Back Pain during pregnancy is very common: it is estimated that between 50-80% of women experience some form of back pain during pregnancy. There are varying degrees / levels back pain can take when you are pregnant. It may just become a little bit stiff and achy as a result of the increase in weight and accompanying postural changes. This may be a low back pain, or commonly pregnant women get pain between their shoulder blades, in their mid-back or around their ribs.
This type of pain can often be rectified using mobilisation techniques, soft tissue release, and exercises specific to the problem. Sometimes strapping techniques can be used to help alleviate pressure from certain muscles or structures.
During pregnancy, some women develop more serious back problems, known as Pelvic Girdle Pain (PGP) or Symphysis Pubic Dysfunction (SPD). This again can take different levels of severity, sometimes resulting in having to use crutches, or even in very severe cases, needing a wheelchair. If such a problem is caught early, the correct Physiotherapeutic treatment can make a tremendous difference in improving the pain, and often relieving it completely, although this does depend on a number of factors.
What is PGP or SPD?
The pelvis is the largest bony part of the skeleton, made up of 2 halves, connected at the front by a fibro-cartiliginous joint called the symphysis pubis (SP). During normal conditions very little movement occurs at this joint, but the pregnancy-related hormone, relaxin, softens the ligaments of the SP at the front of your pelvis and the sacro-iliac joints (SIJ) at the back of your pelvis in order to facilitate the passage of your baby during labour. As a result, there is a greater laxity of these joints during pregnancy, and for up to 3 months afterwards.
This laxity, paired with a biomechanical hip and/or lower back problem can give riseto pain and symptoms in one or all three of the afore-mentioned joints. The pain may also travel down the inside of your thighs or between your legs.
Other possible symptoms include:
Pain when rolling over in bed
A waddling gait
Unable to stand on one leg
Clicking or grinding in the pubic area or around the SIJ
Difficulty lifting or opening the leg
Difficulty getting into or out of the car, and struggling to get from sitting to standing
What does treatment involve?
Your physiotherapist will conduct a full assessment of your signs and symptoms and your patterns of movement. She will determine if your pelvis is out of alignment and then perform gentle and safe mobilisation techniques to re-align any abnormalities. Advice and self-help tips according to your condition will also be given. In some cases acupuncture may be used.
Problems and Pain post- pregnancy
During your pregnancy, your posture and muscle strength changes dramatically. Pregnancy and delivery can have a significant, and long lasting, impact on the abdominal wall ultimately affecting both the form and the function of the trunk and thus performance across multiple tasks (walking, running, continence, breathing etc).
As a lady, post-pregnancy and delivery, you may seek the attention of a personal trainer for exercise instruction, unaware of the potential dangers of returning to sport without a proper physical examination. Returning to certain sport too quickly can result in a variety of problems, from back pain to uterine prolapse as a result of a weak pelvic floor and non-optimal muscle synergies, post- pregnancy. Physiotherapists training in the rehabilitation of the abdominal core, are the profession best suited to providing this care. Annelies Wymer has spent the past 8 years specialising in Pregnancy and post natal problems and would be happy to assess you and guide you in your return to exercise, advising you how to get your stabilising muscles firing in an optimal fashion and improving your posture for a possible next pregnancy.