Causes of Back Pain During Pregnancy
Women may experience lower back pain during pregnancy, upper back pain during pregnancy, back pain during early pregnancy, and some may have even severe back pain during pregnancy. These are all due to different causes. The most common is the lower back pain, at the area where the spine and pelvis meet (the sacroiliac joint). Weight gain, the baby and uterus putting pressure on the nerves and blood vessels, posture changes, hormone differences that loosen ligaments, muscle separation from the uterus expansion, and stress can all lead to back pain and spasms. For most women, this type of back pain will go away after birth.1 Upper back pain, or thoracic spine pain, is also possible during pregnancy, especially in the third trimester. This is due to the center of gravity shifts and excess weight, as well as the hormones. Breast enlargement strains the neck, thoracic spine, and shoulders due to posture alterations.2 It is possible to have back pain in the early stages of the pregnancy too. Unlike later stages, this back pain is typically more of an “achiness”.3 Since some “serious pregnancy complications” can be the cause of back pain, it is important to consult a healthcare professional if severe back pain during pregnancy occurs.4
Prevention and Treatment Options
Exercise is not only a stress reliever, but it improves flexibility and muscle strength. Pregnant women can safely swim, walk and use a stationary bike. Physiotherapy may also be recommended. Heat or cold on the back might provide relief, although care should be taken not to put the heat on the abdomen. It is important to have proper posture when working, sleeping, or sitting. When sleeping on the side, a woman should put the pillow between the knees. For desk sitting, it could be helpful to put a rolled-up towel behind the back or rest the feet on a stool or some books. A support belt may help. Stress can be alleviated with counseling. Some women benefit from acupuncture for lower back pain. Of course, chiropractic care can also be a safe option for pain alleviation.5 For the upper back pain, posture is key, and women should avoid carrying and lifting heavy objects. Wearing a supportive bra is important as well. In addition to regular exercises, women can do some simple stretches. To do some doorway pectoralis stretching, one stands in a doorway and places the arms on the frame (shoulder height, elbows at 90 degrees) and then, placing one foot in front of the other, lunges forward, holding for 30 seconds. This can be repeated a few times a day. Scapular retraction is another exercise. After stretching the chest, the patient should “keep the arms relaxed at your side and gently pinch the shoulder blades together”, holding for 5 seconds and repeating about 20 times a day. Massage may also be beneficial for upper back pain.6
Pregnancy Chiropractic and Massage
Chiropractic, when performed by someone trained to work with pregnant women, is a safe prenatal treatment option. It is a drug-free therapy. There are several types of designations that indicate if a chiropractor has received additional training in pregnancy wellness and infertility, including DAACP, CACCP, “Member of ICPA reflecting special interest”, and Webster Certified. The latter is “trained to work specifically with pelvic balance in pregnancy”. The specially-trained chiropractors might “use tables that adjust for a pregnant woman’s body” and specific “techniques that avoid unneeded pressure on the abdomen”. Chiropractors can suggest stretches and exercises that are safe for pregnancy, also.7 There are massage therapists who are certified in prenatal massage. Massage can provide stress, anxiety, and depression relief, alleviation of joint paint and muscle aches, and even improved labor outcomes. Swedish massage relaxes tension in the muscles and could “improve lymphatic and blood circulation”. It can even help with “hormone regulation”, such as reducing cortisol and norepinephrine (stress hormones) and increasing serotonin and dopamine (mood-regulating hormones). Edema (joint swelling), could also be prevented by massage, and this therapy might provide nerve pain relief, such as in patients with sciatic pain. Patients may even have fewer headaches and improved sleep. The safest position for pregnancy massage is on the side so that there is no pressure on the abdomen. It is important to seek out a “certified prenatal massage therapist”. A healthcare professional should be consulted if the patient has pregnancy induced hypertension, a high risk pregnancy, preeclampsia, prior pre-term labor, severe and sudden headaches, swelling, or high blood pressure, or if they have recently given birth. Sometimes massage will not be performed in the first trimester, due to the risk of miscarriage in the first 12 weeks, but some facilities offer massage throughout the pregnancy.8
Find out more about pregnancy and chiropractic.