Pregnancy and Back Pain

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Here's a fact: Pregnancy often time leads to lumbar/sacroiliac pain, or "lower back/tailbone pain." But why? Is it because of the increased curvature produced in the lower back because of the growing fetus in the womb? Is it because the ligaments lining the "tailbone" become loose in preparation for childbirth? Or could it be due to the decreased core strength related to the stretched out abdominal musculature?

Yes, a growing fetus is adding weight to a woman’s stomach which is shifting her center of gravity forward. As a result, she will unconsciously arch her lower back so that she doesn’t pull a humpty dumpty and tip over. This also causes more of a flexed over posture in her thoracic spine or “mid-back” by default. Furthermore, her neck will have a tendency to go into what we call a “forward head” posture which basically involves a chin protrusion with increased extension. As you can see, this is a whole body affair which I’m sure most pregnant ladies could attest to.

Yes, increased levels of the hormone called “relaxin” have been found in a woman’s body as that little nugget of hers is getting ready to introduce him/herself to the world (1). This hormone, as the name suggests, loosens the ligaments surrounding the sacrum which allows the pelvis to widen itself to make room for the nugget’s descent. Not only that, but these increased levels of relaxin could cause loose joints everywhere.

Yes, the abdominals are stretched out as well because of the increased weight of the little guy or girl. Because of these lengthened muscles, it is much more difficult to stabilize the spine for pain-free movements.

Research has tried time and time again to show that posture is the single most cause for pregnant women’s troubles with lower back pain. And time and time again, they can’t. However, what we do know is that it's highly likely that a combination of all of the above is playing a role in pregnant back pain. The bottom line is that every woman giving childbirth is different and it is our job as medical professionals to properly assess each woman's condition individually to come up with a proper treatment plan.

Please comment below to let us know your experiences with this issue!

1. Bryant-Greenwood G. Relaxin as a new hormone. Endocr Rev. 1992;3:62–97.