Many expectant mothers who are preparing to take their baby in their arms complain of back pain. These pains can become unbearable, especially as the birth approaches. By paying attention to some important points, expectant mothers can go through this process comfortably.
Memorial Bahçelievler Hospital Gynecology and Obstetrics Department Op. Dr. Emine Barın gave information about low back pain and precautions to be taken during pregnancy.
The most common pains during pregnancy are pain due to tension or relaxation of the muscles and joints around the pelvis or waist region. These can be both together. Low back pain during this period can occur due to biomechanical, hormonal, vascular or other reasons. The incidence of low back pain during pregnancy is between 40-60 percent. However, in 15-20 percent of these cases, there is severe back pain that can affect daily life.
Studies show that those with more waist pit before pregnancy are prone to low back pain during pregnancy. Excessive weight gain in a short time can cause back pain. During pregnancy, growth in the uterus may cause an imbalance in strength between the abdominal and back muscles, or the weight of the enlarged uterus can directly cause compression. During pregnancy, relaxin, estrogen and progesterone serum levels increase. High relaxin level may contribute to joint relaxation and estrogen may contribute to the development of low back pain by increasing the effect of relaxin. It causes compression on large vessels such as the growing uterus and aorta, and ischemia and metabolic disorder can cause back pain. In addition to these, work and psychological factors can cause back pain. Transient osteoporosis in the hip or surrounding bones (especially in pregnant women with vitamin D deficiency, softening and fractures in bones due to increased deficiency), muscle strain may also be the cause of pain.
Low back pain in pregnant women usually begins in the middle of pregnancy (4th – 6th months). Because the main causes of low back pain intensify in these months. These are listed as follows:
- The uterus becomes heavy and the body shifts its center of gravity, pulling it forward
- Gaining weight
- Pregnancy related posture disorders
- Loosening in waist joints due to increased hormones during this period.
Since the factors that cause low back pain will increase more towards the end of pregnancy, back pain has become more severe in recent months. However, mild back pain can be seen in some expectant mothers in the first months of pregnancy. If low back pain is very severe in the first months of pregnancy, it should be kept in mind that there may be a reason other than pregnancy (such as lumbar hernia) and an evaluation should be made in this direction.
In the vast majority of expectant mothers, pregnancy is usually at the 4th-6th day of pregnancy. Since the back pain seen in months passed after birth to a great extent; It is seen as an inevitable complaint of pregnancy by obstetricians. It is observed more frequently in those who are overweight during pregnancy, those with spine disease, multiple pregnancies, and those with previous lumbar hernia.
Some pregnant women may experience low back pain in the first days of pregnancy. This situation can occur due to increased hormones. Back pain caused by the growing uterus and hormones in the first 3 months of pregnancy can be considered as miscarriage risk and cause anxiety in pregnant women. If the groin pain during pregnancy occurs together with low back pain, there may be a risk of miscarriage. Vaginal bleeding is often observed with or after pain. Back pain in the last 3 months of pregnancy may be a sign of premature birth. Low back pain in the last month can be confused with labor pains. A doctor must be consulted to differentiate this.
The risk of developing lumbar hernia increases a little during pregnancy. However, more importantly, hernias that normally do not cause back and leg pain can cause back pain due to pregnancy. Leg pain in pregnant women develops due to direct pressure on nerve roots or reflected pain. In addition, pain can be seen as a result of ischemia (vascular compression) in the nerves as a result of pressure on the nerves. In the last three months of pregnancy, leg pain may occur as a result of the pressure of the aggravated uterus on the arteries and veins. In this case, tests for circulatory disorders should be requested. The pressure of the uterus on the ureters can cause serious health problems and should never be neglected.
Although being fit before pregnancy and having strong abdominal and back muscles decrease the possibility of low back pain; It does not relieve pain around the hip and pelvis. Some people have more relaxin hormone secretion. This hormone increases the pain in these areas. To spend the pregnancy period more comfortably;
- Try not to gain more weight than necessary.
- Get enough vitamin D and calcium.
- Do not stand still for a long time, walk often.
- Maintain the proper posture of your body to reduce the tension and strain on your muscles.
- Rest often during the day. Change positions frequently while sitting. Use a lumbar pillow while sitting on the chair.
