its “lie-back” seat! At work ask your employer to do a pregnancy risk assessment of your work place including your chair and computer to avoid postural strain of your back.

No Heavy Lifting.
We can all be tempted to lift heavy objects in the wrong way. Faced with a bag of shopping, you will do less damage if you split the load into two bags and carry the weight evenly. If you have a child in need of comfort try to sit down first, so that you can give love and hugs with them on your knee.

If you really do have to lift something, hold the load you want to lift close to you and use your legs. Bending your hips and knees means you are using leg muscles which are much stronger than your sensitive back muscles.

The best advice is to avoid lifting. So check with yourself first whether the job could wait until you get some help. Yes, it means you are not being Superwoman, but you will be avoiding back pain and creating a more enjoyable pregnancy!

Watch your Step.
High heel shoes may look good, but they throw your weight incorrectly, and cause back pain even in women who are not pregnant. Flip flops and other lightweight shoes can sometimes be a problem if you have to strain to keep them on your feet. Your feet may swell more easily – especially during the summer – and your shoes should fit you comfortably.

Rest.
In the old days women in high society were often expected to withdraw and rest while they were pregnant. We don’t want those days again but even 20 minutes a day of time to yourself with your feet up will help you enjoy this special time in your life. Chores can wait!

If you have back pain what can you do to help stop it?

Exercise. Pelvic tilts are great for strengthening the abdominal muscles and have the added bonus of relieving pain.

Rest comfortably. Lie on your side with a wedge shaped maternity pillow under your tummy and a pillow between your knees. This will help you get a better night’s sleep and supports the body, causing less strain.

Apply heat. Aching backs do not respond well to showers, but a hot bath can work wonders. Or use a hot water bottle, electric heat pad, or the Wheat or Gel packs which you heat in a microwave oven, to bring heat and comfort to your lower back.

Wear a support belt. Your physiotherapist or midwife can advise you whether a support belt would be helpful for you.

Massage. A gentle massage from your therapist or partner can relieve a lot of tension and pain even if the effect tends to be temporary.

Physiotherapy. Don’t let anyone tell you it is normal to be in pain and there is no cure for the pain because the hormones have made the joints looser! Physiotherapy safely treats pain, and you will be prescribed individual exercises for your condition. This helps you to look after your own back. Physiotherapy is highly effective for PGP pain and uses gentle mobilising techniques to re-balance the pelvic joints.

If your back pain gets progressively worse it is important to see a doctor or a physiotherapist to assess any underlying conditions. Worrying about pain can itself be damaging, so I would advise you to get reassurance and peace of mind at this very precious time in your life.

© Christina Carlsen

Christina Carlsen and her team are chartered physiotherapists and see pregnant and maternity patients at her clinic, Ealing Physiotherapy.
Please telephone for a booking 020 8847 1887, www.ealingphysio.co.uk

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