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The most important element in treating back pain
during your pregnancy is avoiding the back pain. This
means starting on a regimen of back exercises during
the first few months of your pregnancy and maintaining
those for the duration of your pregnancy. For some
women, this may not be possible; others can do those
exercises until their term. The other important element is maintaining your weight and not gaining unwanted extra pounds during the pregnancy, which only will increase the stress on your back. In order to keep your back strong, and to keep your weight down, I strongly suggest that you practice pelvic tilt exercises—particularly those that use exercise both for leverage and to increase strength.
An important visual for many women is the concept of your center of gravity. Normally, your gravity center is in your mid-abdominal area, that area that we frequently refer to as your core. Imagine as you go through your pregnancy, your center of gravity moves constantly forward with additional weight of an expanding uterus and a healthy growing fetus. Now, imagine the extra strain that your back muscles have to deal with as the center of gravity moves forward. For many women, this visual helps remind them to keep their back strong, keep their weight down and continue exercising.
Back pain or discomfort associated with pregnancy is to be expected by most women, and the back pain can be experienced during any point in your pregnancy; however, it most commonly occurs late in the pregnancy as the weight of the baby increases. Remember that you are not alone. The prevalence varies with different reports, but most obstetricians would agree that between 50 and 70 percent of all pregnant women experience back pain.
The unfortunate thing is that if the back pain occurs, it can disrupt your daily routine and interfere with a good night’s sleep. In order to avoid the back pain in pregnancy and to manage the pain in those who have developed it, several important steps can be taken. It is also crucial to point out that those women who are most at risk for back pain are those who are overweight, have had back pain prior to their pregnancy, and who did not have a regular workout routine to strengthen their back muscles prior to pregnancy.
The most common cause of back pain during pregnancy is due to additional weight that your back muscles support. This frequently leads to poor posture and excessive standing and bending, which in turn can trigger or escalate the pain you experience in your back.
Needless to say, one’s back is also frequently the weak spot in the body, and because of the changes in your pelvic area, you may experience an increase in back pain during stressful periods of your pregnancy. It is also important to remember that as your baby grows, it puts additional strain on your back, alters your posture and induces the cycle that may lead to back pain.
In order to prevent or at least manage these symptoms, I recommend that you use exercises, squat to pick up something rather than bending over to pick it up, and avoid high heels and other shoes that do not provide adequate support. Avoid sleeping on your back (in fact, try to sleep on your left side with a support pillow under your knees as much as possible). Wear a support belt on the lower abdomen, particularly during the last months of your pregnancy, and get plenty of rest with your feet elevated.
If, however, your back pain worsens, I frequently recommend that you use an ice pack or hot pack (depending on what seems to work best for you and depending on the recommendation from your obstetrician as to whether he or she thinks that you could have a trial of anti-inflammatories). I also find that many women benefit from massage therapy from a chiropractor. It is important to remember that if you develop increased or severe back pain that is abrupt or rhythmic cramping, you should see your health care provider immediately, as this may be a sign of preterm labor or a worsening condition actually related to your back.
For most women, I would again recommend that the best way to treat back pain during pregnancy is to treat it early and to begin with an approved exercise program to support your abdomen and back. Also, make sure you rest, eat properly and do not gain an inordinate amount of weight.
Have a happy, healthy baby and keep exercising your core. It’s the best way I know of to avoid that pain in the back.
Neurosurgeon Jack Stern, MD, PhD, FACS, is the founding partner of White Plains–based Brain & Spine Surgeons of NY (www.safespinesurgery.com). He’s been named to New York magazine’s list of “Top Doctors” for eight consecutive years.
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