Get in-depth answers to frequently asked questions about back pain during pregnancy from a trusted source: IBJI’s Dr. Mehul Garala, a fellowship-trained and double-board certified physician with over 10 years of experience helping moms-to-be with back problems find relief.
Mehul Garala, MD Physical Medicine and Rehabilitation Physician with Fellowship Training in Spine and Sports Medicine
Dr. Garala: There are many possible causes of back pain during pregnancy including weight gain, in which the spine and pelvis now have to support the added weight.
As the baby grows, it can lead to abdominal muscle separation which may contribute to pain. There are postural changes due to the shift of the center of gravity as well as hormonal changes that play a role.
In particular, there is a hormone released during pregnancy called relaxin that makes the ligaments in the pelvic region relax and stretch to accommodate the growing fetus, which can cause pain involving the sacroiliac joints.
Dr. Garala: The low back is a common area, however as mentioned the sacroiliac joints can be impacted (these are the main joints in the buttock region). The pelvic floor, which is the sling that helps keep the pelvic organs in place, can also be a source of problems.
What Types of Pain Do Pregnant Women Experience?
Dr. Garala: It depends on the potential source of the pain and how it manifests. A lot of women have pain confined to the back or buttock region. However, if a nerve is being compressed, then a woman can have pain that shoots down her leg.
How Common Is Back Pain During Pregnancy?
Dr. Garala: Generally, approximately 80 percent of people are going to have back pain sometime in their life. Throw in the additional potential causes for pregnant women and it is a common occurrence.
What Are Some At-Home Treatments for Women Who Have Low Back Pain in the Third Trimester?
Dr. Garala: I recommend patients be proactive to maintain their flexibility and muscle strength.
I explain how maintaining proper posture, using ergonomic chairs with good back and arm support, sleeping with a body pillow on their side (to help with spinal alignment), and wearing comfortable and loose clothing can make a difference. Because of the growing abdomen and the pelvis region, we want to avoid constricting areas that are susceptible to injury.
I also recommend comfortable low-rise shoes. I advise against high heels or completely flat shoes because that can further affect posture during pregnancy.
When Should Someone Seek Care for Back Pain During Pregnancy?
Dr. Garala: We are always available to see a patient if there is a concern no matter how much pain the person is experiencing. However, I would recommend an evaluation if the pain is intolerable, radiates down the legs, is associated with numbness/tingling or weakness, or if the woman has bowel or bladder dysfunction.
How Do You Treat Patients With Back Pain During Pregnancy?
Dr. Garala: It depends on their presentation of what we think is the main pain generator. However, physical therapy for an individualized treatment program is usually recommended.
Pregnancy limits the treatment options that are otherwise available. The safest and really only medication to take is Tylenol. Anti-inflammatories and potential injections that require X-ray guidance are contraindicated. That is why I think it is better to be proactive in trying to prevent low back pain than reactive because there are limitations with treatment.