In anticipation of bringing new life into the world, pregnancy can be a time of excitement and joy. Often, it also brings new aches and pains previously unknown to a woman’s pre-pregnancy body with back pain being one of the most common. Fortunately, back pain may be well managed with proper treatment, allowing a woman to more fully enjoy this special time in her life.

Risk factors

Women who have a history of back pain prior to pregnancy are at a greater risk for experiencing back pain during pregnancy and may also experience pains earlier in their pregnancy. Women who have had previous pregnancies, engage in physically demanding work, or are involved in the care of small children are at an increased risk of developing back pain during pregnancy, as well.

Back pain can begin at any point in one’s pregnancy, even as early as 8-12 weeks, but is most likely to begin between the fifth and seventh month. Activities that can trigger pain often involve asymmetrical loading of the spine, such as twisting, lifting, negotiating stairs, running, walking, rolling over in bed, and bending forward.

If the baby is carried in the front, why does my back hurt?

Several factors may contribute to the development of back pain during pregnancy. As a woman’s uterus becomes heavy with the growing fetus, her center of gravity changes. In response, her body makes postural adjustments to accommodate for these changes in the forces imposed on the frame of the body. This may result in muscle imbalances and subsequently may put strain on her back muscles. Abdominal muscles that normally help support posture become stretched as the belly grows and offer less support in their newly stretched state. Decreased abdominal support, along with weight gain associated with normal pregnancy, add to the strain on back muscles and spine. In addition, hormonal changes that naturally occur with pregnancy cause laxity in ligaments. While this laxity is especially necessary in the pelvis to allow for the baby’s eventual delivery, it may also cause increased mobility and instability in the joints, and lead to low back pain during pregnancy.

A pregnant woman should seek medical attention immediately if her back pain suddenly becomes severe, is accompanied by cramping, or is persistent for more than two weeks, as these can be symptoms of preterm labor or other medical problems.

Pain Prevention

Just as an athlete trains in preparation for a big sporting event, preparing one’s body through exercise and training before pregnancy is the best way to avoid some of the issues associated with back pain in pregnancy. General conditioning, with an emphasis on strengthening core muscles, abdominals, and gluteus muscles will assist in supporting the spine and help balance the strain of pregnancy.

During pregnancy, staying active with moderate exercise can ease pain; swimming and walking are good choices. One can take the strain off tired back muscles by choosing shoes with a comfortable low heel/wedge that provide good arch support. High heels and extreme flats with no support should be avoided.

Pregnancy is a good time to pay particular attention to body mechanics, both at work and at home. Keeping the spine and muscles in proper alignment during sitting, standing, and various activities will help minimize unnecessary strain. One should avoid standing in one spot for long periods of time. When standing, one should put one foot up on a low stool. Postural awareness can be improved by standing in the mirror sideways. The visual feedback from the mirror helps guide one’s body into correct alignment. One should stand with her chin up, shoulders back and down, buttocks squeezed, and avoid locking one’s knees.

When seated at a desk, feet should be planted comfortably on the floor, with one’s back straight and the desk at an appropriate height to avoid hunching over or having to reach up to the desk surface. It may be helpful to place a lumbar roll or a small pillow at the area of the low back to support its natural curve. Twisting and reaching at the same time as well as heavy lifting should be avoided; when picking things up, bending over should be avoided. Instead, one should bend at the knees, maintaining a straight back. Sleeping on one’s left side, with a pillow placed between the knees may help avoid back pain at night.

While back pain during pregnancy is common, addressing these issues early with appropriate physical therapy evaluation and treatment can help manage these symptoms throughout one’s pregnancy, thus allowing the pregnant mother to better enjoy what should be an exciting time of her life.

Rivki Chudnoff PT, MSPT is a NY/ NJ licensed physical therapist with over 14 years of experience working in both pediatrics and women’s health. She currently resides in Bergenfield with her husband Scott and their children. She can be reached at rivkichudnoff_gmail.com

By Rivki Chudnoff PT, MSPT