Pregnancy and Back Pain

First it was the nausea, then the skin breakouts, the swollen feet, the forgetfulness, the heartburn, the klutziness and now the back pain. Sound familiar? I agree, it’s not fair.  But don’t despair; there is help.

Back pain affects 50% of pregnant women, and 30% of those will become disabled by it.  Many of those individuals with back pain will continue to experience it well after their pregnancy.  For those women, having the baby is not the cure for their troubles.

Now the causes of back pain can be varied.  Unfortunately, being pregnant does not make you immune from any of them.  However, 80% of women who develop back pain during pregnancy will have a pelvic imbalance as the source.  There are several reasons for this.  At eight to ten weeks of pregnancy, the corpus luteum (part of the ovarian system) starts to secret a hormone called relaxin.  Relaxin helps to loosen the ligaments of the pelvis. As the baby grows and then ultimately comes down the birth canal, the pelvis is able to expand without doing any significant damage to the supporting soft tissues.  Childbirth puts stress on the pelvic ligaments.  If these ligaments are not properly prepared, there would be even more difficulties during childbirth.

Ligaments, the glue that holds the joints together, have sensory nerve endings that tell us where our body is in space. That’s why we can walk on uneven terrain without stumbling because we have that constant feedback mechanism (reflex) going on behind the scene to assess and correct foot placement. We are unaware because this happens automatically, reflexively. When the ligaments are affected by relaxin, they lose some of their feedback efficiency and your body does not react as it normally would, making you feel clumsy. But, I digress; this article is about back pain and pregnancy.

As your pelvic ligaments relax, they lose some of their ability to keep your pelvis in place. Combining this less stable system with disproportionate weight gain, you have a recipe for a shifting pelvis and low back pain. The pain results from stress on the joint surfaces and ligaments that, in turn, can cause the muscles to tighten up and spasm. This will often cause irritation to the sciatic nerve, resulting in the dreaded sciatica, made infamous by the nasty leg pain that results.

“But I thought the baby was on a nerve,” you say.  Actually, no. The baby, the toddler, the adolescent, and the teenager will most certainly get on your nerves, but in this case, the kid is innocent. The baby is in a fluid-filled sac called the uterus and is well protected; therefore, it is highly unlikely that your baby will cause any sustained pressure on your spinal nerves.

So now that we understand the likely cause of low back pain in pregnancy, we can treat it.  But just to be clear, I have made a lot of assumptions here in order to facilitate this conversation.  A thorough history and exam by someone experienced in treating pregnancy and low back pain is imperative for an accurate diagnosis and implementation of an effective treatment plan.

It stands to reason that if a pelvis has shifted or is stuck, putting stress on pain-sensitive tissues, it could be corrected by shifting that pelvis back into proper alignment, restoring normal function.  Pressure comes off those involved structures and pain is relieved.  This is the approach most chiropractors take to treat the pregnant female with sacro-iliac joint pain and sciatica.  Chiropractic is a safe, low-cost, low-tech, gentle, highly effective approach to correcting these problems.  Being on staff at Women & Infants Hospital, I have had the opportunity to treat hundreds of pregnant women with low back and neck pain. I have witnessed firsthand the relief that is possible when pelvic function is restored.

To be sure there are some, but very few, complicated pregnancies that may be inappropriate for certain procedures.  If there are ongoing complicating issues, consultation between your OB-GYN and your chiropractor is a must before treatment begins.

Having your spine evaluated and treated by an experienced chiropractor during pregnancy is a safe, effective way to take care of any ongoing neck or back problems and will help prepare you for the childbirth experience.


Dr. Andrew Crellin is a chiropractic physician and licensed physical therapist in West Warwick, RI. Dr. Crellin utilizes skill sets from both disciplines in his treatment program. He is a past president of the Rhode Island Chiropractic Society and is currently on staff at Women & Infants Hospital. He can be reached at 821-6091

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