Back pain affects over half of all pregnant women due to substantial biochemical and anatomical shifts in the body. Back pain during pregnancy can range from a mild nuisance to severe debilitation. Fully understanding the types of back pain that can arise and how the symptoms present themselves can aid in navigating this challenging aspect of the journey.
Relating Back Pain to the Phases of Pregnancy
Back pain often intensifies at different stages of pregnancy due to the interacting physical changes unfolding over 9 months, including:
First Trimester
- Hormone surges initiating ligament/muscle loosening
- Nausea/fatigue disrupting activity levels
- Initial postural adaptations to accommodate womb
Second Trimester
- Ongoing hormonal and postural shifts
- Weight gain stressing back/core muscles
- Outgrowing bras/clothes disrupting balance
Third Trimester
- Peak relaxin/progesterone elasticity
- Maximum baby bump size and breast growth
- Greatest forward center of gravity shift
While back pain can emerge anytime, it tends to first appear in the late 1st trimester before worsening through the 3rd. Understanding the timing and pregnancy-specific factors in each phase sets realistic expectations.
Types of Back Pain in Pregnancy
Why does back pain vary so widely between expecting mothers regarding symptom location and severity? The answer lies in the 2 predominant subtypes mothers may develop:
Lumbar Back Pain
- Manifests just above pelvis near lumbar spine
- Resembles but intensifies regular lower back aches
- Radiates down glutes and backs of thighs
Posterior Pelvic Pain
- Concentrated under waistline deep near sacrum
- Radiates down sides of buttocks toward knees
- Typically more painful and prevalent
These two types derive from the same pregnancy-induced physical shifts but localize in different spinal regions. However, some women experience pain in both areas simultaneously.
Pregnancy-Related Causes of Pain
While we’ve discussed the different locations of pain, what specifically triggers back pain to occur during pregnancy? Several wide-ranging pregnancy-related changes predispose the back to injury and inflammation, mainly:
Hormonal Changes
- Relaxin/progesterone loosening supportive ligaments and joints
Physical Changes
- Weight gain compressing/stressing spine
- Center of gravity shifts straining posture
- Adaptive postural distortions
Emotional Changes
- Stress-induced muscle tension
- Depression or anxiety disrupting self-care
In essence, the complex biochemical and anatomical transformations of pregnancy converge to inflame nerves, strain muscles, and stress connective tissues — provoking pain. Comprehending this helps expectant mothers grasp why their bodies ache.
Comparing Posterior Pelvic and Lumbar Symptoms
Beyond simply naming the two predominant back pain subtypes in pregnancy, deeply understanding their distinct symptoms empowers sufferers to choose appropriate therapies. Let’s contrast their defining features:
Posterior Pelvic Pain
- Concentrated in lower back/sacrum near pelvis
- Severe, deep, dull ache below waistline
- 4 times as common as lumbar pain
- Pain when rising from chairs, steps, or bed
- Pain when climbing stairs or inclines
Lumbar Pain
- Manifests higher near lumbar vertebrae
- Resembles intensified ‘typical’ back pain
- Radiates down backs of thighs to knees
- Stiffness and difficulty bending spine
- Muscle spasm and reduced mobility
This breakdown of where pain localizes, its qualities, triggers, and other symptoms guide women in accurately communicating distress to their physicians. In turn, doctors can precisely diagnose the subtype and optimal management approaches.
Risk Factors and Vulnerabilities
An important aspect of fully understanding pregnancy-related back pain is recognizing risk factors that increase a woman’s chance of developing it. These risk factors include:
- Carrying excess weight into pregnancy
- History of chronic pain
- Labor-intensive occupations
- Multiple past pregnancies
- Age over 35 years
- Sedentary lifestyle
- Spinal abnormalities
For women falling into these high-risk categories, diligently integrating preventative and pain-relieving strategies is pivotal. Even small exercises or postural adjustments become essential.
Principles of Relief: Rest, Support and Strengthen
While we won’t dive into the specifics of particular treatments, getting familiar with the 3 key elements that most therapies are built on gives a helpful overview:
Rest
- Avoid overexertion
- Alternate movement with rest
- Listen to pain signals
Support
- Stabilize joints with braces
- Improve alignment to ease muscles
- Modify activities minimizing strain
Strengthening
- Exercise safely within limits
- Focus on core and pelvic muscles
- Gently stretch tight nerve and tissue
Whether practicing yoga, wearing a maternity belt, or applying hot packs between activity, applying these simple laws forms the basis of sensible relief.
Conclusion
While some discomfort may hang around despite our best relief efforts, comprehending the origins of back pain can spark patience, adaptation, and personalized treatment. Even if perfect solutions seem out of grasp in the moment, the situation is temporary. Before long, the daylight of delivery will come, bringing new comfort and joy.
If symptoms are severe or last longer than two weeks, be sure to consult your doctors or therapists specialized in prenatal and postpartum care for support. .
Written by Dr. Tony Mork
Orthopedic Spine Surgeon
I’m Dr. Tony Mork, MD, a Minimally Invasive Orthopedic Spine Surgery Specialist in Newport Beach, California. With over 40 years of experience, I’m dedicated to providing information for all topics that involve neck and back pain.
January 31, 2024
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