During pregnancy, that bowling ball, a.k.a. baby, inside your uterus changes your whole centre of gravity, which results in your pelvis arahifting forward. This can lead to a common form of back pain known as pelvic girdle pain (PGP), which spans from the middle lower back area all the way around to your hips and pubic bone, says Sarah Mickeler, chiropractor and founder of West End Mamas, a clinic in Toronto that specializes in pre- and postnatal care.
At the same time, in order to compensate for this forward shift in their pelvis, many women naturally lean backward, which increases the curve of their lower back, potentially leading to low-back pain. Ouch!
All of this can add up to a lot of aches and pains, but the good news is there are a number of ways to prevent and treat it. “Pregnancy does not have to hurt,” says Mickeler. Here are some ways to find relief from pregnancy-related back pain.
1. Exercise the pain away
Staying mobile can really help with back pain as it keeps your muscles from getting too tight, says Cynthia Rebong, a midwife at Midwifery Care North Don River Valley and a yoga and Pilates instructor. Some forms of phsycial activity can become uncomfortable during pregnancy, but Rebong recommends swimming as a pregnancy-friendly way to keep moving.
Can a maternity belt solve your pregnancy pains? Mickeler suggests focusing on your glutes when you exercise. “We have this anterior shift in the pelvis, and now we’re tucking our butt under, so our butt’s getting really tight, and super, super weak,” she explains. And weak glutes can wreak havoc with your lower back because they force other muscles, like your hip flexors, to do the work for them. Mickeler says exercises like squats, lunges, glute kickbacks or bridges can all help support your posture by strengthening not only your glutes but your back, hamstrings and calves, which will help prevent back pain.
If you already have low-back pain, manual osteopathic practitioner Riki Richter, co-owner of Synergy Sports Medicine and Rehabilitation in Toronto, recommends doing squats against a wall, which will give you support at the same time as minimizing that lower back bend. She also suggests cat pose, which will help keep that low-back area flexible. And if you have pain around the dimples in your low back, butt, hips or pubic bone, choose fitness classes that don’t involve forward bending, as that can be painful, says Mickeler.
2. Try pelvic floor physiotherapy
Another contributor to back pain is overly tight pelvic muscles. A pelvic floor physiotherapist can help you work on those internal muscles by doing what’s basically a massage of your pelvic floor through your vagina. This type of treatment has added benefits, too, as Mickeler says it can reduce the incidence of tearing during delivery, and give you a head start for recovery after your baby is born.
A pelvic floor physiotherapist can also assess the shape of what’s called your deep core, which consists of your pelvic floor, your diaphragm, your transverse abdominis and a muscle in your lower back. Mickeler explains that if one part of your deep core isn’t working well, it can mean that other parts of your body will have to compensate, which may lead to pain. Aside from working internally, pelvic floor physiotherapists can also use exercise- and rehab-based techniques to help with low-back pain.
3. Practise deep breathing
Sometimes belaboured breathing during pregnancy can contribute to back pain. “When we’re pregnant, because our organs get squished up from the weight and the size of the baby, we tend to have diaphragms that don’t function properly,” says Mickeler. This can lead to your rib cage not moving as well as it should, which can contribute to back pain, she says. Using proper breathing techniques can help keep your rib cage moving properly. Mickeler suggests practising what’s called core breath, where your ribs go out and up on the inhale, and in and down on the exhale.
Richter explains that this directed deep breathing is also important because super-slow silent inhales through the nose will help get the breath into your side ribcage and lower and middle back, helping to release tightness in those muscles.
4. Seek chiropractic care
You may worry that a chiropractor is going to twist you into a pretzel, but Mickeler says chiropractic care during pregnancy can be extremely gentle. It’s important to choose someone who’s specially trained in treating pregnant and postpartum women. The chiropractor should have a special table or some other way to accommodate a pregnant woman’s belly. The practitioner will manually make adjustments to help align the pelvis and other bones.
5. Perfect your posture
Making some small changes to the way you sit and stand can have a big impact on preventing and soothing back pain. When standing, Mickeler says to pay attention to where you feel the weight in your feet. If it’s in the balls of your feet, that means you’ve pitched yourself forward because of your gravitational shift. “Try to get your weight into your heels,” she suggests, adding that you may need to lean backwards a little bit. Richter says standing with your feet too close together while pregnant can irritate your back, so try to keep them hip-width apart. And if you have another child at home, pay attention to how you’re picking that little one up. Be sure to bend your knees, and hinge at the hips instead of rounding your back. Also be mindful of your posture if you’re nursing, as slouching can bother your upper back.
How you sit can also impact your back. When you are sitting, try staying close to the edge of the seat, like you would on an exercise ball. This will make your pelvis more mobile and help with back pain, partly because letting your belly hang will help get your baby into a better position, Rebong says. And avoid sitting for too long. According to Rebong, too much sitting can lead to tight hip flexor muscles, which can pull on your lower back.
6. Treat yourself to a massage
A massage therapist can offer relief for back pain, though they might not be focused on your back itself. “One of the things that we joke about here is that we spend 50 to 75 percent of our time rubbing moms’ bums,” says Mickeler. The glutes often contribute to back pain because the shift in the pelvis causes women to tuck their tailbones under, which tightens those muscles. A massage therapist will be able to loosen them up, which will offer you some relief. Rebong says moms-to-be can also use a foam roller at home to loosen up their glutes, hamstrings and calves so those muscles don’t pull on the lower back.
7. Practice mindfulness
Some research has shown that pain responds well to mindfulness-based stress reduction (MBSR). So, it’s worth taking time to find an MBSR course, where you’ll learn how to use meditation and mindful movement, like certain yoga positions, to manage stress and pain. Mickeler also recommends an app called InsightTimer, which has more than 9,000 guided meditations for you to choose from so you can try a meditation practice on your own.
8. Strap on a maternity belt
If you have pelvic girdle pain around your middle lower back and hips, a maternity belt may relieve your pain. This support garment does the work of the ligaments, muscles and fascia of the girdle area, explains Richter. But, she cautions, it should not be worn all of the time, because those muscles will stop working and will need to be retrained after you have your baby. “I usually recommend that clients wear them during more taxing activities—such as activities with lots of bending, lifting, walking or standing—just so they’re not in discomfort,” she explains. “And then I give them exercises to try and resolve the issue.”
Mickeler warns against wearing the belts too tightly, which can contribute to pelvic organ prolapse. Because of this, it’s best to have a practitioner guide you on how to use one.