Pregnancy

Lumbar (Low Back) Pain During Pregnancy
Lumbar pain during pregnancy is generally located at and above the waist in the centre of the back. It may or may not be concurrent with pain that radiates into your leg or foot. In general, lumbar pain during pregnancy is similar to low back pain experienced by non-pregnant women. This type of pain typically increases with prolonged postures (such as sitting, standing, or repetitive lifting). Tenderness may also be present in the muscles along the spine during pregnancy.  

Posterior Pelvic Pain During Pregnancy
Posterior pelvic pain (in back of the pelvis) is four times more prevalent than lumbar pain in pregnancy. It is a deep pain felt below and to the side at the waistline, and/or below the waistline on either side across the tailbone (sacrum). This type of pain may be experienced on one or both sides.

Posterior pelvic pain during pregnancy can extend down into the buttock and upper portion of the posterior (in back of) thighs, and does not usually radiate below the knees. It can be associated with pubic pain. The pain does not quickly resolve with rest, and morning stiffness may also be present. Unlike many other forms of low back pain during pregnancy, a previous high level of fitness does not necessarily prevent this problem.

The main goal is for you to maintain an optimal level of function throughout your pregnancy and to have the least amount of discomfort.

Treatment of Low Back Pain in Pregnancy
Conservative management of back pain in pregnancy generally includes performance of appropriate exercise and use of proper body mechanics. These efforts promote and support proper posture, which is essential to avoiding unnecessary stress to supporting structures.

Often just one or two visits to a physiotherapist can be very helpful to help minimize or alleviate unwanted back pain during pregnancy. If more extensive treatment is required, a physiotherapist should perform an individual evaluation and recommend a treatment program for you.

Both lumbar pain and posterior pelvic pain may be caused by several factors related to changes that naturally occur in your body while pregnant.

1) Weight gain—pregnancy can cause you to gain as much as a quarter of your body weight, adding stress to the weight-bearing structures.

2) Centre of gravity changes during pregnancy—secondary to weight gain, the weight is typically carried anterior (in the front) as well as posterior (behind). This change in your centre of gravity creates muscular imbalances and muscle fatigue.

3) Hormonal surges (relaxin and estrogen)—pregnancy related hormones can cause problems by creating joint laxity, especially in the pelvis. These hormonal surges, along with the additional weight and change in centre of gravity, contribute to decreased joint support.