In addition to being common in general population (it is estimated that as many as 80% of US adults will experience a back problem at some point in their life – source: American Chiropractic Association ) back pain, and especially lower back pain, is also common in pregnancy. Most studies show that as much as 50% of all pregnant women will experience it.
And one particular Swedish study even showed that 79% of pregnant woman (who participated in the study) were unable to continue their work due to an intense lower back pain.
So what does this information tell us? Firstly, that back pain is very real and it will probably affect one in every two pregnant women. And secondly, it makes us wonder are we doing everything we can to predict and prevent it?
In the following text we will discuss a study that showed just that – that we can predict future back pain during pregnancy!
Causes Of Back Pain
In most cases, back pain will start in the second half of the pregnancy. There are many different causes which may contribute to it, but it will appear mostly due to changes your body is going through.
The most common causes are:
Changes In Posture
As the pregnancy progresses, the uterus will expand and actually shift your body`s center of gravity. This will stretch and weaken your abdominal muscles. As a result, your body will try to overcompensate, make some small adjustments to your posture and the way you move. This will put additional strain on your back and, often, result in pain.
During a healthy pregnancy, woman will gain up to 35 pounds. This additional weight will put more stress on the spine and especially the lower back. Added weight means more work for your muscles and joints, so the pain in your back might intensify towards the end of the day.
Changes In Hormones
Fortunately, our body is smart enough to prepare itself for the process of giving birth. Crucial part of this process is the production of hormones which will loosen up the joints and ligaments that connect the pelvis to the spine. Naturally, loosening up these joints may cause some instability and lack of support for the spine and cause pain.
Separation Of Rectus Abdominis
Rectus abdominis muscles are a pair of long muscles stretching across the entire abdomen. They are commonly called abs and they are prominent in muscular individuals. The main function of these muscles is flexing the torso, but they also play an important role in stabilizing the back.
As the pregnancy progresses, these muscles may separate and cause lack of stability in the back. This lack of stability may affect posture and cause back pain.
Back muscles may become tense for many different reasons:
- Lack of exercise/stretching or
Whatever the cause may be, tension in your back muscles can cause painful spasms, which can intensify during pregnancy.
How Do You Predict Lower Back Pain In Later Pregnancy?
Back to the study we mentioned at the beginning of the article. The official name of the study is “Functional changes in back muscle activity correlate with pain intensity and prediction of low back pain during pregnancy,” and if you are interested in reading it, here is a link to it – The Study.
The reason we decided to discuss it, rather than just pointing people directly to it is that it can be a bit difficult to understand. After all, this is a medical study and it is written in medical jargon, so wrapping your head around it might require a lot of time and effort.
Anyways… The main goal researchers set out for themselves was to establish if there was a connection between lumbar motion patterns (movements in the lumbar region) and lower back pain in pregnant woman. Of course, the answer was yes, otherwise we wouldn`t be talking about it today :)
It is important to note that the study included 32 pregnant woman with lower back pain, and a control group of 21 with no back problems. Women were examined at 20 and 36 weeks into pregnancy.
Now, in addition to clinical examination and a questionnaire, researchers measured electrical activity of the muscles in the lumbar region during a forward flexion and extension, with an EMG. And this is where things get interesting (sorry if we were boring you up until this point). If you look at the first diagram below, you will see an EMG pattern of a healthy, pregnant woman with no back pain:
The graph shows electrical activity of back muscles located in the lumbar region, divided into 3 stages:
- Forward flexion (bending over)
- Relaxation (bent over) and
- Extension (going back up)
Notice how muscle electrical activity drops in the second stage (in relaxation).
And now, take a look at the second diagram:
As you can see, the graph is also divided into three stages, but now we can spot an intriguing difference – in the second stage electric activity of the muscles does not drop, what this means is that the muscles are still tense, even in relaxation.
This study showed, for the first time, that increased muscle activity in forward flexion (in relaxation) predicts and is related to lower back pain in the future.
This simple EMG test is, typically, covered by health insurance and it should be used to identify those women with high risk of pregnancy-related lower back pain. Informing future mothers that they may suffer from lower back pain during their pregnancy should motivate them to engage in activities which could prevent it or, at least, make it more bearable.
What You Can Do To Prevent Back Pain
Know that, if you`ve already experienced lower back pain, it is not too late, there is still much you can do to alleviate and prevent future back pain. You should:
- Practice proper posture – make sure you mind your posture both when you are sitting and standing up. You might think that lounging in your chair all day long may help your back, but it may do exactly the opposite. Which is why you should get a chair with proper back support, a firm cushion and a foot rest. When standing – keep your head up high, shoulders back and relaxed but, if possible, avoid standing for long periods of time
- Lifting – just avoid it, your body and back don`t need the additional strain
- Massage – massage is awesome for relaxing your back muscles and relaxing your body as a whole. You can either ask your partner to do it or hire a professional
- Acupuncture – there is still some research that needs to be done on this field but the current state of affair is this – in most cases it will help, so why not give it a try
- Additional support – it may be a good idea to consider a back support belt, it will help support your back and relieve pressure off your muscles and joints
- Sleeping – you should sleep on your side. I know that changing your sleeping habits might be challenging at first, but you must make an effort to do so. Sleeping on your back will put a lot of strain to it and might even worsen the pain
- Physical activity – physical activity will not only make your muscles stronger but may also help you deliver the baby faster, with less trouble. Of course, don`t try anything crazy… try just walking or swimming. And if you are interested in some other strengthening or stretching exercises, it would be best to find an expert in your area and consult with them
- Yoga – if you are not already practicing yoga, now might be a good time to give it a go, there are a lot of exercises that may help you with your back condition. One of these is pelvic tilt, we mentioned it in our Waist Pain article from last week
- Changing your footwear – of course, you will want to stay away from high heels, but you should avoid completely flat ones as well. Experts say you should go for shoes with a 2-inch heel
- Heat and cold – if you experience a painful spasm in your lower back, you should use heat. Ice is usually applied when there is an injury present, redness or hot and swollen tissue. Learning when to use heat and ice can prove to be beneficial
- Image credit – “Functional changes in back muscle activity correlate with pain intensity and prediction of low back pain during pregnancy” study at http://ncainternational.com/pdf/sihvonen.pdf
- “Pregnancy Illustration” designed by Freepik