Back Pain During Pregnancy: Causes, Diagnosis And Treatment

Back pain is one of the most common problems during pregnancy. According to the American Pregnancy Association, 50 to 70% of women experience back pain during pregnancy (1). It mostly manifests during the third trimester or after 28 weeks of pregnancy. For some, it may also start at around the 12th week of pregnancy (2) (3). Back pain can be treated with simple exercises and treatments. However, prolonged and severe back pain can indicate an underlying condition.

In this post, we will learn about the causes, symptoms, types, management, and treatment of back pain in pregnancy.

Why Do You Get Back Pain In Pregnancy?

Pregnant women can experience back pain due to different reasons. However, women who are overweight or have a history of back pain may be at a higher risk. Some common causes of back pain during pregnancy include (4) (1):

1. Hormonal changes: During pregnancy, the body releases hormone called relaxin. This protein hormone causes the pelvic area ligaments to loosen and relax in preparation for delivery. The loosening of the joints in the pelvic area, in turn, can affect your back and lead to pain.

2. Weight of the baby: As your pregnancy progresses and the baby grows, it can lead to different changes in the body.

• The weight of the baby inside your growing belly will eventually shift the body’s center of gravity to the front leading to stretching of the abdominal muscles, thus putting a strain on your back muscles.

• The additional weight can cause the spine to get curved and result in a change of posture. Your attempt to stand or walk upright against the added strain on the spine can induce back pain. An incorrect posture can also result in backache.

• Maintaining balance while doing household chores, walking or any other activity with the additional weight of the growing uterus constantly pulling you downwards can cause you to feel a strain on your back.

3. Stress: The growing tension in your abdominal muscles due to increased hormone levels and the weight of the baby together puts a lot of stress on the back and can cause spasms or pain. This may be heightened during the stages of pregnancy, where the weight of the baby increases.

4. Excess or lack of physical activity: Pregnancy may cause you to feel fatigued and exhausted most of the time. But if you spend too much time sitting around without exercise or any physical activity, it may increase the risks for back pain. On the other hand, too many workouts or moving around can also lead to backaches (5).

What Are The Types Of Back Pain In Pregnancy?

Pregnant women may experience back pain in different parts. The various types of back pain include:

• Pelvic pain: This is the most common type of back pain most women experience during pregnancy. Also known as Symphysis Pubis Dysfunction (SPD) or pelvic girdle pain (PGP), it occurs due to instability or rigidity of the joints in the pelvic area during pregnancy.
  Pelvic pain can be felt around the waist or in one or both of the buttocks. At times, the pain can be felt through the hips to the back of the thighs (6) (4).

• Sciatica: The longest nerve in the body, the sciatic nerve, stems from the lower region of the spinal cord, through the buttocks to the legs. Your growing uterus exerts pressure on the nerve leading to inflammation and pain. This can be felt as sharp shooting pain in the lower back, the buttocks, and throughout the legs (7).

• Lumbar pain: The pain radiates from the lumbar vertebrae (concave lower region of the spine) and is felt at the center of the lower back, in the lumbar region, and can shift towards the legs (4).

• Thoracic pain: Upper back pain occurs in the thoracic vertebrae (convex upper part of the spine). Hence, it is also referred to as thoracic pain and commonly occurs in the third trimester.

How Is Back Pain Diagnosed During Pregnancy?

Upon manifestation of back pain, your healthcare provider may carry out a physical examination and a review of your medical history. They may also perform an MRI scan to check for signs of a possible slipped disc causing the pain. Radiation imaging modalities, such as X-rays or CT scans, are not suggested during pregnancy to avoid adverse effects (3).

How To Manage Back Pain During Pregnancy?

Some simple remedies and treatments that help relieve back pain during pregnancy include (8) (4):

• Hot and cold compresses: You can first start with a cold compress applying an ice pack around the affected area for about two to three days. After that, use a hot compress such as heating pads or a hot water bottle wrapped inside a towel to avoid burns. These can gradually ease and reduce the pain.

• Warm bath: Draw a warm bath and sit in the tub for some time. This acts as a warm compress that can ease the pain. You may also take a warm shower to cope with the pain.

• Exercise: Try incorporating some pregnancy-friendly exercises, such as swimming, brisk walking, and cycling, into your daily routine. This increases the flexibility and strength of the muscles. Prenatal yoga involving rhythmic breathing and stretching can also help relieve the pain.

• Massage: Pamper yourself by scheduling a massage with a trained pregnancy massage therapist. Osteopathy is a massage technique that targets the affected area of the back and relieves pain by stretching and massaging the area. You can try this after consulting your healthcare provider.

• Correct posture: Maintain a correct posture while standing or sitting. You can use a supportive belt around your waist to help with the strain on your lower back or use a pillow while sitting. It is recommended to sleep on your side during back pain with a pillow placed under the knees. This can eventually reduce the pain.

• Lift with the correct technique: Avoid bending when lifting any light object. Instead, gently squat and lift the object while keeping your back straight. If the object is heavy or you are finding it difficult to squat, take the help of someone.

• Wear the right footwear: Avoid wearing shoes and sandals with high heels. Choose footwear with flat or low-heeled soles. High heels tend to shift your body’s weight, affecting balance and straining back muscles.

• Medication: Certain medications for pain relief and inflammation may be prescribed. One such medicine is acetaminophen, which is considered to be pregnancy-safe. Your healthcare provider may prescribe other medications for muscle relaxation and pain.

Note: Do not go for over-the-counter (OTC) medications during pregnancy since some of them may harm you and your baby.

When To Seek Treatment?

Although back pain during pregnancy is normal, certain signs call for immediate medical attention. These include (1):

• Unable to distinguish between labor pain and back pain. If the pain persists for more than two weeks, it may indicate preterm labor.

• Numbness in the groin area, the feet or the pelvic region.

• If the pain is accompanied by vaginal bleeding, burning sensation while peeing, or fever, it can be a urinary tract infection (UTI).

• Acute and persistent pain may result from pregnancy-related osteoporosis, septic arthritis, and vertebral osteoarthritis.

References

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