By Gabriel Shannon
Is this a normal part of pregnancy and do you have to put up with it? Why do different professionals say different things? This article seeks to explain the common causes and symptoms of back (and pelvic) pain in pregnancy and to dispel the myths surrounding their treatment.
What causes back pain in pregnancy?
The main cause is hormones. The same hormones that allow the pelvic joints to relax in preparation for childbirth are behind the feeling of pain, aching or pinching in the lower back and hips. As the ligaments of sacroiliac (SI) joints “give”, the lower back and pelvis become less stable. Movements that rely on their stability become more difficult and, after standing, sitting, walking or even getting out of bed, the back feels stiff.
To some extent this is normal. That doesn’t mean that measures cannot be taken to reduce discomfort or to prevent the condition worsening or turning into a sacroiliac dysfunction or its cousin, symphysis pubis dysfunction (SPD).
So what works? What can be done to prevent or manage back pain? Or what if you have already started to feel intense lower back or pain in the pubic bone area?
If pain is mild, usually a rest from long walks or other forms of intense exercise for a short period will give your body a chance to regain balance in the SI joints as your body adapts to your hormones. Then you can gently re-introduce movement, paying attention to symmetry as you move, particularly from lying to sitting and sitting to standing.
If you have acute pain in either the lower back (it might be just one side) or in the symphysis pubis, it is likely that the instability of the pelvis has led to much greater asymmetry and one side of the muscles (adductor, glutes, or pelvic floor) is working harder than the other. This can lead to a vicious cycle whereby these muscles are pulling the pelvis out of symmetry. Rest from asymmetrical movements, e.g. vacuuming, lifting, walking stairs, and even exercise like walking and swimming as these will be temporarily exacerbating the problem.
You should never be told that your condition is “a normal part of pregnancy” or that there is nothing you can do to help alleviate your pain.
You may want to consider seeing either an osteopath or a chiropractor to help bring the pelvis back into alignment. Waiting to see a physiotherapist via a referral from your midwife or obstetrician can take time, but sometimes a physio who is trained in treating pregnancy SI dysfunction or SPD will provide exercises and manual muscle release which helps. You should never be told that your condition is “a normal part of pregnancy” or that there is nothing you can do to help alleviate your pain.
The reason different professionals offer different advice is because they have a different understanding of the causes and remedies. In the last 20 years of practice, including my own four pregnancies, the unequivocal control and resolution of the condition I have seen in hundreds of pregnant mums is based on following the principles of gentle symmetry-rebalancing movements such as yoga therapy or osteopathy.