- Avoid sleeping on your back if your back hurts more at night. Lie on your side and support your stomach with a pillow.
- Avoid movements that will tire your hips and waist.
- Try to relax your muscles by stepping under one foot during long sitting and standing.
- Do breathing and relaxation exercises.
- Avoid wearing high heels.
- You can wear a waist corset under the doctor’s control.
- When you have a lot of pain, you can use medication under the supervision of a doctor.
One of the most common ailments during pregnancy is back pain.
Low back pain during pregnancy occurs due to changes in the body starting from the first weeks. While it is usually annoying, it does not indicate a major problem. However, if it occurs with other symptoms and repeats in a way that limits daily activities, we may need to consult a specialist. With the right precautions, it is possible to overcome the pregnancy period without back pain.
The uterus itself is a very powerful organ and has a very complex structure. Normally the size of a fist, the uterus grows about 1.5 times on days of menstrual bleeding. In pregnancy, it starts to thicken and expand from the first weeks, and as the baby grows, it grows by stretching enough to easily grasp it. Muscles and bones in the waist and pelvis area can be affected by changes in the uterus. This is the reason why back pain is experienced during menstrual periods; The back and spine muscles connected to the muscles around the uterus can be affected and cause pain sensation. The uterus that grows and changes in the same way during pregnancy can affect the muscles in the lumbar region.
Gaining weight: A total weight gain of 10-15 kg during pregnancy is considered normal, in some cases even more weight gain. The weight gain causes more burden on the skeletal and muscular system and pain may occur around the spine, especially in the lumbar region.
Pregnancy hormones: Some hormones that are secreted all the time in the female body start to work differently during pregnancy and cause various changes. In particular, the hormone relaxin prepares the body for birth by helping the muscles and joints to relax and expand. As the pregnancy progresses, the hormone relaxin, which increases in the body, can affect the functioning of the muscles and joints around the waist and the ligaments between the vertebrae, triggering pain.
Change of posture: As the baby grows, the center of gravity of the body changes and the spine tends to lean forward. If the waist muscles are not strong enough, this may cause back pain.
Stress: Stress and psychological tensions directly affect our body. Stress and pain during pregnancy are also closely related. Physical tensions caused by stress can cause pain in the vulnerable lumbar region.
Wrong movements: Body balance and center of gravity change during pregnancy. The bending and tilting movements that you can easily do while you are not pregnant can be difficult during pregnancy, especially in the last weeks. Suddenly doing a move that strains your body can cause muscle and nerve compression, causing back pain.
Back pain due to hormones, stress and weight gain can be seen from the first weeks of pregnancy. However, since body weight increases especially after 24-26 weeks of pregnancy, it is normal to encounter more frequent back pain in the last trimester (last three months).
You don’t have to worry about back pain that goes away with rest. However, if you have a recurrent low back pain that keeps you from your daily work, you should consult a gynecologist or family health center. If your doctor deems necessary, he or she can refer you to a physiotherapist.
To prevent and relieve back pain during pregnancy, you can try:
- Support your leg by putting a pillow between your knees while lying down. This position will prevent your leg from putting a load on your waist and will relax your lumbar vertebrae and muscles.
- Avoid gaining excess weight. For a healthy and comfortable pregnancy, it is recommended that you do not gain more than 10 to 12 pounds.
- Strengthen your waist and back muscles. Strong muscles around the waist will support your spine, improving your posture and preventing pain. For this, you can attend pregnancy pilates or pregnant yoga classes and work with an expert.
- If you are experiencing stress-related pain, take a warm shower, lie on one side of your legs with a pillow and warm your waist. Hot water and hot compress will help the muscles in the area to warm up and relax.
- Practice yoga regularly. Pregnant yoga helps you cope with stress by improving your breathing, corrects your posture and helps you to be more balanced by strengthening your body.
- Pay attention to your actions. Be careful not to put any strain on your waist while you lie down or stand up. Move by evenly distributing the entire weight of your body.
If you are past 38 weeks and you have a sudden onset of back pain, it may be a sign of birth, albeit unlikely. Uterine contractions can also affect the muscles around the waist, causing a feeling of low back pain. If you think your labor may have begun, relax, rest and notify your obstetrician or midwife.
Compiled by: Duygu islamoglu