Low back pain is one of the most common complaints amongst the pregnant women. Low back pain during pregnancy causing negative impact on their quality of life and affect their activity of daily living. Pregnancy related low back pains are always underestimated and not treated properly. Pregnant women may experience back pain that is localized to the lower back or could possibly radiating into the buttock, thigh, and legs. Two most common factors causing pregnancy related low back pain are mechanical and hormonal.

Postural changes during pregnancy cause mechanical challenges to the musculoskeletal system, especially in the lower back. Pregnancy related low back pain and pelvic discomfort usually begins between the 20^th and the 28^th week of being pregnant. However, it may have an earlier onset, a small percentage of pregnant women may experience low back pain as early as 4^th to 16^th weeks.

Weight gaining during pregnancy is associated with the mechanical factor of low back pain. It shifts the centre of gravity forwards and thus increase the strain on the lower back. As a result, compensated postural changes such as increase in lumbar lordosis can be used to balance the anterior shift. This increases the natural inward curvature of the lumbar spine, this in turn, places additional stress on the structures like intervertebral discs, ligaments, and facet joints.  

In addition, enlarging uterus by the growing of the baby putting stress on the blood vessels and nerve around the pelvic and lumbar spine. It also causes the abdominal muscles to stretch to accommodate the enlarging uterus leading to muscle fatigue and adding extra load on lumbar spine.

During pregnancy, body will increase the release of the hormone called relaxin. This hormone causes ligament in the pelvic area to relax for the preparation of birth process. Relaxin can cause the ligaments that support the spine to become loose. Laxity of the ligaments therefore can affect the stability of the pelvic and spine and lead to back pain.

Pre-natal program may include the following:

• Postural education on sitting, standing, and lifting without causing additional stress at the spine
• Activity modifications
• Heat therapy
• Lower back mobility exercises
• Lower back stability exercises
• Pre-natal massage

If you are experiencing low back pain during your pregnancy, you can try out our Natal360 program which will help you to strengthen and maintain your pelvic floor muscle strength, as well as maintain general strength and flexibility. This can help reduce your risk of pain and discomfort through the pregnancy, as well as giving you the best chance for a smooth delivery and recovery. Book a Natal360 program with us now: https://physioclinic.sg/programs/natal360/

Or if you have any queries, please do not hesitate to contact heal360 physioclinic on:

Website: www.physioclinic.sg | Call: 62244178 | WhatsApp or SMS: 91510068 | Email: info@physioclinic.sg

References

Katonis, P., Kampouroglou, A., Aggelopoulos, A., Kakavelakis, K., Lykoudis, S., Makrigiannakis, A., & Alpantaki, K. (2011). Pregnancy-related low back pain. Hippokratia, 15(3), 205–210.

G, I., A, K., JF, R., S, R., J, N., & N, B. et al. (2017). Back Pain during Pregnancy and Quality of Life of Pregnant Women. Primary Health Care Open Access, 07(01). doi: 10.4172/2167-1079.1000261

Bishop, A., Holden, M., Ogollah, R., & Foster, N. (2016). Current management of pregnancy-related low back pain: a national cross-sectional survey of UK physiotherapists. Physiotherapy, 102(1), 78-85. doi: 10.1016/j.physio.2015.02.003