Pregnancy and low back pain

Causes of back pain during pregnancy The release of a hormone called relaxin causes an increase in the mobility of joints, this hormone assists during delivery to relax the joints for the birth, but has an effect from conception. The weight gain during pregnancy has an effect on the spine. Due to the centre of gravity moving forwards as the abdomen enlarges, there is a tendency to increase the lumbar spine curve, an adaptation made to accommodate this change. This in turn puts additional stress on the back muscles and ligaments. Fatigue during pregnancy can often lead to poor posture, this can also increase low back pain.
Prevention of back pain during pregnancy
Standing – Good posture can reduce back pain. Standing up straight and feeling that the baby is tucked into the pelvis decreases the strain on the lower back and improves the spinal posture. You should also avoid transferring weight onto one leg for long periods of time. Sitting – In sitting make sure that your back is well supported, a small cushion or rolled up towel in the lower back may assist in maintaining the lumbar curve and avoid putting stress on the back muscles and ligaments. Sleeping – Sleeping positions change during pregnancy due to the change in body shape. Some women find it comfortable to lie on the side with a pillow under the bump and a second under the top knee. Lying flat on the back should be avoided. Getting out of bed should be done by rolling onto one side then pushing up through the arms into sitting over the side of the bed, the reverse to lie down, this avoids abdominal strain.

• Housework
• Low down activities such as making the bed and cleaning the bath should be performed in kneeling position.

• Working at kitchen surfaces it may be more comfortable to stand with one foot slightly forward and possibly supported on a small stool (a phone book can be as effective).

• Lifting – heavy lifting should be avoided.
• General lifting advice;
• Never lean forward from the waist to lift, always bend your knees
• Your feet should be apart to give you a wider, stable base
• Hold the object you want to lift close to you, not at arms length as this can cause additional strain on your spine

• Lifting from the floor;
• Ensure the item you wish to move is light enough for you to lift comfortably
• It may be advisable to lift in stages, i.e. floor to chair then chair to upright

• Lifting from a height;
• Make sure that the object to be moved is easy to reach
• Hold the object close to you
• As the pregnancy progresses it is not advisable to stand on stools or step ladders as your balance can be affected by the body changes occurring in pregnancy

After any activities in which you have spent a period of time leaning forward it is important to stretch in the opposite direction by putting your hands into your low back and gently extending over them.

Back pain is common during pregnancy, however the advice above can help to prevent this from being aggravated. If the pain is persistent or more severe you may benefit from seeking advice from a Chartered Physiotherapist as there are exercises and supports that can be used for back pain, hip pain and pelvic pain during pregnancy.

Disclaimer: This is general advice only. If you are experiencing back pain or other issues you should contact your doctor. Remember to keep your midwife informed of any problems you may be experiencing and any treatment you are receiving. It is always important to ensure that you are being treated by an appropriately trained and registered health care professional and during pregnancy this is even more imperative to ensure the safety of you and your child.