During pregnancy, a woman’s body undergoes a lot of changes to house the baby. These changes affect the muscles and joints of pelvis and lumbar spine leading to low back pain (LBP). It is estimated that almost 68% to 80% pregnant women experience back pain during or after their pregnancy.
The pregnancy related low back pain is usually moderate to severe in intensity, burning type of sensation in lower back without any radiation to the leg. It almost occurs daily but not present throughout the day, starting at any point of the day and is more severe at night.
The causes of this back pain are a combination of multiple factor, as discussed here-
Mechanical Cause-During pregnancy, due to increase in the size of the breasts and abdomen, the center of gravity moves forward resulting in stress over the spine and tension in the muscles around the back causing problems in balance. This is one of the most common causes of back pain.
Decreased blood flow– Normally in a woman’s body, blood vessels (arteries and veins) lie behind the uterus. These vessels are responsible for carrying oxygen and nutrition to the structures of the lower back. During pregnancy, the size of the uterus increases and puts pressure over these vessels, resulting in decreased blood flow to the structures in the lower back. This can also contribute to back pain particularly in last half of pregnancy.
Hormonal Causes– Relaxin is a hormone that is produced in increased quantities during pregnancy by parts of uterus and ovary. It relaxes (loosen/Lax) tissues which bind the joints leaving the lumbar spine and hip joints less stable and therefore more susceptible to stress and pain.
It must be clearly understood that “Not all low back pains during pregnancy has the pregnancy itself as a triggering factor.” Much of the low back pain existed before the pregnancy and persisted or worsened during the period of pregnancy.
The common risk factors which can increase the chances of low back pain during pregnancy include-
Physical Factors
Age – Younger age
Weight – Obesity (BMI > 29.9)
Parity- No of children
Lack of excercise
Psycho social Factors
Stress level
Strenuous work
During Pregnancy/Labor
Baby weight >3 kg
Long time taken to deliver the baby
Traumatic delivery
Others
Previous low back pain
Low back pain during menstruation
Trauma to the back
Vitamin D deficiency
It must be clearly understood that “epidural/spinal anesthesia and analgesia techniques performed during delivery or cesarean section are not associated with the development of this pain.”
Note:- All the information provided in this article has been compiled by Dr. S. K . Jain, who is an Orthopaedic surgeon. He is currently providing services at “Nidaan Wellness Centre” Dilshad Garden and formerly worked at many prestigious institutes in India and abroad. He has more than 20 yrs of experience in this field.
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