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Pregnancy and Back Pain

Posted by Sarah on February 3, 2018

 Back Pain and Pregnancy

By Dr. Andrew Kirschner, D.O.

Pregnancy brings with it a whole host of changes to a woman's body, and the process is associated with all kinds of common complaints: fatigue, weight gain, increased frequency of urination, nausea and others. Perhaps the most widespread and problematic problem faced by women during pregnancy is the onset of back pain- experienced even by women who never had back issues before their pregnancy. Depending on whose statistics you go by, as much as 70% of women will experience back pain over the course of their pregnancy.

The primary underlying cause of back pain during pregnancy is obvious; women experience a more rapid weight gain during this 9-month physiological extravaganza than during any other time in their lives. Furthermore, this weight is carried in a location where it causes more structural issues than if it were distributed virtually anywhere else on a woman's body.

There is a secondary, less obvious cause of back pain during pregnancy. You see, during delivery, a woman has to push a baby through a space which is physically smaller than the baby itself. In anticipation of this process, a woman's body produces a hormone known as 'relaxin'. This innocuous sounding hormone loosens the ligaments in the pelvic girdle- a process which by itself would be sufficient to destabilize the lower back. Unfortunately, its activity doesn't stop there. It is indiscriminate, in how it works and loosens all of the ligaments and connective tissue of the lower spine as well. The result is a destabilized back that feels pain.

So, does this mean pain is an inevitability during pregnancy? Well, again from a statistical point of view, it is not. As I said earlier, about 70% of women will have pain. But what separates the other 30% of women from the pack? Is there anything you can do to avoid this uncomfortable side effect of pregnancy.

Here is what I can tell you based on my clinical experience. There seem to be several factors which play a role in whether a woman is likely to experience back pain during pregnancy, and you may be able to use these to your advantage.

Women who routinely exercised prior to becoming pregnant seem to be less prone to back pain. In my clinical experience, it doesn't matter if the woman in question is lighter or heavier prior to pregnancy- simply whether they exercise or not was a reasonably accurate predictor of back pain.

Women who exercise regularly have better muscle tone, so the destabilizing effects of relaxin have a less detrimental effect.

Women who prioritize quality sleep tend to have less back pain during pregnancy. The reason for this is fairly obvious: well-rested individuals have better energy reserves, and the muscles supporting their spine are less prone to fatigue.

Women who consume well-rounded diets tend to have less back pain during pregnancy. This is again, likely due to having greater energy stores associated with good nutrition. Furthermore, there is some evidence that well-rounded diets are less inflammatory- and inflammation can worsen back pain. 

Women who take time to participate in relaxing activities such as meditation or yoga seem to have less incidence of back pain. The reasons for this should be self-evident.

As I said earlier, pregnancy-related back pain is very common- but understanding its origin, and taking simple steps to help prevent it can often result in a pain-free pregnancy. As for the delivery....well, there you're on your own......