Prenatal and postpartum back pain

Prenatal and Postpartum Back Pain, What is it?

What exactly is Prenatal and Postpartum Back Pain and how can you treat it? These are great questions that we will help you better understand. Preparing for a new baby is exciting and there is much to do in the months and weeks before a new baby’s arrival. Unfortunately, approximately two-thirds of women experience prenatal and postpartum back pain during this time. Not only can back pain be uncomfortable and stressful, but it can also affect the ability to complete daily activities. At a busy time for an expectant mother, back pain is much more than an inconvenience.

During pregnancy, a woman’s hormones fluctuate and her body is preparing for labor and delivery.  Ligaments become looser, which may cause shifting of the spine and pelvis, especially the closer she gets to the due date.  During this later stage of pregnancy is when most women develop back pain. She may not only experience back pain, but she may also have the sensation of feeling unstable in the hips and pelvis.

Postpartum back pain occurs in about half of new moms.  A lot of changes have occurred during the pregnancy and delivery process, due to hormonal changes, postural changes, and the stresses of delivery.  Added to that are new physical stresses of repetitive lifting, postural habits during feeding, and carrying a lot of equipment needed by the baby.

What causes Prenatal and Postpartum Back Pain?

Beyond hormonal changes that may cause ligament laxity during pregnancy, there are a few other causes for pre-and postnatal back pain.

The typical weight gain of 25-35 pounds and changes to posture during pregnancy can contribute to back pain.  Women’s bodies are naturally designed to make structural adjustments during pregnancy and to prepare for delivery.  The low back, also called the lumbar spine, is structured in such a way to handle changes in load. The lumbar spine connects with the pelvis, which is also designed for carrying loads, to stabilize the low back.  The added weight of the baby, plus changes in posture and the center of gravity in a relatively short period of time, adds stress to the spine and trunk musculature.

Hormonal changes cause laxity, or less stability, within and around the low back and pelvis region.  This is necessary for delivery and to accommodate the growing baby.  However, this extra movement can cause pain and irritation and result in pain during movements like walking, sitting, or rolling over in bed.

Compression of blood vessels and nerves from the growing baby can also result in discomfort, and sometimes that may include referred pain, numbness, or tingling into the legs.

Muscles of the abdomen, back, and pelvis are working very hard to keep the spine and pelvis stable during pregnancy, while still doing the work of the normal everyday function of the expecting mother.  Due to the changes in the musculoskeletal system of the trunk, pain can occur as well.

Finally, stress can play a role in pregnancy-related back pain.  Much is happening with the changes a new baby brings.  When stress levels are elevated, muscles will sometimes feel tight and strained, and different stress hormones can be a factor in how the body will respond.   Sleep is sometimes impacted as well, and fatigue can also contribute to stress.

The delivery of the baby results in tremendous changes and accommodations of the tissues.  Some tissues can be injured during the process, including the pelvic floor, hips, and abdominals.  It is important to care for these parts of the body after delivery as well.

In addition to the normal changes after delivery, taking care of a newborn is strenuous and very busy.  Sleep is at a premium, and caring for an infant presents new challenges.  Lifting and carrying the baby while also trying to manage necessary gear like diaper bags and carriers frequently set a new mother up for areas of discomfort and pain while her body is working to return to its pre-pregnancy state.   It takes several weeks for the tissues to recover, but the human body adapts quickly and becomes stronger and pain typically decreases.

Symptoms of Prenatal and Postpartum Back Pain

The two most common locations of back pain related to during and after pregnancy are low back (lumbar) and buttock area.  The area in the lower abdominal area below the baby is also quite uncomfortable for many women.  Pain may feel dull and achy or sharp, and for many women, increases as the day progresses.  It also may be increased with transitional movements, like rolling in bed or rising from sitting; and with prolonged time standing or walking.

If you are pregnant and are experiencing back pain, here are a few symptoms to watch for as they are indicators of when you should see your physician:

  • Difficulty with, or pain during, urination
  • Sudden or abrupt pain
  • Severe pain
  • Rhythmic pain and cramping

How is Prenatal and Postpartum Back Pain?

Being pregnant and experiencing back pain is common. Most pregnant women have some form of back pain during and after their pregnancy. There are times, however, when an expectant mother should seek medical attention.

Experiencing pain with urination, sudden sharp pain, or experiencing rhythmic cramping requires seeing a physician immediately. With low back or buttock pain that is irritating and impacting your daily activities, a physical therapist can help.

A visit with a physical therapist (PT) or a physician will help to determine the best course of action to take to ensure the expectant mother and baby stay healthy. A complete physical exam, review of medical history, questions about your symptoms, and completing a few special tests will most often properly pinpoint what is causing the pain.  A PT can also make recommendations about posture, ways to lift better, and positioning for comfort to minimize unnecessary strain and discomfort.

A physical therapist is an expert in the musculoskeletal system. A qualified PT can differentiate the primary cause of symptoms.  If he or she suspects the symptoms are not related to normal musculoskeletal changes, he or she will immediately contact the patient’s physician.

In all states, physical therapists can be seen without a physician’s order.  However, every state has different guidelines and insurance coverage may vary as well.  Physical Therapy Direct Access By State can help identify each state’s guidelines.

Treatment of Prenatal and Postpartum Back Pain

The good news is conservative treatment like physical therapy can help make the last few months of pregnancy and the first few months after delivery a more comfortable time for a new mother.

A few quick solutions may help alleviate symptoms without medical intervention. Within the first 24-48 hours of onset of back pain, ice can be applied for 10-20 minutes several times per day.  Care should be taken for protection the skin and positioning.

Being aware of posture can have a significant effect on pain.

  • Avoid slouching
  • Sleep in sidelying (if tolerated) with a pillow between the knees
  • Rest frequently, avoid prolonged standing or walking
  • Place a rolled towel in the small of the low back when sitting

A PT takes a conservative approach to care and will have the health of the mother and baby as top priority. The primary goal, besides keeping mother and baby healthy, is to manage the symptoms to allow performance of  necessary daily activities.

A PT will customize a plan of care based on clinical findings individual to that patient. There is no “cookie cutter” approach to physical therapy care. Each mom and her baby is unique which is why getting treatment from a qualified PT is important. Specific, prescriptive exercises that are pregnancy-appropriate are key.

Next Steps

Early intervention and treatment of back pain is important to conservative care in getting back to doing the necessary and enjoyable activities of life with preparing for a new infant. A physical therapist is an excellent resource in providing appropriate care in this exciting time.

As a consumer of health care, patients have a choice in finding the right provider to meet their needs. Look for a physical therapist with excellent outcomes and with experience in treating pregnancy-related back pain.

Find a highly qualified PT, by geographical region, with great outcomes by clicking here.

For those of you who are not familiar, the term “home exercise program” refers to a collection o

Read More

One of the hallmark symptoms of Read More

Over 80% of the adult population will experience back pain in their lifetime, and estimated losses i

Read More

Leave a Reply

Your email address will not be published. Required fields are marked *