Hi friends! Have you been pregnant and told by your physician that your back pain is normal and will go away after delivery? Does it feel like your back pain is just getting worse the farther along you are? Maybe the pain is so bad that it is stopping you from being able to do your daily tasks like walking or standing.
You are not alone. It is estimated that over half of pregnant individuals experience some form of low back and/or pelvic girdle pain during their pregnancy (Clinton, 2017). Yet only 15-30% receive any treatment when they report it to their physicians (Owens, 2002; Stapleton, 2002).
There are some things that make you more susceptible to low back pain in pregnancy like: (Clinton, 2017)
Having previous pregnancies
Joint hypermobility (e.g. Ehlers-Danlos syndrome)
Irregular periods
Higher body mass index (BMI)
Hip/leg dysfunction
History of trauma to the pelvis
History of low back or pelvic girdle pain (especially in a previous pregnancy)
Work dissatisfaction
History of smoking and cessation of smoking in the first trimester
Even though back pain is very common and it seems like almost everything can cause it, what can we do about it?
There are varying options for back pain but please note these options are not medical advice and do not replace evaluation and treatment by a licensed healthcare provider. Speak with your provider before using any treatment options.
Physical therapists, especially those with special training to work with pregnant and postpartum individuals, as well as special training in pelvic health, can help! A physical therapist will do an assessment at your first appointment, typically looking at the flexibility, strength, and coordination of the muscles in your back, abdominals, and legs. They may also look at your posture, the way your body moves when you do things like walk or pick up items from the floor. After the assessment is completed, a physical therapist will develop a treatment plan just for you.
This plan may include several options, including hands-on techniques and exercise (Clinton, 2017). Exercise has been shown to reduce pain and improve function/disability in women with pregnancy-related pelvic girdle pain (Belogolovsky, 2015;van Benten, 2014).
If needed, your physical therapist can help you with posture and body mechanics to improve movements and decrease pain for daily activities like doing the laundry, picking up little ones, or even rolling over in bed.
Your physical therapist may also recommend use of a support belt/brace (like the V2 Supporter) or a TENS unit (Clinton, 2017; Koukoulithras, 2021).
In addition to helping with pain relief and improving your ability to perform your daily activities, a pelvic floor physical therapist can help with pelvic floor muscle preparation for delivery. Pelvic floor muscle training has been shown to be beneficial and does not increase the risk of tearing. In fact, we need to learn how to drop/open the pelvic floor muscles to let the baby out.
If you are suffering from pain, speak up! It’s possible that the pain will not go away after delivery, and back/pelvic girdle pain during pregnancy has been linked to postpartum depression. To find a pelvic floor physical therapist near you, ask your doctor for a referral or go to www.mypfm.com/find-a-pt.
To learn more about your pelvic floor muscles, check out these great resources:
Watch our YouTube playlist on Pregnancy and Your Pelvic Floor
Watch Netflix for Your Pelvic Floor at Pelvic Flicks
Learn more about your pelvic floor on our Instagram
Visit our Amazon store for our favorite pelvic health products
Sign up for our email newsletter
For providers, check out our online courses to help your clients. Consider joining our Ambassador Program and most of our courses are included with your membership!
Pacifying Pregnancy Pain with Dr. Caitlyn McCurdy-Robinson, PT, DPT
Contemporary Considerations for Management of Pelvic Girdle Pain: Pregnancy and Postpartum with Dr. Susan Clinton, PT, DScPT, OCS, WCS, FAAOMPT
How to Help Prenatal Clients Prepare for Birth with Melissa Stendahl, PT, DPT
Written by Emily Reul, PT, DPT
References
Belogolovsky I, Katzman W, Chirsopherson N, Rivera M, Allen D. The effectiveness of exercise in treatment of pregnancy-related lumbar and pelvic girdle pain: a meta-analysis and evidence-based review. J Womens Health Phys Therap. 2015;39(2):53-64.
Clinton SC, Newell A, Downey PA, Ferreira K. Pelvic girdle pain in the antepartum population: physical therapy clinical practice guidelines linked to the international classification of functioning, disability, and health from the Section on Women’s Health and the Orthopaedic section of the American Physical Therapy Association. J Womens Health Phys Therap. 2017;42(2):102-125.
Koukoulithras I, Stamouli A, Kolokotsios S, Plexousakis M, Mavrogiannopoulou C. The effectiveness of non-pharmaceutical interventions upon pregnancy-related low back pain: a systematic review and meta-analysis. Cureus. 2021;13(1):e13011
Owens K, Pearson A, Mason G. Symphysis pubis dysfunction—a cause of significant obstetric morbidity. Eur J Obstet Gynecol Reprod Biol. 2002;105(2):143-146.
Stapleton DB, MacLennan AH, Kristiansson P. The prevalence of recalled low back pain during and after pregnancy: A south Austrailian population survey. Aust N A J Obstet Gynaecol. 2002;42(5):482-485.
Van Benten E, Pool J, Mens J, pool-Goudzwaard A. Recommendations for physical therapists on the treatment of lumbopelvic pain during pregnancy: a systematic review. J Orthop Sports Phys Ther. 2014;44(7):464-473.