Low back pain (LBP) and pelvic girdle pain (PGP) are experienced by roughly 50% of pregnant women. LBP is pain which occurs anywhere from the bottom of the ribs to bottom of your gluteal muscles (buttocks). PGP is any pain from the top to the bottom of your glutes however mainly centres around the base of the spine and the sacroiliac joints (the joint joining the pelvis and spine) as well as the symphysis pubis (joint at the front). It can occur at anytime during pregnancy but is more common in the 3rd trimester and postpartum period.
Why does this happen?
As the weight of the foetus increases, your body position changes (pelvis tilts forwards) placing a lot of stress on the low back. The muscles of your low back are shortened and therefore become tight and the glutes fatigue trying to cope with the increased load. In addition, the pressure of the foetus bearing down on your pelvis in combination with the hormone relaxin (which causes the ligaments around the pelvis to lengthen in preparation for birth) can lead to pelvic instability with pain and discomfort even during low level activity such as walking.
When will I get symptoms?
Women suffering with PGP and LBP often find the following activities/ positions difficult or painful to do (list not exhaustive):
- Walking
- Standing on one leg
- Opening legs wide i.e getting out of the car or turning around quickly with a wide stance
- Turning over in bed
- High impact exercise such as running
So, if you do start to struggle what can you do to limit the level of discomfort and pain?
Research has shown the following:
Exercise: Exercise during pregnancy does not reduce your chance of LBP and PGP but it reduces the severity during and following pregnancy. Specific exercises can help strengthen the pelvic and low back area to help support the growing foetus. Please see my examples below.
Massage: This is by far my favourite. In addition to getting a professional to treat you like myself, it is also of great benefit to get your partner to continue the work at home. Massage can be given daily (If your partner is happy to!). Not only does it relieve LBP but it is allows you to relax and it gives you and your partner quality time together before the birth.
Taping: Kinesiology tape (a soft tape) can be applied by a therapist to your low back/ bump. It works but overriding the pain receptors to the brain so that you experience less pain. The tape will stay on for a few days and you can shower in it which is great. It can then be re-applied when needed.
Chiropractic care – adjusting the spine and pelvis ensures it is moving correctly and that your body is in its best physical condition for labour. If joints are working better, then you are less likely to suffer from pain and stiffness.
Additional forms of pain relief – Using a Transcutaenous Electrical Nerve Stimulation (TENS) machine for short periods of time throughout the day can help alleviate the pain. These can be purchased on the high street but discuss with your healthcare provider. In addition, acupuncture and heat on the achy muscles can be very effective in reducing pain levels.
Additional Equipment – There are additional pieces of equipment to help you through the last few weeks of pregnancy such as low back belts/supports. Again please ask your healthcare provider for more details.
What should I do to reduce my risk of LBP/PGP
- Get regular preventative treatment from sports therapists/ chiropractors
- Use a pillow at night between your knees and when turning over
- Keep your legs together when getting out of the car
- Complete strengthening exercises for pelvic floor muscles and core
- Continue to exercise for as long as possible as long as pain free
- Avoid breaststroke when swimming
- Avoid standing on one leg
Remember – getting help early is better than waiting until you are in a lot of pain and discomfort.
I hope this blog has given you a little more insight into LBP and PGP during pregnancy. If you are suffering or know anyone who is then please contact us to book in with a sports therapist or chiropractor and we will do our best to ensure you have a comfortable pregnancy.
Bridget Higgs – sports therapist MSc
Reference: Davenport M.H, et al. Exercise for the prevention and treatment of low back pain, pelvic girdle and lumbopelvic pain during pregnancy: a systematic review and meta-analysis. Br J Sports Med 2019; 53: 90-98.