5 Ways to Ease Back Pain During Pregnancy

Low back pain and pelvic pain are among the most common problems that occur during pregnancy —if you are pregnant and experiencing these symptoms, read on, you're not alone. About half of pregnant women will complain of significant low back pain symptoms. The changes your body experiences during pregnancy are dramatic, and these physiologic changes can cause unexpected pain and difficulty with seemingly normal activities.

Contrary to popular belief, back pain is not only a problem later in pregnancy. In fact, the incidence of back pain during pregnancy peaks around 18-24 weeks. While the added weight of the developing fetus is a large component of why pregnant women develop these symptoms, it is not the only reason. A complex set of physiologic changes in the body can contribute to the development of lower back symptoms.

Causes of Back Pain in Pregnancy

There are several physiologic changes that occur in a pregnant body that can explain the increased chance of developing back pain. The most notable is the weight gain that occurs during pregnancy which is typically 25-35 pounds, with at least half of that weight gain occurring in the abdominal region. The weight change also shifts the posture of the spine and changes your body's center of gravity.

The second major change that occurs is hormonal. These hormone levels that are raised increase the laxity of joints and ligaments in the body. One of these important hormones, called relaxin, has been shown to correlate with symptoms of back pain. Studies have found that women with the highest levels of relaxin often have the most significant back pain.

Diagnosis

Making the diagnosis of back pain during pregnancy can be limited to an extent by risks to the developing fetus. Because of these concerns, doctors tend to be very wary of imaging tests in a pregnant mother.

The best method of diagnosing symptoms of back pain is by taking a careful history of the symptoms and then performing a complete examination to assess the functioning of the spinal muscles, joints, and nerves. X-ray tests are avoided during fetal development, with the fetus most at risk between 8-15 weeks of development. Fluoroscopy and CT scans are almost always avoided completely because of high dose exposure to the fetus.

MRI imaging can be performed more safely during pregnancy, but even MRIs are avoided with some possible concerns of injury to the developing fetus. While MRI is considered the safest test available for back pain in a pregnant woman, there are theoretic concerns to developing auditory systems as well as possible heat exposure.

Treatment Options

While treatment options may be limited, there are options available, and some can be effective:

• Complementary treatments: Many women find relief from alternative medical therapies. These include chiropractic treatment and massage. If you're not finding relief with the above methods, you might try one of these treatments to see if it is helpful for you. Ask if your massage therapist or chiropractor has specific training and experience with treating pregnant women.
• Exercise and physical therapy: The most effective treatment has been shown to be exercise and therapy. Keeping moving is actually helpful and bed rest tends to exacerbate symptoms. Find a physical therapist in your area who has worked with pregnant women and can help promote better posture and movement of the spine.
• Ice and heat application: There is limited scientific evidence to support their use, but many people find relief by using cold therapy or heat application for back pain. One of these modalities is not necessarily better than the other, and some people find better results with cold therapy while others may find relief with heat.
• Medications: As you probably know, medications during pregnancy are used with extreme caution. Medications used during pregnancy are rated by a classification scale to help patients and doctors understand the possible risk to the developing fetus. This classification scale is useful to patients weighing the risks and benefits of different medication treatments. Tylenol is generally considered safe and is rated Class B. Oral anti-inflammatory medications have some risks and are considered Class C in early pregnancy and Class D in later pregnancy. Some muscle relaxing medications are safe to use while others should be avoided. Narcotic medications should generally be avoided, if possible. Always discuss medication use both with the doctor treating your back pain and your obstetrician.
• Supports and pillows: Support pillows, particularly when sitting or sleeping at night, can be extremely helpful. Pregnant women with back pain usually find sleeping on their side with a support pillow between bent knees to be the most comfortable.

Recovery Timeline

Unfortunately, there is seldom a quick fix to low back pain that occurs during pregnancy. Because treatments are limited, they can take time to take effect. While many people hope for quick resolution following birth, the truth is that resolution of pain may take months or longer following delivery. Many women find relief within 6 months of delivery, but about 40% of pregnancy-associated low back pain patients took over 6 months for complete resolution of symptoms.

It is important to note that there are some unusual causes of back pain that are not simply attributed to physiologic changes of pregnancy. While the vast majority of problems are related to the physiology of pregnancy, there are problems including disc herniations, spondylolisthesis, and other sources of back pain that can occur. Your doctor can examine you to look for signs of more unusual causes of back pain during pregnancy.

A Word From Verywell

Back pain is very common. It often occurs earlier in pregnancy than people would expect, is the result of a complex set of changes in a pregnant woman's physiology, and typically improves with some simple treatment steps. Women who develop this type of back pain should find strategies that work for them to relieve the symptoms since the problem may not go away completely during pregnancy and may take months or longer after delivery to fully resolve.