Low back pain during pregnancy can be very distressing and should not be ignored as a normal part of pregnancy. Approximately 50-80% of pregnant women report low back pain at some stage during their pregnancy. However, only about 50% of women seek treatment for their pain, possibly because they are not aware of the treatment options available. This results in a significant number of pregnant women suffering pain needlessly.
What Causes Low Back Pain During Pregnancy?
Back pain during pregnancy can affect the lower lumbar and pelvic girdle region. This can be caused by a combination of factors including:
Postural changes due to the developing fetus
New or re-occurring injuries – e.g. from stepping off a kerb, a fall, lifting your baby in and out of the car.
Changes in circulation and body fluids
It is normal to gain between 10-20 kg’s whilst pregnant, which can put an enormous strain on the pelvis and lumbar spine. This weight gain shifts the centre of gravity forward and increases the curvature of the lumbar spine. This can also cause loading of the discs in your spine causing more stresses and strain on the spine. The abdominal muscles responsible for core strength are also stretched and may lose their strength and flexibility, reducing the support they normally provide to the lumbar spine.
New Injuries or Re-occurring Injuries
Pregnant women can also hurt their back in a similar way to a non-pregnant woman. This can be caused for example; by stepping off a kerb, lifting something, or a fall or slip. An old low back or pelvic injury can also re-occur due to added stress on the body. So an accurate diagnosis of your back pain or pelvic pain is always required.
Hormonal changes may also be a contributing factor to low back pain. Relaxin is a hormone released during pregnancy and may cause ligaments and the sacroiliac joints in the pelvis to become lax, offering less support to the overall spine.
Changes in circulation and fluid retention may also be a contributing factor to back pain, especially when the pain is worse at night and can wake the patient up. When lying down the growing fetus can push on the vena cava, and combined with fluid retention can cause venous congestion in the lumbar and pelvic area, causing pain.
Psychological stress during pregnancy can also have its part to play in low back pain. Stress responses can be caused by issues in the home, workplace, or simply by patients catastrophising their back pain event, whether real or perceived, leading to more pain and inflammation. Some patients also receive poor information regarding their back pain, the treatment options available, and future prognosis, which can add significantly to their stress levels, and hence impede their recovery.
How is Low Back Pain Diagnosed During Pregnancy?
It is essential for pregnant patients to get an accurate diagnosis of their low back pain whilst pregnant. This will then inform the treatment process. A full case history and hands-on examination of their spine will always be required. A diagnosis from a healthcare provider over the phone is not acceptable, and can only result in an inaccurate diagnosis and untold stress for the patient.
If a detailed clinical examination cannot shed light on the cause of the back pain, or conservative treatment is failing, an MRI may be required. X-ray is not recommended as the fetus may absorb moderate to high levels of radiation.
What Treatments Are Available For Back Pain?
Only 50% of pregnant women seek treatment for their back pain, resulting in many women suffering from back pain needlessly, and relying on bed rest, crutches or wheelchairs to get around.
Treatment options generally include:
Physical therapy such as osteopathy, chiropractic or physiotherapy
Pain relief medication – prescribed by GP’s
Pelvic stabilisation belts.
Osteopathic Treatment of Low Back Pain During Pregnancy
Osteopathic treatment is a safe, gentle and drug-free approach used to help ease aches and pains in pregnant women and address issues of low back pain and pelvic girdle pain.
Osteopaths take a holistic approach, beginning with a detailed medical history and a thorough examination of the spine. Once a diagnosis has been confirmed, a treatment plan will be devised and tailored to the patient’s specific needs.
Osteopathic treatment consists of a range of hands-on manual techniques, which may include soft tissue stretching, spinal manipulation, resisted ‘muscle energy’ stretches and exercise prescription. Osteopaths always look to address the underlying cause of the pain, and as such, often treat areas remote from the symptomatic area.
At Better Health Osteopathy, we treat pregnant women on a daily basis and find that osteopathic treatment can result in significant improvements in patients’ low back and pelvic girdle pain. We always try to avoid the use of crutches and wheelchairs as this could possibly impact on the overall health of the patient.
Osteopathic treatment also aims to avoid the use of medications for pain relief. However, on occasion, some pregnant patients may need some pain relief assistance, but patients should always consult their healthcare provider/ GP before taking any medication.
How Long Will The Back Pain Last?
Back pain is unique to each individual patient. No two patients will suffer or recover from an injury in the exact same manner. This is why an accurate diagnosis is very important so that a treatment plan can be devised, and a prognosis given for each individual patient. In our experience, at Better Health Osteopathy, most women recover pretty well after a few osteopathic treatments, however, this depends on the exact injury. I personally love treating pregnant women and helping to resolve their issues, by hands-on osteopathic treatment, exercise prescription and postural advice.
What Should Women Do Post-Delivery?
I highly recommend that all women get a thorough spinal check-up post-delivery to address any underlying spinal issues if present. Osteopathic treatment at this stage aims to support spinal functioning through the breastfeeding months, and to encourage pelvic floor and core strength development after delivery, and to ease any aches and pains present.
If you have any queries or comments regarding the above, feel free to comment below, or call your local Christchurch Osteopath (Lorraine Herity) and discuss your condition. We would love to hear from you!
Lorraine Herity is the Clinic Director of Better Health Osteopathy in Christchurch, New Zealand. She previously worked in Osteopathic clinics in London and Ireland, before moving to New Zealand. Lorraine trained at the British School of Osteopathy in London, where she gained her Master of Osteopathy (M.Ost). Lorraine is a dedicated and passionate Osteopath. Her main aim is to help her patients regain their health, and to return her patients back to their everyday activities, in as quick a time as possible.