Pregnancy Back Pain
How To Manage Pregnancy Back Pain
The good news is, your baby is growing, which is what should be happening, but it can still be tough on your back. You’ve got lots of company – many pregnant women experience back pain, usually starting in the second half of pregnancy.
You should know that there are things you can do to minimise your back pain.
Causes Of Back Pain In Pregnant Women
Pregnancy back pain typically happens where the pelvis meets your spine, at the sacroiliac joint or SIJ, in the lumbar spine or at the joint between the two halves of the pelvic rim known as the pubic symphysis.
There are many possible reasons why it happens. Here are some of the more likely causes:
During pregnancy, your body makes a hormone called relaxin that allows ligaments in the pelvic area to relax and thus 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, particularly if before pregnancy, you had some weakness of the muscles supporting this region.
As the uterus expands, two parallel sheets of muscles (the rectus abdominis muscles or six-pack muscles), which run from the rib cage to the pubic bone, may separate along the centre seam. This separation may worsen back pain.
During a healthy pregnancy, women typically gain weight. The spine has to support that weight. That can cause lower back pain. The weight of the growing foetus and uterus also puts pressure on the blood vessels and nerves in the pelvis and back.
Pregnancy shifts your centre of gravity. As a result, you may gradually – even without noticing – adjust your posture and the way you move. This postural change may result in back pain or strain.
Emotional stress can cause muscle tension in the back, expressing itself as back pain or back spasms. You may find that you experience an increase in back pain during stressful periods of your pregnancy.
Treatments For Back Pain In Pregnancy
There is good news! Unless you had chronic backaches before you got pregnant, your pain would likely ease gradually before giving birth.
Meanwhile, there are many things you can do to treat low back pain or make it rarer and milder:
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 the 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. Your physiotherapist is the best person to advise you if this is likely to be beneficial for you.
Your physiotherapist is an expert when it comes to assessing and managing your pregnancy-related back pain. After a thorough assessment, there is a lot that physiotherapists can do to help you with your pregnancy-related back pain. In most cases, they can help you with improving your joint position and control.
Your physiotherapist will devise a specialised program tailored to your needs and the stage of your pregnancy.
Physiotherapy treatment may include any of the following, depending on your specific needs:
- Joint Mobilisation
- Kinesio Taping
- Heat or Ice
- Joint mobility and stability exercises
- Posture education
- Pregnancy support prescription
- Yoga or pilates based exercises.
Regular general exercise strengthens muscles and boosts flexibility – which may ease the stress on your spine.
Safe exercises for most pregnant women include:
- Stationary Cycling
It is best to discuss your pre-pregnancy and current exercise regime with your physiotherapist, who can recommend the best exercises for your needs to strengthen your back and abdomen.
Some women benefit from a supportive maternity back brace specially designed for pregnant women. Ask your physiotherapist if one would be suitable for you.
More details are available here: Maternity Belt
Heat and Cold
Applying heat and cold to your back may help. Be careful not to apply heat to your abdomen during pregnancy.
Common SIJ & Buttock Pain Sources
The following conditions may cause buttock pain or SIJ issues.
- Piriformis Syndrome
- Poor Hip Core Control
- Core Stability Deficiency
- DOMS - Delayed Onset Muscle Soreness
Lateral Hip Pain
Article by John Miller
SIJ & Buttock Pain Treatment Guidelines?
While SIJ and buttock pain treatment will vary depending on your specific diagnosis, your physiotherapist will have the following aims.
PHASE I - SIJ Pain Relief & Joint Protection
While pain relievers or anti-inflammatory medications are often prescribed for acute SIJ dysfunction, they will not address the actual cause of SIJ pain. A healthcare practitioner who has a comprehensive understanding of the biomechanics and muscular control of your SIJ, pelvis and hip complex should thoroughly assess chronic cases of SIJ dysfunction. Managing your sacroiliac pain is the main reason that most people seek treatment for sacroiliac joint dysfunction. In truth, it was the final symptom that you developed and should be the first symptom to improve in most cases. If this is the case, the prevention of a recurrence becomes your priority.
You can often achieve natural short-term pain relief using ice or heat packs applied to your SIJ's.
You are managing your inflammation. Sacroiliac joint inflammation is best eased via ice therapy and techniques or exercises that unload the inflammed structures. Your doctor may recommend a course of non-steroidal anti-inflammatory drugs such as ibuprofen. Some seronegative arthritis conditions can predispose you to sacroiliitis. Your doctor can arrange special blood tests to assist in diagnosis in these conditions. Prolonged morning stiffness is a common complaint. See Ankylosing Spondylitis.
SIJ Protection & Support
Sacroiliac joint instability occasionally requires additional passive support until your muscles successfully control the joint. Supportive taping is often beneficial during the initial pain reduction phase.
SIJ Stability Belt
You may manage longer-term instability with a sacroiliac joint stabilisation belt. However, an exercise protocol to specifically address your SIJ issue usually is more effective.
