Back pain during pregnancy can be expected by about half of all expectant moms.
Experiencing back pain before pregnancy and having had more than one pregnancy increases the risk.
It might seem a wonder that more pregnant women don't experience back pain, what with all the musculoskeletal, weight, and hormonal changes that occur.
To accommodate a shifted center of gravity and stay upright, pregnant women must alter their posture in spine-stressing ways.
Meanwhile, as the pregnancy progresses, the hormone relaxin, which allows the pelvis to expand for the growing baby, increases tenfold, loosening ligaments and joints, which alters balance.
Abdominal muscles become stretched by the enlarging uterus, reducing their tone and their ability to keep the body in a neutral posture that doesn't stress the spine.
Pregnancy back pain is usually felt in the low back, in one or a combination of three types: 1.
Lumbar pain.
Occurring in the lower area of the spine, lumbar pain can be experienced with or without pain in the legs.
It is prompted by carrying weight or sitting for long periods.
Turning in bed at night can make it feel worse.
2.
Sacroiliac pain.
Four times more common than lumbar pain is sacroiliac pain, which is felt lower than and on the side of the lumbar spine in the pelvis and buttocks, sometimes radiating down to knee level or beyond.
Symptoms of sacroiliac joint pain, the longest-lasting, can continue for months after delivery.
This type of pain can be brought on by staying in one position for a prolonged period, heavy loads, and turning in bed.
It's been estimated that 20 to 30 percent of pregnant women experience both lumbar and sacroiliac pain.
3.
Nocturnal pain.
The third type of pain is felt only at night while lying down.
Nocturnal pain is cramp-like, reminiscent of the low backache of menstruation, and can wake a woman from sleep, although turning in bed won't hurt.
Theories about its causes include the accumulation of the day's muscle fatigue, and circulatory slow-downs associated with lying down.
Backache of any kind can interfere with sleep and waking activity, both of which are important to a healthy pregnancy.
In addition to observing standard precautions against back pain, pregnant women are advised to consider the following list of recommendations to help prevent and cope with back pain.
Consult your doctor.
Don't take any medications - not even over-the-counter remedies - without your physician's approval.
Use moderate heat and ice instead of drugs.
A warm shower or bath might ease your pain, but avoid hot water, Jacuzzis or whirlpool baths, and heating pads.
Watch your posture.
Physicians can teach you the neutral spine posture that avoids excessive lumbar lordosis (lower back curving), and excessive reversal of it.
Massage therapy may provide short-term back pain relief.
Be sure to tell your massage therapist that you're pregnant (if it's not obvious), and avoid excessive joint manipulation.
Sleep smart.
To relieve or prevent night pain, sleep on your side, with a pillow beneath the abdomen and between the legs.
Bend the lower knee and prop the other leg with a pillow.
Full-body pillows and other ergonomic devices can also help during sleep and waking hours.
Exercise appropriately.
Pregnancy-appropriate exercise programs can help relieve lumbar and sacroiliac pain.
Start out with a trained physical therapist well-versed in pregnancy-related aches.
Exercises that are done lying flat on the back should be modified or omitted after the first trimester.
No X-rays.
Radiographs are not part of the diagnostic workup for pregnant women who have back pain.
An MRI can be performed if the doctor suspects a neurological cause severe enough to merit surgery or other invasive treatment.