Pregnant women commonly suffer from lower back pain, pelvic girdle pain, or both. More than 30% of pregnant women report their first experience of lower back pain during pregnancy, while 90% of pregnant women experience pain. The cause of the pain experienced may be multifactorial in nature. Trigger factors include, but are not limited to, biomechanical changes (for example, the change in centre of gravity due to weight gain leading to an increase in the reverse C-shaped curvature of the lumbar spine which causes excess strain on the discs, joints, ligaments and muscles), change in hormones (for example, relaxin that helps preparing the human body for giving birth by producing ligament laxity), metabolic factors, as well as trauma.
Symptoms of pregnancy-related lower back and pelvic pain may already be experienced during the first trimester. These include a dull ache or sharp, burning pain in the lower back, unilateral lower or mid-back pain, pain that radiates (tingling sensation) into the buttock, back of thigh, hip, leg or foot, pubic symphysis pain, or compromised endurance capacity for standing, sitting and walking. Round ligament pain is also a great contributor of pain during pregnancy due to strain caused by a forward tilted pelvis. This type of pain is located in the lower belly or groin area and can be experienced unilateral or bilaterally. It most often occurs during the second trimester and is typically described as an achy, crampy, sharp, stabbing, stretching or pulling sensation.
Risk factors for developing pregnancy-related lower back or pelvic pain are frequently associated with having a history of lower back pain, previous pelvic trauma, multiple pregnancies, as well as a high work load.
Pregnancy-related lower back or pelvic pain can compromise activities of daily living and cause substantial disability for many patients. Lower back or pelvic pain should not be viewed as a normal and acceptable part of pregnancy, since this belief often cause a delay or not seeking care at all, often contributing to the development of chronic pain postpartum.
Chiropractic care is both safe and effective during prenatal and postpartum periods. Treatment for pregnancy-related lower back or pelvic pain typically includes manual therapy such as spinal manipulative therapy, mobilizations, soft tissue techniques, stretching and strengthening exercises, as well as home care advice including ergonomic tips for carrying, lifting and maintaining proper posture.
In an observational prospective cohort study of 115 patients published by Peterson, Mühlemann and Humphreys in 2014, the majority of pregnant patients undergoing chiropractic treatment reported clinically relevant improvement at every session evaluated.
Apart from chiropractic care, you can also try the following at home to reduce the frequency and intensity of pain:
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- Use a maternal support belt or supportive taping
- Sleep with a pillow between your knees
- Try avoid crossing your legs while seated as it causes a shift in the pelvis and stresses the round ligament on one side
- Try using a heat pack or taking a bath for achy muscles
- Remember to do your stretching and strengthening exercises