By Dr. Tom Cotter

Dr. Tom Cotter

Our first child coming in eight weeks and my wife is now coming in for regular visits to keep pregnancy-related back pain at bay. Pregnancy, as you can imagine, has been on my mind a lot. Pregnancy can be a wonderful thing. It brings new life, experiences, and memories into this world. Unfortunately, it can also have some unwanted side effects, one of those being back pain. Pregnancy causes back pain in 80 percent of women. Furthermore, back pain during a pregnancy is the highest predictor of future back pain. According to a 2004 study, 68 percent of women who experienced moderate-to-severe low back pain during pregnancy continue to have back pain after birth.

During pregnancy the body goes through several changes that make it more prone to back pain. The enlargement of the abdomen and increased weight of the baby causes the abdominal muscles to stretch to their elastic limits. As this happens, the hip flexors become shorter and tighter, which in turn inhibits the gluteal muscles. This results in hyperextension of the low back. In the upper back the enlargement of the breasts causes the shoulders to be pulled forward, rounding the mid-back and causing hyperextension in the neck.

These changes and the resulting back pain have widely been seen as simply a consequence of pregnancy and have largely been ignored, much to the detriment of mothers’ spines. A lot of the pain experienced is a result of repetitive microtraumas. Microtrauma is minor damage that, by itself, heals quickly and doesn’t become a problem. With a pregnant mother though, this event happens over and over, turning a microtrauma into significant pain. For example, as the weight of the baby increases and the hip flexors become tighter, preventing hip extension and inhibiting the gluteal muscles that normally counterbalance the hip flexors. The low back is now constantly hyperextended. Each time a step is taken or she leans backward, the back is further strained. If this happened with just one step it would not be a big deal, but this happens all day for several months leading to constant back pain.

The good news is if mothers start with specific exercises in the first trimester most of this pain can be avoided. If exercises are started during the second trimester pain can likely be reversed. Even if the mother doesn’t address her pain until the third trimester, pain can be minimized with ongoing care. Regardless of what point the exercises or therapies are added, the work done before birth helps tremendously postpartum.

It might seem as though all these postural changes are inevitable. “What can possibly be done?” It is quite simple, actually. Do the reverse of what the body does throughout the pregnancy. We start off with core exercises, such as front and side planks, to increase the integrity of the abdominal muscles. We give glute bridges and hip flexor stretches to prevent gluteal inhibition and keep the pelvis properly balanced. For the upper back, we give pec stretches and scapular retraction exercises to protect against the rounding of the mid back and neck hyperextension.

Back pain during pregnancy is a very common thing and it shouldn’t be. It is seen as hopeless and simply endured or masked with pain meds. Through specific treatments and simple exercises our patients have significant improvement of their pregnancy induced back pain. If you or someone you know is concerned about pregnancy0-related back pain, be sure to have them give us a call.

This sponsored column is brought to you by Active Health Solutions. At Active Health Solutions, we use the most current evidence-based protocols and techniques to functionally assess and treat patients with neuromusculoskeletal conditions (disorders of the nerves, joints, and muscles). Contact us today to schedule your appointment.