Backpain in Pregnancy

Written by Dr.M.D.Mazumdar, MD

Back pain occurs in almost all pregnant women to a greater or lesser extent, especially in the later stages of pregnancy. It can occur for the first time in pregnancy, or, it can be an exacerbation of a chronic backpain.

Whatever the cause, back pain can make the pregnant woman's life miserable.

Backpain occurs more commonly while getting up from bed in the morning or while standing up from a sitting position after a period of relative immobility.

The pain is commonly centered in the curve of the lower back and can radiate from this site down to the hips and the legs or along the sides to the abdomen.

Sometimes, the pain may be severe enough to cause pain in the shoulders and the neck.

Causes of Backpain in Pregnancy

A hormone called 'Relaxin' is released during pregnancy to relax the ligaments and joints of the pelvis so that it can accommodate the growing uterus.

But this also means that the lax joints are prone to suffer from minor stresses, even from daily activities like walking and sitting. So unless the joints are kept supple with regular exercise, any movement can cause pain.

As pregnancy progresses, the enlarging uterus tends to protrude in front of the body. This upsets the centre of gravity of the body. To compensate for this shift in the centre of gravity and to keep herself from falling forwards, the pregnant woman leans her shoulders and back backwards. The resultant increase in the the curvature of her back strains the muscles and ligaments, causing pain. It also causes the woman in the later stages of pregnancy to adopt the characteristic 'waddling gait of pregnancy'.

The position of the foetus can also be responsible for backpain to a some extent. Normally the foetus lies head down in the uterus, face towards the mother's back (occipito-anterior position). If however the foetus is in the occipito-posterior position, that is if the back of the foetal head is towards the mother's back, the bones of its skull presses against the sacrum (the 'tailbone') causing pain.

Urinary tract infection in pregnancy can present as backpain.

Other causes can be strain on the back muscles and ligaments due to poor posture or relaxed ligaments, muscle spasm due to any cause, sciatica or prolapsed spinal disc.

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How to manage backpain in pregnancy

Wear low-heeled but not flat shoes. A one inch heel is ideal to maintain a good posture.

If you have to stand for a long time, as for example while working at the kitchen counter, place one foot on a small tool about 6 inches high.

Do not bend your back too much. If you need to pick up anything from the floor, bend your knees rather than your back to reach down. Do not hesitate to ask for help.

When sitting on a sofa or a chair, place a small cushion at the small of your back for support. It will help to maintain the curvature of your lower back and prevent stress.

When you need to get up from the bed, roll over to your side, place your hands flat on the bed, and push yourself upright. Let your arms take your body weight, not your back

When lying on the bed, try to lie down on your side as long as possible. Support your upper leg on a pillow or rolled up blanket so that it is more or less at the same level as your hips.

While lying on your side in bed, place a pillow under your abdomen to prevent it from dragging on the skin and ligaments of your back.

Massage, heat pads or a hot water bag can do a lot to decrease muscle spasm. Place the heat pads over your lower back and hips to relax your muscles.

Pregnancy Support belts: Pregnancy support belts and prenatal cradles take the weight of the growing baby away from the back and abdominal muscles and are very helpful in decreasing backpain.

See your doctor to rule out pain from any disease process like urinary tract infection, sciatica and prolapsed spinal disc.

A muscle relaxant and pain relieving gel or cream can be applied over the lower back.

Oral pain-relieving pills can decrease the pain but have to be taken under the strict guidance of your doctor. Many pain relieving pills contain medicines that are not safe during pregnancy.

Exercises that stretch the muscles of the back can relieve pain to a great extent. Do them as soon as you get up from the bed in the morning. You will feel better the whole day.

Toe touching: Stand straight with feet together. Inhale and raise your arms above your head as if you are trying to touch the ceiling. Feel the muscle of your back stretching. Now exhaling, bend forward slowly and try to touch your toes with your fingertips.
It does not matter if you can't, just go down as far as you can go. Done properly, you will feel the stretch along the whole length of your back from your neck to your bottoms. Hold for a count of 10, then slowly straighten up. This is 1 set. Do 3 sets 2 times a day. It will go a long way towards relieving your backache.
Side bending: Stand straight with your feet about 12 inches apart. Raise your arms above your head and clasp the fingers of both hands together. Lock your elbows to prevent bending. Now exhale and bend slowly to one side as far as you can go. Feel your muscles stretching along the sides of your body. Hold for a count of 10. Inhale and straighten up. Now exhale and bend to the other side. This makes 1 set. Do 3 sets at least 2 times a day.

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