Back Pain During Pregnancy
Lower back pain is a very common complaint during pregnancy. European and U. S. studies have shown that about half to three-quarters of pregnant women experience pregnancy-related lower back pain (PGLBP).
Women who have a history of lower back pain before their current pregnancy – either when not pregnant or during a prior pregnancy – are more likely to suffer from PGLBP. However, many women who have had no problem with back pain prior to pregnancy will experience their first onset of back pain during a pregnancy.
Recognize the Pain
The pain intensity of PGLBP is usually moderate, and many women simply try to live with it. In fact, studies have shown that many women with PGLBP do not even report it to their prenatal provider. However, ignoring the pain can be problematic for a number of reasons. First, the intensity of PGLBP usually increases the longer it lasts, so moderate pain right now may turn into severe pain in a few weeks. Second, PGLBP results in impaired activities of daily living and sleep disturbances in over half of the women who suffer from it. This can pose problems for any expectant mother, and especially for those who are caring for other children as well. Finally, in almost one-third of untreated cases, PGLBP can result in chronic back pain after pregnancy. This can interfere with postpartum exercise as well as caring for the newborn.
PGLBP is typically due to some irritation of the joints and/or muscles of the back. Sometimes this irritation is caused by the increased strain on the back from the normal weight gain of pregnancy. However, many times the pain begins early in the pregnancy before a woman has gained much weight at all. In these instances the irritation is likely due to the effects of various hormones on the spinal joints.
Prevent the Pain
Here are some suggestions to help decrease your chance of suffering from back pain during your pregnancy.
- Be proactive: get rid of back pain before you conceive. If you have a "bad back," pay some attention to it before you become pregnant. Seek appropriate treatment, learn correct exercises, and improve your aerobic conditioning. There are many reasons to get in better shape before pregnancy; helping to prevent PGLBP is one.
- Stay active: regular exercise is your best friend. Simple cardiovascular exercise is one of the best means of decreasing the risk for back pain. Back stretching and strengthening exercises help also, but aerobic exercise is best. Of course, pregnancy is not the time to begin a new exercise program. But if you have been active before, continuing to exercise while pregnant gives you many benefits. If you are uncertain, ask your prenatal provider.
- Don't be overactive: no superwomen, please. Your body is undergoing an amazing process that requires a lot of energy. You will need to manage the demands on your time and physical activity. At some point, you cannot put out the same amount and intensity of effort for work, household chores, and recreation as you did before becoming pregnant. Also, some things that may have had little effect on you before you were pregnant (like high heels, prolonged standing, and extended hours at a computer) may now result in significant discomfort.
Despite your best efforts, you will most likely experience some back pain while pregnant. If you are lucky, it will go away in a day or two and stay away. But if it lasts longer, or continues to come and go, ask your prenatal provider about your treatment choices.
Treat the Pain
One such choice is chiropractic treatment. Chiropractic treatment of PGLBP includes many options such as advice on proper body mechanics, instruction in appropriate exercise and stretching, the use of supports, and various types of massage or muscle treatments. However the one treatment chiropractors are best known for – and the one that is most effective for helping back pain – is the chiropractic adjustment.
The goal of a chiropractic adjustment is to decrease pain and improve the proper biomechanics (essentially the motion and position) of a given spinal joint.
Some chiropractic adjustments involve the chiropractor using his/her hands to apply a thrust to a joint, which usually results in a "popping" sound. Other adjustments involve moving or positioning a patient's joints without thrusting, and without popping. It is important to choose a chiropractor who is skilled in both types of adjustments, since one or the other may be appropriate for any individual woman at different times during her pregnancy and postpartum period.
Chiropractic treatment for PGLBP can be very effective, and is safe for both the mother and baby. There is no reason to believe that chiropractic treatment will induce labor or result in any other problems in an uncomplicated pregnancy. Special tables are used and modifications are made to adjustment techniques to avoid any pressure on the abdomen. Choose a chiropractor who is experienced in the treatment of pregnant women and who has cooperated with obstetricians and midwives in the past. For pregnancies involving complications or higher risks, a conversation between the chiropractor and the prenatal provider can help determine if chiropractic treatment would be appropriate.