Vivek Panikkar, FRCS
An estimated 50% to 80% of women experience some form of back pain during pregnancy. This pain may be a mild pain that only happens with specific activities. It may also be a more severe acute (short-term) back pain or even chronic (long-term) back pain. The two main types of back pain pregnant women experience are low back pain and posterior pelvic pain.
Low, or lumbar pain during pregnancy is generally located above the waist in the center of the back. This low back pain may or may not be associated with pain that radiates into the leg or foot. In general, lumbar pain during pregnancy is similar to low back pain experienced by non-pregnant women. This type of pain typically increases with prolonged sitting, standing or repetitive lifting. The highest incidence of low back pain in pregnancy occurs between the fifth and seventh month of pregnancy. However, in some cases, pregnancy pain in the lower back can begin as early as eight to 12 weeks into the pregnancy. Women with pre-existing low back problems are at higher risk for back pain, and their back pain may occur earlier in the pregnancy.
Posterior pelvic pain is four times more prevalent than lumbar pain in pregnancy. It is a deep pain felt below and to the side at the waistline, and/or below the waistline on either side across the tailbone. This pain may be experienced on one or both sides. Posterior pelvic pain in pregnancy can extend down into the buttock and upper portion of the posterior thighs, and does not usually radiate below the knees. It can be associated with pubic pain. The pain does not quickly resolve with rest, and morning stiffness may also be present.
Posterior pelvic pain during pregnancy can be brought on or aggravated by the following activities:
- Rolling in bed
- Sitting and rising from a seated position (such as getting in and out of cars, bathtubs, bed)
- Lifting, twisting, bending forward, running and walking
Jobs that involve prolonged postures at extreme ranges (such as sitting at a computer and leaning forward, or standing and leaning over a desk or workstation) increase the risk of developing pregnancy pelvic pain. It is a myth that previous high fitness levels prevent posterior pelvic pain while pregnant.
To prevent or minimize the risk of pain, follow these simple guidelines:
- Adopt a good posture
- Wear low heeled shoes
- Use a maternity support belt
- Sleep on your side
- Lift properly
- Try a warm or cold massage
