Stable Health

Back pain through pregnancy is a common complaint and it’s not surprising. During pregnancy, many changes happen to your body, of which can lead to pressure changes through your spine and pelvis resulting in moderate to severe back pain.

So, what happens to my spine during pregnancy?

The release of hormones

During pregnancy a hormone called relaxin is excreted. Relaxin plays an important role in controlling cardiovascular output between the mother and the foetus in the 1^st and 2^nd trimester, insuring there is adequate blood blow to the placenta. Towards the end of the 3^rd trimester, relaxion promotes dilation of membranes around the foetus as well as causes ligaments in the pelvis and lower back to relax. This process helps prepare the body during the end stages of pregnancy in preparation for childbirth. However, ligaments around the lower back and pelvis can become overly strained which can lead to pain or discomfort.

Changes in the centre of gravity

As each trimester of pregnancy advances and the foetus progressively grows, there is an increased forward weight from the abdomen. This results in a slightly altered centre of gravity, changing the way the body is positioned. In order for the body and spine to remain centred and avoid any imbalance, the lower back counteracts the weight from the foetus by increasing muscle contraction and loading patterns through the spinal joints. These changes result in increased pressure through spinal joints, ligaments and muscles which can at times lead to strain and potential injuries.

So, what can I do to help?

Correct Your Posture

• Hold your head up straight with your chin tucked in and stretch the top of your head towards the ceiling. Avoid your head and neck tilting forwards.
• Keep your shoulder blades back and your chest forward
• Gently pull your stomach in and avoid tilting your pelvis forward or backward
• Point your feet in the same direction and balance your weight evenly between both feet. 
• Avoid standing still or staying in the same position for too long.
• When sitting, ensure the lower back is adequately supported and the spine is neutral. This will help avoid slouching forwards and prevent any strain through the lower back.

Sleeping Position

• Lie on your side (preferably left) with a pillow/cushion between your knees. Bend the top knee and keep the bottom leg straight. This position helps keep the spine in the correct alignment and reduce pressure on the pelvis.
• The use of a pregnancy pillow can additionally help keep the shoulders and neck supported.

Low-grade stretching and exercise

Clinical trials have indicated that exercise including low grade aerobics, resistance training, pilates and yoga are beneficial for general health during pregnancy, reducing back pain as well as post-partum recovery (1,2,3).

Seek Professional Advice

If you are pregnant and find that your back pain is getting worse despite making changes to your posture and lifestyle, it is a good idea to get it properly assessed. Recent empirical evidence has determined that osteopathic manipulative treatment is significantly effective for reducing back pain during pregnancy (4,5,6). So, if you find yourself struggling with spinal pain, get professional advice and the help you need.

Reference List

1. Nascimento, S. L., Surita, F. G., & Cecatti, J. G. (2012). Physical exercise during pregnancy: a systematic review. Current Opinion in Obstetrics and Gynecology, 24(6), 387-394.
2. Babbar, S., Parks-Savage, A. C., & Chauhan, S. P. (2012). Yoga during pregnancy: a review. American journal of perinatology, 29(06), 459-464.
3. Price, B. B., Amini, S. B., & Kappeler, K. (2012). Exercise in pregnancy: effect on fitness and obstetric outcomes—a randomized trial. Medicine & Science in Sports & Exercise, 44(12), 2263-2269.
4. Licciardone, J. C., & Aryal, S. (2013). Prevention of progressive back-specific dysfunction during pregnancy: an assessment of osteopathic manual treatment based on Cochrane Back Review Group criteria. The Journal of the American Osteopathic Association, 113(10), 728-736.
5. Lavelle, J. M. (2012). Osteopathic manipulative treatment in pregnant women. Journal of the American Osteopathic Association, 112(6), 343.
6. Schwerla, F., Rother, K., Rother, D., Ruetz, M., & Resch, K. L. (2015). Osteopathic manipulative therapy in women with postpartum low back pain and disability: a pragmatic randomized controlled trial. J Am Osteopath Assoc, 115(7), 416-25.