The joy of preparing for a new baby is diminished for many women by persistent back pain during pregnancy, causing stress and frustration due to the lack of relief available. For this reason, it is important to know as much as possible about why you may be experiencing back pain as well as effective alternatives to taking pain-reducing drugs.

What are the symptoms?

Common symptoms can include low back pain, pelvic and pubic joint pain, leg and hip pain and pain in the ribcage, shoulder girdle, and neck. Headache and migraine, carpal tunnel, heartburn and numbness in the arms and legs are also common symptoms.

How common is back pain during pregnancy?

During pregnancy a woman’s body changes dramatically. Pregnancy is a time of constant change in preparation for the new and growing baby. Postural changes, increased weight gain and the ligaments becoming more stretched are a normal progression of pregnancy and can often be the cause of pain and discomfort in expectant mothers. Almost half of all pregnant women experience back pain during pregnancy.

What causes back pain?

There is no single cause to explain back pain during pregnancy; however, postural and hormonal changes do contribute to the problem. The most common postural changes are due to the bulk of the growing baby, the enlarging breasts and secondary weight gain. Hormones released during pregnancy, particularly oestrogen and progesterone, cause softening and relaxation of the ligaments and joints making them more prone to injury and pain.

Can it be treated?

A range of techniques suitable for the pregnant woman are used to provide comfort and pain relief, but it is essential that you find a practitioner who has a special interest and experience in prenatal and post natal care. This, along with sleeping advice, exercise recommendations and education about the best positions to adopt to support your back, provide excellent support to help you accommodate the changes your body is undergoing.

How can I prevent lower back and pelvic pain?

Posturally, it is vital to keep upright and straight. As there is added weight on the body, tasks like gardening, vacuuming and lifting need to be done gently and with caution. Making a few simple everyday changes can help to keep back pain to a minimum.

Pelvic girdle pain

Some women will find their bodies feeling less supportive and even unstable, especially in the lower back, pelvic region and the pubic symphysis joint. This condition is now more widely recognised and diagnosed, but many women still find they are left without helpful advice, support or treatment. The awareness of pelvic girdle pain (PGP) is increasing, but a wider knowledge of this diagnosis is still needed.

Common Symptoms:

Some women are unable to walk for any length of time or even go up stairs. Many find it hard to look after their homes and children. Cleaning, shopping and getting in and out of the car can also be very difficult. Symptoms include pain, stiffness, swelling or “clicking” in the sacro-iliac joints at the back, symphysis pubis joint at the front or a combination of all of the above. Sometimes the pain refers down the thighs and legs.

This can really affect the confidence and emotional well-being during a time where hormones are already flowing wildly and your life is about to change drastically. It may also be a strain for the relationship.

How does this happen?

The pelvis forms a ring structure with the sacrum and two iliac bones. They fit snugly together, aided by pelvic muscles and ligaments for support. However, with the added weight and ligamentous softening associated with pregnancy, the stability and function of the pelvis may be affected. This is further aggravated if the pelvis is out of alignment from before, such as from an injury.

Don’t forget the feet!

The function of the pelvis is hugely influenced by the alignment of the feet. Some women may present with a ‘roll in’ (pronation) or ‘roll out’ (supination) posture of the feet, which may affect the knees, hips and pelvic stability. This is most commonly diagnosed by a Podiatrist.

It is essential that you find a therapist who has a special interest and experience in prenatal and post natal care. Research from the Pelvic Partnership has found that manual therapists specialising in pelvic alignment and function during pregnancy can be very helpful.

The treatment needs to be individually tailored to make the best possible progress! The treatment needs to be gentle and adapted to each stage of the pregnancy. Muscle rehabilitation such as core stability techniques, Gym Ball, Pilates and Yoga are also very helpful; especially for long term progress.

Try to get help early to achieve stability and alignment of the back and pelvis as soon as possible. Don’t expect pain to be normal!

The goal for any pregnant woman should be to achieve:

• Good postural, spinal and pelvic alignment.
• Muscle balance and relaxation.
• Good alignment of the feet.
• Awareness of posture and exercises for birth preparation.

Top tips for pelvic girdle pain (PGP)

• Stand evenly with the weight on both feet.
• Avoid crossing the knees when sitting.
• Avoid straddling movements such as getting in or out of a bath.
• Put a plastic bag on the car seat and swing the legs in together when you sit down (don’t forget to remove it before you drive off).
• Keep the knees together when you turnover in bed.
• Use an ice pack over the joint for ten minutes/hour to reduce inflammation and pain.
• The banana shaped pregnancy pillow is excellent support for both knees and the bump in bed.
• Avoid weight bearing on one leg at a time, so sit down to get dressed.
• Brace your abdomen as a corset when you need to bend or lift, such as hoovering, shopping or using a pushchair.
• Wear supportive shoes and avoid flip-flops at all cost!

For further help and advice contact Wickford Chiropractic Clinic or look at www.pelvicpartnership.org.uk

With thanks to Tone Tellefsen Hughes at Luck’s Yard Clinic: 01483 527945.

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