Pregnancy & Lower Back Pain

Lower back pain is a very common complaint that a lot of pregnant ladies struggle with. A question I get asked a lot is why and how can I stop it? Unfortunately, you cannot eliminate it completely but don’t worry, there are things you can do that help you with your discomfort.

Whilst pregnant the reproductive organs alongside the neuroendocrine axis release different

types of hormones that help prepare the woman for birth and maintain pregnancy. One of these hormones is called relaxin. Relaxin is secreted from the ovaries and the placenta (the sac in which the fetus grows). Its role is to loosen the connective tissue within the pelvis, making the pelvic ligaments more pliable with the aim of making delivery a little easier.

Now, add a growing fetus onto the ligamentous laxity, and ouch! As the fetus develops and

grows, your center of gravity changes, and your structural support systems aren’t quite what they used to be due to the relaxin, so injuries can occur.

Common injuries linked with pregnancy and lower back pain:

1. Sacro-iliac torsion - your sacrum (located at the bottom of your spine) connects with two bones, one either side known as the ilia (ilium singular); these make up your pelvis. With correct glute activation, inner core support, and the structural integrity of your sacral (pelvic) ligaments, this joint should move in harmony with the rest of your spine. When the ligaments experience a ‘loosening’ or the muscles surrounding the joint become lax one ilium can move into a fixed position causing a torsion in the pelvis. This will cause pain on movements such as bending, getting in and out of a car, twisting to one side or even climbing stairs.

2. Facet joint irritation - In all of your vertebrae you have facet joints, these are two small

joints (one on each side) on your vertebrae that connect one another, making the

vertebral column. These are very prone to irritation, even when there is no pregnancy!

They become irritated when excessive force or a quick unexpected movement is posed

on them - this includes a growing fetus placing pressure on the front of your spine.

The joint then either strains its capsule by resisting the excess force, pulls a

muscle or ligament that is very deep in the spine with close proximity, and finally can

pinch on itself. The inflammatory response of this irritated facet joint can cause multiple

presentations; a sharp pain that causes altered sensations in your limbs such as pins

and needles, numbness, or an electric shock feeling. On the other hand, it can present as

a dull nagging pain that you just can’t shift. Movements that you may experience pain on

are bending backward or twisting to the side, fast movements, coming up from bending

forwards, or rolling in bed at night.

Now don’t worry if you don’t quite understand the mechanism of injury, just know you are not

alone! So I have made a list of a few things you can do or should avoid doing to help you with

your discomfort.

What can you do to avoid lower back pain during pregnancy?

- Avoid straining on the toilet - now during the second trimester, women experience

constipation. Now this is all thanks to those hormones, progesterone this time. As you

push/strain, you place an increased amount of pressure on your lower back and you

increase the risk of injuring a disc along with other elements of the spine. So addressing

your constipation with a healthcare provider is essential, remember they’ve always seen

worse so please don’t feel embarrassed.

- Pregnancy pillows - now I love a pregnancy pillow. If you imagine all your muscles are

like a spring, once you have stretched that spring it never quite returns to that same firm

spring, and this too happens to your muscles! So as you’re sleeping or sitting in a

position you may find comfortable, you won’t notice its effect until you move. So placing

a pillow under the leg that you like to lift during your sleep, definitely one underneath

your bump, and even when you are sitting down, placing one across your mid back is

going to reduce the pulling effect on the muscles.

- Pelvic floors - hopefully you have already started your pelvic floors by now, if not please

do! Every female over the age of 18 should be doing pelvic floors, regardless of being

pregnant or not. Your pelvic floor muscles are shaped like an upside-down umbrella in

your pelvis. As you strain, laugh, cough, and sneeze - they have to hold all the contents in

your stomach up (slightly exaggerated, but you get the picture). In addition, your pelvic

floor muscles along with your diaphragm, are a key factor in core strength to protect your

lower back, so by strengthening these muscles you are more likely to increase the

support you offer to your lower spine.

I hope you have found this blog useful, if you have any questions then please do send us an

email! And I hope to see you all next week for another post on Women’s Health Wednesday.