Bringing a new life into the world has a big impact on a woman’s body, including back pain during pregnancy that often goes unaddressed. While as many as 80% of pregnant women have back pain, only about 24% of women in the U.S. get care! In an effort to help, chiropractors within the SpineCare clinics at the Froedtert & the Medical College of Wisconsin health network use a multidisciplinary approach to help expectant moms manage their back pain and stay active during pregnancy.

The price that Mother Nature exacts from women to generate a new life is significant. While research is ongoing, it is increasingly clear that pregnancy has a big influence on women’s bodies. Historically, pregnant women have just lived with back pain during pregnancy and a heightened overall risk for chronic back pain, hip and knee arthritis and pelvic floor dysfunction. As knowledge advances, mothers-to-be should know that getting timely help can make a big difference.

Why Does Lower Back Pain Occur During Pregnancy?

The body changes in multiple ways as pregnancy progresses, and science has shown that these effects, including labor and delivery, persist well after babies arrive. Some of these effects are:

Biomechanical — With added stomach weight, the shoulders must be thrown back just to stand up and walk. This causes a “sway back,” as the curve in an average pregnant woman’s lumbar spine increases 60% during pregnancy, resulting in a lot of spine stress, particularly in the low back.

Hormonal — Most women know about progesterone, but pregnancy causes a major jump in another hormone: relaxin. Among its other effects, relaxin softens the cervix and ligaments (the bands that knit our joints together) throughout the body, but particularly in the pelvis as the body prepares for labor and delivery. As pregnancy advances, ligament stretch can reduce joint stability and increase stress on the sacroiliac (S.I.) joints and the pubic cartilage.

Muscular — Pregnancy forces the back and pelvic floor muscles to work harder to maintain upright posture. This also stretches the stomach muscles making them less effective at supporting the spine.

Energy — Fatigue can affect posture with related strain on the entire spine. In addition to diet and exercise, managing daily activities and work is often a balancing act that requires problem solving.

Preventing Lower Back Pain During Pregnancy

Despite the high risk for pregnancy-related back and pelvic pain, steps can be taken to minimize it. The American College of Obstetrics and Gynecology recommends that pregnant women get 150 minutes of moderate intensity exercise per week.

While exercise can help prevent back pain during pregnancy, it can be pretty tough to be active when back pain gets in the way. Managing the pain is important, since we know that women who remain fit during pregnancy have an easier labor and delivery, and their babies tend to be healthier. Moderate intensity exercise can be as simple as walking or swimming. Swimming also reduces load stress on the spine and pelvis.

As an added benefit, walking improves blood flow to the placenta and back to the mother’s heart, which also must work harder during pregnancy.

Peripartum Back Care: An Integrated Approach

If back pain during pregnancy is beginning to impact your daily routine or job, it’s likely that you need care. While back and pelvic pain in pregnancy may be severe and alarming, early access to a spine specialist at a SpineCare Clinic can help with a differential diagnosis and to lessen your fears.

Depending on the severity of your condition or how far your pregnancy has progressed, you may also meet with a physical or occupational therapist for self-help tactics, including exercises to relieve back pain during pregnancy and simple advice on managing day-to-day activities, like caring for other children.

Our Vision

From its inception, SpineCare has prioritized collaborative care. Our program is aligned with obstetrics and gynecology (OB/GYN) specialists throughout the Froedtert & MCW health network. Our goal is to help women manage pregnancy-related back and pelvic pain as effectively as possible and almost always without the use of medications.

The doctors of chiropractic (DCs) at SpineCare prioritize communication with the attending obstetrician. Communication and patient education, with a focus on the latest scientific evidence, has created a unique support system for our patients. We find this approach both effective and reassuring for moms-to-be.

Academic patient care at the Froedtert & MCW health network keeps us a step ahead. Faster access, continuous education and safe heath care options are critical. Our patients have been thrilled to find that back pain need not define their pregnancies. We find great joy in helping mothers nurture a healthy life without having to sacrifice their own health and wellbeing!

About the Author

Gregory L. Whitcomb, DC, is a chiropractor within the Froedtert & the Medical College of Wisconsin SpineCare Clinics, where he led the development of a program for pregnancy-related axial pain alongside the department of obstetrics and gynecology.