Back pain is incredibly common during pregnancy, affecting approximately 65-75% of pregnant women. Back pain during pregnancy most commonly affects the lower back. It can begin in the first trimester and often intensifies as the pregnancy progresses.  Addressing back pain is essential to maintain comfort and well-being throughout pregnancy.

Nobody wants back pain, and having a baby bump makes stretching the back more difficult and, thus, the pain harder to treat. This article will examine why this happens and what you can do about it.

Why Does Back Pain Happen During Pregnancy?

There are several reasons why your back may hurt during pregnancy. Here are the most common:

1. Lordosis (over arched back)

The most common reason your back will hurt is simply the overarching of the back. As the baby grows, a pregnant person’s center of gravity shifts. Many people naturally adjust their posture to compensate, often arching the lower back more than usual.  

The spine’s vertebrae stack optimally for comfort, and deviation from this alignment for long periods can strain muscles, ligaments, and joints, often leading to discomfort. Differentiation from a neutral spine for long periods puts extra strain on the muscles, ligaments, and joints. Just this is enough to cause discomfort, and this alone is often the most significant cause of back pain during pregnancy.

2. Weight Gain

Healthy weight gain during pregnancy is normal and necessary, but it strains the lower back and surrounding muscles. Pregnancy weight gain is also usually mostly on the abdomen, which puts a lot of pressure on the back.

3. Hormonal Changes

During pregnancy, the body produces a hormone called relaxin, which softens the ligaments and joints in the pelvic area in preparation for childbirth. While this is necessary for delivery, it also means the joints around the spine, particularly the lumbar sacral area and sacroiliac joint, can now move around. 

Add the pressure from the baby’s weight, and now you can move around. Add the pressure from the baby’s weight, and they often do. Pain from the sacroiliac joint can radiate into the back and often presents as back pain. The additional weight and loosened joints can lead to instability, contributing to back pain.

4. Muscle Separation

As the baby continues to grow, pressure builds on the abdominal wall. To accommodate the bump, the two straps of the rectus abdominal muscles sometimes divide, causing a condition called diastasis recti (separation of the abdominal muscles). This reduces core stability and even further back arching, increasing the strain on the spine.

5. Stress and Fatigue  

Stress and fatigue are common factors that affect back pain. When we’re stressed, cortisol rises, affecting the absorption of magnesium, which is essential for muscle relaxation. Magnesium depletion then disrupts the balance of calcium, meaning more calcium is in the blood stream. As Calcium is responsible for muscle contraction, this, in turn, means that the muscles stay more contracted. Excess muscle contraction causes pain.

What Can You Do About Back Pain During Pregnancy?

Although treating back pain during pregnancy is a little more challenging, there are still lots of things that you can do:

1. Stretching 

Stretching is one of the best protocols to prevent back pain. In particular, stretching the lower back (erector spinae muscles) helps reduce the lordosis (overarching) of the spine. The other two essential muscles to stretch are the hip flexors and the TFL muscle. 

If these two muscles are tight, they cause reciprocal inhibition, leading to a weakness in the glutes, which causes those difficult-to-stretch QL spasms you want to avoid. It’s always best to see a physiotherapist for specific stretches appropriate to your trimester. 

2. Strengthening

While sit-ups become more impossible as the baby grows, inner ab work can help keep the core strong and the back supported. Your glutes are also a vital and often forgotten part of your core. 

During pregnancy, strengthening exercises for the adductors, abductors, lats, and hamstrings are essential. These muscles all contribute to SI joint stability. SI joint pain is thought to cause 20-35% of pregnancy-related lower back pain cases.

3. Acupuncture

Dry needling is a great way to release muscles that can’t be stretched; your physiotherapist will usually be able to release tight muscles this way, particularly QL spasms. Eastern acupuncture techniques can also be great for pregnancy. 

4. Magnesium or Epsom salts

Pregnancy can be stressful; financial stress, pregnancy nerves, and dealing with your partner during pregnancy can deplete your magnesium levels, causing muscle spasms. Topping up your magnesium with supplements or hot baths in Epsom salt can relieve the tension. Magnesium can also be absorbed through the skin via Epsom salt baths.

5. Sleep Modifications

Side-sleeping is recommended during pregnancy, mainly sleeping with a pillow between the knees to maintain alignment in the hips, which will reduce lower back strain. You can also pop a small pillow under your bump, and specific pillows are designed for pregnancy. 

6. Hot and Cold Therapy 

Hot water bottles or hot bean bags are your friend for pain relief. Heat is a great pain reliever without needing pills, and it can ease muscle tension. Cold packs are great for reducing inflammation and numbing any sharp pain. Alternating between heat and cold can be an effective way to manage back pain.

Final notes

While back pain is common during pregnancy and can feel difficult to treat, there are, in fact, lots of options available. Our top tips for reducing pain are to keep the core strong and the hip flexors loose. It’s also super important to strengthen the muscles around the SI joint while you have relaxin in your system.

SI joint pain is poorly understood but very easy to prevent. Never underestimate the power of hot and cold packs. For more info or to see a pregnancy specialist physiotherapist, visit https://www.miraclerehabclinic.com/novi and read their blog post about it.