Article # 100. Back Pain During Pregnancy

Back Pain in Pregnancy

The good news is, your baby is growing. That's exactly what should be happening -- but it can still be tough on your back.

You've got lots of company -- most pregnant women experience back pain, usually starting in the second half of pregnancy.

You should know that there are things you can do to minimize your back pain. Here's what helps.

Causes of Back Pain in Pregnant Women

Pregnancy back pain typically happens where the pelvis meets your spine, at the sacroiliac joint.

There are many possible reasons why it happens. Here are some of the more likely causes:

• Weight gain. During a healthy pregnancy, women typically gain between 25 and 35 pounds. The spine has to support that weight. That can cause lower back pain. The weight of the growing  baby  and uterus also puts pressure on the blood vessels and nerves in the pelvis and back.

• Posture changes.  Pregnancy shifts your center of gravity. As a result, you may gradually -- even without noticing -- begin to adjust your posture and the way you move. This may result in back pain or strain.

• Hormone changes. During pregnancy, your body makes a hormone called relaxin that allows ligaments in the pelvic area to relax and the joints to become looser in preparation for the birth process. The same hormone can cause ligaments that support the spine to loosen, leading to instability and pain.

• Muscle separation. As the uterus expands, two parallel sheets of muscles (the rectal abdominis muscles), which run from the rib cage to the pubic bone, may separate along the center seam. This separation may worsen back pain.

Treatments for Back Pain in Pregnancy

More good news: Unless you had chronic backaches before you got pregnant, your pain will likely ease gradually before you give birth.

Meanwhile, there are many things you can do to treat low back pain or make it rarer and milder:

• Exercise.  Regular exercise strengthens muscles and boosts flexibility. That can ease the stress on your spine. Safe exercises for most pregnant women include walking,  swimming , and stationary cycling. Your doctor or physical therapist can recommend exercises to strengthen your back and abdomen.

• Heat and Cold. Applying heat and cold to your back may help. If your health care provider agrees, start by putting cold compresses (such as a bag of ice or frozen vegetables wrapped in a towel) on the painful area for up to 20 minutes several times a day. After two or three days, switch to heat -- put a heating pad or hot water bottle on the painful area. Be careful not to apply heat to your abdomen during pregnancy.

• Improve your posture.  Slouching strains your spine. So using proper posture when working, sitting, or sleeping is a good move. For example, sleeping on your side with a pillow between the knees will take stress off your back. When sitting at a desk, place a rolled-up towel behind your back for support; rest your feet on a stack of books or stool and sit up straight, with your shoulders back.  Wearing a support belt may also help.

• Counselling.  If back pain is related to stress, talking to a trusted friend or counselor may be helpful.

• Acupuncture.  Acupuncture is a form of Chinese medicine in which thin needles are inserted into your skin at certain locations. Studies have shown that acupuncture can be effective in relieving low back pain during pregnancy. Check with your health care provider if you're interested in trying it.

• Chiropractic.  When performed correctly, chiropractic manipulation of the spine can be safe during pregnancy, but consult with your doctor before seeking chiropractic care.

Here are some ways to help ease your back pain:

·         Try not to lift anything that weighs more than a few pounds. If you have to pick up something heavy (or a small someone), make sure to lift correctly. Don't bend down at the waist; instead, bend at your knees, squat down, and lift with your legs, not your back.

·         Don't sit or stand for long periods. If you can't get around it, use a box or stool to prop up one foot when standing or both feet when sitting. If you must stand for a long time, make sure to take frequent breaks.

·         Sit in ergonomic chairs with supportive backs or put a small pillow at the small of your back. And try to sit up straight.

·         Stand up straight. Resist the urge to push your belly far forward.

·         Apply a warm towel, warm water bottle, or heating pad on the lowest setting.

·         Wear an abdominal support garment or maternity pants with wide elastic bands that fit under the belly.

·         Don't wear high heels. Shoes with low heels and good arch support are the way to go.

·         Get a firm mattress or put a board between your mattress and box spring.

·         Sleep on your side, with at least one knee bent. Try using a pregnancy pillow to make sleeping more comfortable. Or put a pillow between your knees and another under your belly.

·         Ask your doctor about recommended stretching exercises and if any low-impact exercises are safe for you — regular exercise can help with back pain.

Get a gentle pregnancy massage if your doctor says it's OK.

Don't take any medications without checking with your doctor first.