Dealing With Back Pain and Pregnancy: Causes & Tips for Relief

Having back pain during pregnancy is a fairly common finding, and a lot of women do complain about this.

Pain becomes pronounced during the latter part of the third trimester and can go on for some time after delivery. Most women blame the extra weight and the size of their body during pregnancy and the weight of the baby as the cause of their lower back problems. Even though there is some contribution from that, the lower back and hip pain often is caused by pain in a pair of joints called the sacroiliac joints or the SI joints in the back of the pelvis.

Understanding the Source of Back Pain During Pregnancy

To better understand the source of such pain during pregnancy, it helps to know the basics about SI joints. These joints attach two major bones in the back of the hip called the sacrum which is at the base of the spine and the ilium of the pelvis. These are weight-bearing joints and act as shock absorbers and stabilizers during walking. These joints are also a rather common cause of lower back and hip pain in men and non-pregnant women. In fact, it’s not uncommon to have SI joint dysfunction go unrecognized for a long time.

The reason for the pain particularly during pregnancy has to do with physiological changes unique to pregnant patients. A woman’s body undergoes a multitude of changes during pregnancy and this, combined with surges in various hormones and particularly one called Relaxin, bring about softening of ligaments in the pelvic area in anticipation of delivery. This relaxation can disrupt the stability of the SI joints leading to pain in the back of the hip and the lower back.

When Does the Pain Get Worse and Where’s It Typically Located?

The pain can become pronounced during the following activities:

• Walking
• Climbing stairs
• Getting in and out of bed
• Getting in and out of a car

Note that the laxity of ligaments can go on for some time after delivery. And, the typical location of the pain is the very lower part of the back and the buttocks. The joints also become tender if one were to press on them.

Ways to Decrease SI Joint Pain

For treatment and during pregnancy, injections and medications are to be avoided for obvious reasons to avoid exposure of the fetus to any foreign chemicals or x-ray. To decrease the pain, one should minimize use of stairs, avoid getting in and out of bed or a car with one leg at a time but rather by sitting first and swinging both legs at the same time, avoid crossing legs while sitting, and avoiding being in the same position for a long time while sitting and standing.

If pain persists AFTER delivery, or in cases where patients suffer from SI joint dysfunction regardless of pregnancy, physical therapy and anti-inflammatories are helpful. For persistent cases, a pain specialist can inject the joints a couple of times with a small amount of anti-inflammatory steroids (not muscle building ones) under x-ray to effectively alleviate the pain.