Editorial ↵

Back pain in pregnancy

Backache during pregnancy is a common problem and affects more than 80% of pregnant women at some point during their pregnancy. Backache can range from mild pain associated with certain positions or specific activities to chronic back pain. Women with pre-existing lower back problems are at higher risk for back pain, and their back pain can occur earlier in the pregnancy. The good news is that usually, most backaches in pregnancy will ease after childbirth.

Common Causes of Backache during Pregnancy –

  • Low backache – Vit D deficiency, calcium deficiency, osteopenia, poor posture, wearing high heels, lack of exercise, complete bed rest.
  • Upper backache – Vit D deficiency, calcium deficiency, poor posture, prolonged work on computer with abnormal height of keyboard (too high), wrong bra size leading to tightness.
  • Generalized muscular and bony pains – Vit D and calcium deficiency, lack of exercise.

It is vital to distinguish musculoskeletal back ache from the backache associated with cervical effacement and possible preterm labour. During the last trimester of pregnancy, the cervix “ripens” or changes to prepare for labour. This change, also known as effacement, can also be the cause of backache. Hence, it is important to get checked by your doctor to rule out this possibility. Preterm labour is especially likely if you are carrying twins, have previously had a preterm delivery or if you are also experiencing some spotting or bleeding. Any such symptoms along with backache should be taken seriously and a visit to the doctor is mandatory to rule out preterm labour.

  •  Practice good posture: As the baby grows, the centre of gravity shifts forwards, which causes a pregnant woman to lean backwards. This causes a strain on the muscles of the lower back and this can be avoided by following some good posture practices –
  • Stand up straight and tall
  •  Hold your chest high
  • Keep your shoulders back and relaxed
  • Use a wide stance for good support while standing
  •  If standing for long, use a low step stool for one foot and take breaks o Choose a good chair with lumbar support, or place a small pillow behind
    your lower back.
  •  Prop up your feet on a low stool, this relaxes your back
  • Wear low heeled shoes or slippers with good arch support.
  •  A maternity belt also supports the expanding tummy and may help
  •  Lift correctly – While picking up something from the floor, do not bend from the back, squat down and sit. Avoid lifting heavy weights.
  •  Sleeping position: Sleep on your side, not flat on your back, especially after 26 weeks. Using a pillow between your knees and below your bump as supports also helps.
  • Supplements of Vitamin D and Calcium: A large number of women are deficient in Vitamin D pre-pregnancy and during early pregnancy. This leads to a serious reduction in the bone density, esp. in the lower spine. Hence, check your Vitamin D levels in early pregnancy and correct the deficiency, if any. Take regular Vitamin D supplements along with a good calcium intake (diet and supplements). 1000 IU of Vitamin D and 500 – 1000 mg of calcium per day is necessary for maintenance. In addition, this should continue
    throughout lactation as well.
  •  Local treatments: Try using ice packs or head pads to reduce the pain. You can start by putting cold compresses (such as a bag of ice or frozen vegetables wrapped in a towel) on the painful area for up to 20 minutes several times a day. After two or three days, switch to heat – put a heating pad or hot water bottle on the painful area. Be careful not to apply heat to your abdomen during pregnancy. You can use local balms/ ointments containing methylsalicylate, but anti-inflammatory ones like ibuprofen or diclofenac gels are not allowed, esp. in the third trimester.
  •  Exercise: Regular exercise strengthens muscles and boosts flexibility. That can ease the stress on your spine. Safe exercises for most pregnant women include walking, swimming, and stationary cycling. Your doctor or physical therapist can recommend exercises to strengthen your back and abdomen.
  •  Yoga: Certain pregnancy yoga postures could help in reducing back stress. “Cat and camel” posture, “vajrasana”, “bridge” pose or “kandarasana” are some such postures that relieve lower back pain.
  •  Counseling: If back pain is related to stress, talking to a trusted friend or counselor may be helpful.
  •  Acupuncture: Acupuncture is a form of Chinese medicine in which thin needles are inserted into your skin at certain locations. Studies have shown that acupuncture can be effective in relieving low back pain during pregnancy. Check with your health care provider if you’re interested in trying it.
  •  Chiropractic: When performed correctly, chiropractic manipulation of the spine can be safe during pregnancy, but consult with your doctor before seeking chiropractic care.