Lumbopelvic Pain in Pregnancy

Incidence

Approximately 70% of women experience back or pelvic pain during pregnancy, known as lumbopelvic pain.  Lumbopelvic pain typically occurs later in pregnancy, between 5 – 7 months.

Women who have pre-existing low back pain prior to pregnancy, are at higher risk of developing pregnancy-related low back pain.  This can become debilitating, affecting the expectant mother’s ability to mobilise comfortably, sleep, work or socialise and can often lead to increased stress and anxiety.  In up to one-third of cases, lumbopelvic pain does not alleviate postpartum and can continue for up to 1 year.

What causes it?

Lumbopelvic pain during pregnancy can be multifactorial but is generally due to the changes which occur in the woman’s body during pregnancy.

These include:

  • Hormonal changes – increased relaxin and oestrogen create laxity in the ligaments which support the joints of the pelvis.
  • Weight gain – increased stresses on the lumbar spine and pelvis due to increased weight.
  • Postural changes – as the baby grows, the centre of gravity shifts further forward, causing the pelvis to tilt forward, which causes an increased curve of the lumbar spine.

Should I see a physiotherapist?

Physiotherapy can help to alleviate symptoms, through exercise prescription, advice on how to alter daily activities to reduce pain, education, bracing and manual techniques.

There are several things a woman can do to reduce and prevent lumbopelvic pain during pregnancy:

  • Avoid prolonged sitting – get up and move around regularly.
  • Avoid prolonged static standing – When preparing a meal you can alternate between sitting at the table and standing.
  • Avoid heavy lifting where possible – if lifting is necessary for childcare then ensure correct lifting technique i.e. avoid bending from the spine. Bend at the hips and knees and push through your heels to return to standing.
  • Ensure good sitting posture, particularly if you work in a desk-based role.
  • Exercise – This can be land-based such as walking or Pilates, or water-based such as swimming or aqua aerobics.

References

Pregnancy and Low Back Pain: Physical Therapy Can Reduce Back and Pelvic Pain During and After Pregnancy. (2014). Journal of Orthopaedic & Sports Physical Therapy, 44(7), 474–474. doi:10.2519/jospt.2014.0505

Water-gymnastics reduced the intensity of back/low back pain in pregnant women (Kihlstrand, B, Nilsson, & Axelsson, 1999)

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