Almost 75% of all women experience back pain during their pregnancy.
Common causes of back pain during pregnancy include:
Hormones
During pregnancy some hormones like progesterone and relaxin are released to help soften ligaments and joints in the pelvis. But the hormones don’t just work around the pelvis. It will also circulate around the body and affect other joints. In the first trimester of pregnancy, this softening and loosening can directly impact the structures at the spine and can often be experienced as aches and pains.
Stress
Fluctuations in hormone levels especially in the post-pregnancy period can make pain worse. The anxiety about having to juggle with pregnancy related issues and complications, work, and family can be overwhelming and aggravate the pain.
Shifting center of gravity
The center of gravity is shifted forward when the tummy gets bigger. This can lead to a change in posture and back strain. Lack of mobility and avoidance of exercise and a reduction in activity can lead to weakening of the core muscles which exacerbates back pain.
Weight gain
The spinal column supports the weight of the mother and fetus which is around 12kg heavier than pre-pregnancy weight. This can lead to muscle strain and increased stress around the back, knee, ankle and shoulders.
Tips
- Maintaining good posture.
- Avoid standing for long periods of time.
- Remember to squat instead of bending at the waist when picking something up.
- Avoid lifting heavy things.
- Wear supporting shoes.
- Sleep on the side, with pillows tucked beneath belly and between knees for gentle support.
- Do some pregnancy-safe exercises to strengthen abdomen and back.
- Wear a supportive garment or belt to reduce back pressure.
Medications
Because we have to consider both the health of the mother and the foetus, and because no one will do experiments on a pregnant woman as it is not ethical, there has only been some observational studies.
The general rule of thumb is that in the first trimester, it will be best to avoid any medication if possible. For the rest of the pregnancy, paracetamol has a very low risk of side effects and is probably safe to take. Non-steroidals like ibuprofen and COX II inhibitors like arcoxia and celecoxib are probably safe to take for short periods of time but should be avoided in the third trimester. Weak opioids with a low dose can be taken for short periods. Please consult your health professional for more detailed advice.