If you have any questions, please seek the advice of your SIJ physiotherapist.
PHASE II - Restoring Normal ROM and Strength. Early Hip Core Exercises.
As your SIJ pain and inflammation settle, your physiotherapist will turn their attention to restoring your normal pelvic joint alignment and normalising the dynamic muscle control that affects the SI Joints.
Your physiotherapist may commence you on a lower abdominal core stability program to facilitate your important muscles that dynamically control and stabilise your lower back and pelvis. They will also implement a similar activation and strength program that addresses your deep gluteal muscles. These muscles are sometimes referred to as your hip core muscles. Your physiotherapist will assess your muscle recruitment pattern and prescribe the best exercises for your specific needs.
PHASE III - Restoring Full Function
Your physiotherapist will turn their attention to restoring your normal pelvic alignment and maintaining sacroiliac joint range of motion during more functionally stressful positions. They will also work on your muscle power, proprioception, balance and gait (walking pattern). Depending on your chosen sport or activities of daily living, your physiotherapist will aim to restore your SIJ function to allow you to return to your desired activities safely.
Everyone has different demands for their sacroiliac joints that determine what specific treatment goals you need to achieve. For some, it is simply to walk around the block. Others may wish to run a marathon. Your physiotherapist will tailor your sacroiliac joint rehabilitation to help you achieve your own functional goals.
PHASE IV - Preventing a Recurrence
Sacroiliac joint dysfunction does tend to return if a thorough muscle control program is not undertaken. The main reason it is thought to be chronic and specific muscle weakness. Your physiotherapist will assist you in identifying the best exercises for you to continue indefinitely or periodically.
In addition to your muscle control, your physiotherapist will assess your SIJ, spine, hip and lower limb biomechanics and correct any deficits that may predispose you to SIJ pain and dysfunction. Fine-tuning and maintenance of your sacroiliac joint stability and function are best achieved by addressing deficiencies and learning self-management techniques. Your SIJ physiotherapist will guide you.
More information: SIJ Pain & Dysfunction
Common Causes of Hip & Groin Pain
Hip Joint Pain
- Hip Arthritis - Hip Osteoarthritis
- Hip Labral Tear
- Hip Pointer
- Femoroacetabular Impingement - FAI
- Perthes Disease
- Slipped Femoral Capital Epiphysis
- Stress Fracture
- Avascular Necrosis of the Femoral Head
Lateral Hip Pain
Adductor-Related Groin Pain
Pubic-Related Groin Pain
Inguinal-Related Groin Pain
- Inguinal hernia
- Sportsman's hernia
Iliopsoas-Related Groin Pain
- Hip Flexor Strain
Other Muscle-Related Pain
- Piriformis Syndrome
- Muscle Pain -Muscle Strain
- Poor Hip Core
- DOMS -Delayed Onset Muscle Soreness
- Core Stability Deficiency
Common Sources of Spinal Pain & Injury
- Neck Pain - Cervical Spine
- Upper Back Pain - Thoracic Spine
- Lower Back Pain - Lumbar Spine
- Sacroiliac Pain - SIJ
- Scheuermann’s Disease
- Spinal Stenosis
- Rib Stress Fracture
Nerve-related / Referred Pain
What is Physiotherapy Treatment?
Physiotherapists help people affected by illness, injury or disability through exercise, manual joint therapy, soft tissue techniques, education and advice. Physiotherapists maintain physical health, allow patients to manage pain and prevent disease for people of all ages. Physiotherapists help encourage pain relief, injury recovery, enabling people to stay playing a sport, working or performing daily living activities while assisting them to remain functionally independent.
There is a multitude of different physiotherapy treatment approaches.
Acute & Sub-Acute Injury Management
Hands-On Physiotherapy Techniques
Your physiotherapist's training includes hands-on physiotherapy techniques such as:
- Joint Mobilisation (gentle joint gliding techniques)
- Joint Manipulation
- Physiotherapy Instrument Mobilisation (PIM)
- Minimal Energy Techniques (METs)
- Soft Tissue Techniques
Your physiotherapist has skilled training. Physiotherapy techniques have expanded over the past few decades. They have researched, upskilled and educated themselves in a spectrum of allied health skills. These skills include techniques shared with other healthcare practitioners. Professions include exercise physiologists, remedial massage therapists, osteopaths, acupuncturists, kinesiologists, chiropractors and occupational therapists, to name a few.
Your physiotherapist is a highly skilled professional who utilises strapping and taping techniques to prevent and assist injuries or pain relief and function.
Alternatively, your physiotherapist may recommend a supportive brace.
Acupuncture and Dry Needling
Many physiotherapists have acquired additional training in acupuncture and dry needling to assist pain relief and muscle function.
Physiotherapists have been trained in the use of exercise therapy to strengthen your muscles and improve your function. Physiotherapy