Strategies for Lower Back Pain During Pregnancy

Pregnant and suffering from low back pain? If you are, you’re not alone! In fact, most women who are pregnant experience low back or pelvic pain throughout their pregnancies. This can be so frustrating during a time that is supposed to be full of excitement and joy! Thankfully, there is help. In this blog, we will discuss strategies for managing low back pain during pregnancy and tips on how to get rid of it for good! 

What Causes Low Back Pain During Pregnancy?

  Most pregnancy-related low back pain is due to the many changes that happen to the body during pregnancy. As you progress through pregnancy, your center of gravity shifts forward, causing a forward tilt in your pelvis. This can put a lot of pressure on the structures of the low back such as the lumbar spine and sacroiliac joints. In addition, the hormone relaxin causes stretching and loosening of the ligaments of the pelvis, making women further susceptible to pain, instability and muscle spasms in the lower back. And finally, all the extra weight of the baby, on top of the changes noted above, can create the perfect storm for pain and discomfort. 

Strategies for Managing Low Back Pain During Pregnancy: 

Posture and Body Mechanics

As previously stated, as the baby and uterus grow, the center of gravity shifts forward. This causes the pelvis to rotate forward, putting more pressure on the lumbar spine and sacroiliac joints. Sometimes women further arch their back to compensate for this postural change, and that only makes the problem worse.

Work with your PT on finding your new “neutral” spine position in your pregnant body. This will involve retraining postural muscles and unlearning old patterns. Deep core strengthening will also help you maintain a better position throughout the day. The stronger the core, the more easily you can maintain a good pelvic and spine position. 

Sleeping Position

Between pregnancy insomnia and aches and pains, sleeping can be tricky for most pregnant women. Since we spend a third of our day in bed, it is important to sleep in positions of ease for the back and hips. 

• Positions to Avoid:
  • Sleeping on your back if you are >28 weeks OR experiencing nausea or dizziness in this position
  • Stomach sleeping 
  • Sleeping with one leg bent up towards your chest – this may initially feel good, but it places rotational stress on your lumbar spine and hips
  • Sleeping with a pillow between your knees – this may seem sufficient but for most pregnant people, it is not enough support and can cause similar stress on your body as the above scenario. 

• Ideal Sleeping Positions:
• Sleeping on your side with 2 pillows between your legs – this gives enough height and support so there is no strain on the pelvis.
• Sleeping with a thick pregnancy pillow – Try to keep the pillow between your knees and ankles for optimal alignment. Most pregnancy pillows are long enough to facilitate this. This position keeps everything stacked optimally.
• Depending on how far along you are, in either of the above scenarios you may also benefit from a wedge pillow placed under your belly to take pressure off the back and hips throughout the remainder of your pregnancy. 

SI Belts

If your therapist determines that your pain is stemming from the ligament laxity and hypermobility in the pelvis (a common finding with pregnancy), in addition to a holistic treatment plan, your PT may recommend a sacroiliac belt. These belts compress the pelvis at the SI joints posteriorly and the pubic symphysis anteriorly. This compression supports the pelvis and takes the stress off the joints and surrounding structures during activity. 

Do not jump to Kegels

Many pregnant women who experience back pain wrongly assume that strengthening their pelvic floor via more and more kegels will solve the problem. This can potentially make back pain worse. If the pelvic floor already has excessive tone (another super common finding), strengthening on top of this can worsen the hypertonicity and cause trigger points in the pelvic floor. These areas of high tension in the pelvic floor can refer to the back or hips, worsening pain. Therefore it’s so important to get a thorough assessment from a specialist before you self-diagnose!

Get a Full Assessment 

As stated above, nothing replaces a thorough and holistic assessment of your entire body when you are experiencing pregnancy-related low back pain. Pregnancy creates full-body changes and needs a full-body approach. A specialist PT can do a detailed assessment, get to the root of the problem, and walk you through an individualized treatment plan. 

Pregnancy is a beautiful experience! If you are pregnant, congratulations! We’d love to help you start feeling your best and fully enjoying this time in your life!

Call us today to learn more about how we can help you through low back pain during pregnancy!