Low Back Pain during Pregnancy

What is low back pain?

Low back pain is pain and stiffness in the lower back. It is very common during pregnancy. It can interfere with your normal daily activities.

How does it occur?

Low back pain is usually caused when the ligaments or muscles supporting the vertebrae (spine) are strained. When these muscles or ligaments become weak, the spine losses its stability and back pain develops. These muscles and ligaments may become weak and loose because of the hormone Relaxin. Relaxin is a hormone made by the pregnancy to help the body prepare for the pregnancy and the delivery of the baby.

Low back pain can have many causes. For example, it may occur from lifting and carrying heavy objects, from sitting or standing in one position, or from bending over the wrong way. During pregnancy back pain often occurs because of:

• a change in the body's center of gravity as the baby and your abdomen get bigger
• poor posture
• a loosening of the muscles and ligaments during pregnancy before you are ready to deliver the baby
• the pressure that the growing baby puts on blood vessels and nerves in the pelvis and back

Often, back pain during pregnancy is the result of poor posture. When you are pregnant, you may tend to throw your stomach forward, which can cause back muscle aches.

What are the symptoms?

Symptoms include:

• pain
• stiffness
• weakness
• limited motion of the back or legs

The pain may be continuous or it may occur just in certain positions. You may have it only in one spot or it may spread to other areas, such as down the buttocks and thigh.

How is it diagnosed?

Your healthcare provider will review your medical history and examine you. He or she may order X-rays. In some cases an MRI (magnetic resonance imaging) may be done to get a better look at your back. Your provider may suggest these or other tests to evaluate your back more completely after you have had your baby.

X-rays and CT scans should not be done in the first trimester of pregnancy unless absolutely necessary. X-rays and CT scans use radiation which can affect the baby (embryo). An MRI is safe to do during pregnancy because it does not give off radiation.

How is it treated?

These are ways you might treat low back pain:

• Put a heating pad or hot water bottle on your back.
• Rest in bed on a firm mattress.
• Take pain medicines or muscle relaxants that are safe during pregnancy and recommended by your healthcare provider.
• Have your back massaged by a trained person.
• Wear a belt or corset to support your back.
• Talk to a counselor if your back pain is related to tension caused by emotional problems.
• Follow a program of physical therapy or exercise recommended by your healthcare provider. Your provider will recommend a program that is safe and easy for you to do while you are pregnant.
• Some alternative treatments include acupuncture and hypnosis.

Back pain that gets worse despite treatment indicates a more severe problem and should be evaluated.

How can I take care of myself?

In addition to the treatment described above, keep in mind these suggestions:

• Put a pillow under your knees and abdomen when you are lying on your left side.
• Sleep without a pillow under your head.
• Sleep on a firm mattress or put a plywood board between your mattress and box spring.
• Gain only as much weight during your pregnancy as recommended by your healthcare provider.
• Wear low-heeled shoes while you are pregnant.
• Do not stand for long periods of time. If you must stand for long periods of time put one foot up on a box or stool. Change to the other foot resting on the stool frequently.
• When you lift something, bend from your knees, not your waist.
• Exercise during pregnancy to strengthen your muscles and joints.

How can help prevent low back pain?

You can reduce the strain on your back by doing the following:

• Practice good posture. Stand with your head up, shoulders back and straight, chest forward, pelvis tucked in, and stomach pulled in.
• Don't push with your arms when you move heavy objects. Push backwards so the strain is taken by your legs.
• Whenever you sit, sit in a straight-backed chair and hold your spine against the back of the chair.
• Bend your knees and hips and keep your back straight when you lift a heavy object. Avoid lifting heavy objects higher than your waist.
• Hold packages you carry close to your body, with your arms bent.
• Bend your knees and squat when you bend over.
• Sit at least 10 inches away from the steering wheel when you drive and use your seat belt and a hard backrest or pillow.
• Lie on your left side with your knees bent when you sleep or rest.

Written by Tony Angello, MD.
Published by RelayHealth.
© 2009 RelayHealth and/or its affiliates. All Rights Reserved.