Back Pain While Pregnant " Zarah is a 29-year-old female who is five months into her second pregnancy"

Case study ( 6475 views as of July 8, 2020 )

Zarah is a 29-year-old female who is five months into her second pregnancy. She has an active two-year-old running around at home keeping her busy. She is finding herself fatigued, mildly short of breath when she exerts herself and she is having significant pain throughout much of the day in the lower back and pelvis. She has tried stretches, pillows under her knees and sleeping in different positions, but she just cannot get comfortable. She is worried that she won’t be able to tolerate four more months of this, and her mother-in-law is adamant that it’s a sign that there is something wrong with the baby.

Zarah could benefit from a visit to her Family Physician, Obstetrician/Gynecologist and/or midwife. She may be referred to a Rheumatologist and/or Physiotherapist/Massage Therapist and could also benefit from yoga and a consultation with a pharmacist.

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Conversation based on: Back Pain While Pregnant " Zarah is a 29-year-old female who is five months into her second pregnancy"

Back Pain While Pregnant " Zarah is a 29-year-old female who is five months into her second pregnancy"

  • The primary cause of Back Pain in pregnancy is due to the hormone “relaxin” being released. This hormone causes you to change your center of gravity and alters joint stability. Being pregnant, there will be more weight out in front of you from the baby. To accommodate this weight, people typically will lean back and compress the lumber spine causing pain. If you are interested in treatment for Back Pain, seeing a Physiotherapist could help.
  • A former co-worker of mine wore a brace type device while pregnant. She had severe back pain and was barely able to walk . The brace helped provide support for her lower back and stomach. Would this type of thing help with back pain Zarah describes ?
  • One thing to keep in mind is that back pain doesn't always end with delivery. She should continue her back pain regime after the baby is born, as her body recovers
    • Shirley how long did it take for your back pain to go away after your baby was born ? I found that I had back pain when standing or sitting for long periods for about 6 months after my pregnancy
    • I did not have back pain prior to pregnancy. After my son was born I found it difficult to sleep and sit for long periods of time, as my back would ache. Spoke to the doctor and he said this was common and I needed to move around and stretch my back more.
  • I greatly benefitted from massage therapy and yoga during and after my pregnancies.
  • There are some very important considerations with pregnancy. If you do have rheumatoid arthritis and are on medications, some of those medications are unsafe in pregnancy and as a result, you need to talk to your doctor about those medicines.
    • Healthymama that's great advice. There are lots of ways to modify your routines to help back pain. Something like resting your foot on a stool while washing dishes can ease back strain.
    • She should learn some proper ways to pick up or help with her toddler that will put less strain on her back.
  • In fact, up to 50 percent of women experience back pain during their pregnancy. Sometimes this back pain can be mild. It can sometimes be so severe that it may interfere with their work, or with their day-to-day activities. It may even predispose back pain during future pregnancies.
    • Management and treatment of back pain during pregnancy are mostly entered around modifying physical tasks and positioning, resting (sounds great right?) and exercising within certain parameters
    • I definitely experienced back as well as hip pain during my pregnancy.
    • A good stretching program can be very beneficial if you are pregnant and experiencing back pain. Consult your local athletic therapist or trainer if they are experienced and training in stretching pregnant women.
  • Being male, I will never experience being pregnant with a sore back, but I know that it's the last thing any pregnant woman wants. Treatment can be somewhat challenging because its uncomfortable to lie prone, but in general the pain is associate with postural changes and spinal loading patterns as a result of the changes to body morphology associated with a growing baby. The good news is that in the greater majority of cases these changes reverse after delivery. Management and treatment of back pain during pregnancy are mostly entered around modifying physical tasks and positioning, resting (sounds great right?) and exercising within certain parameters. Contact your local physiotherapist who can provide sound advise and appropriate treatment strategies.
    • A physiotherapist should be able to advise ways to change her daily routine to avoid further stress on the back.
    • Could a physiotherapist offer advice on how to manage the toddler without straining the back?
  • If she is working at a desk, she should consider getting an ergonomic assessment. As her body is changing, she may need to change her set-up to alleviate her back pain.
    • Yes just a simple prop for her feet can make a huge difference.
  • If she is comfortable, she could take her mother-in-law to her next midwife/OB appointment. Sometimes it helps to hear it from the professional. And will alleviate the extra stress of having her MIL worried about the health of her baby. Stress can make it hard to relax enough to let pain subside.
    • That's a good idea, sometimes people need to hear it from a professional before they believe it!!
  • How would the mother's aches and pains be related to the health of the baby?
    • Some people believe that a painful pregnancy is nature's way of telling you there is something wrong with the baby. It's an old wive's tale
    • That's a good question!
  • One of the things that I wish I had tried in my pregnancies was prenatal yoga. I do a lot of yoga now and it is great for mind and body. A nice gentle stretching routine might be good for the back during pregnancy.
    • There's some very simple, common sense-type of things that everyone can do that can both facilitate the positive physiological factors and protect the back against pain, discomfort as the pregnancy progresses.
    • I did, I really enjoyed it. It helped with all kinds of pain in pregnancy, as well as being a nice time to connect with the being I was growing.
    • Me too.. I always meant to do prenatal yoga but it never happened!
  • It would be wise to see a physiotherapist or a chiropractor for a back assessment before she enters the third trimester, where there will be more precautions to take when it comes to moving and exercise. Since she is running after her 2 year old, she is probably doing more bending and lifting that may aggravate the lower back. The latter in combination with the extra weight from the baby and the general instability/laxity in all the joints that is a normal consequence from the circulating pregnancy hormones, can be causing her lower back pain. So, first step would be to assess the back and see if there is a mechanical component that can be addressed with a simple exercise. Second, improve her body mechanics when 'running' after her toddler and doing house chores or whatever. Thirdly, start core exercises to provide joint stability within the vertebral column - stability ball exercises and Pilates would be great.
    • Also an occupational therapist can help teach her some ways to do things around the house that are less stressful on the back. Something as simply as resting your foot on a stool while doing dishes removes strain on the back by shifting your center of gravity
    • I would watch the weight gain in third trimester too. I gained too much in mine and it really affected my back.
    • A physiotherapist mentioned to me that some women with back problems prior to pregnancy may find some relief as the baby grows as the baby acts like a splint for the core area. Have you had this experience with clients?
  • When I was pregnant I tried my best to get regular exercise but also went for pre-natal massage. It was really helpful not just for my body but for my mind. If anyone is experiencing back pain in their pregnancy I would highly recommend seeking out a massage therapist that caters to pregnant women.
    • I had massage with 2 of my pregnancies and it helped with pregnancy pain. Someone with back pain in pregnancy could definitely benefit.
    • Massage during my pregnancies helped me immensely.
    • I saw an rmt who had no experience with pregnancy and he was totally freaked out! I would definitely ask ahead of time!
  • Core strengthening and proper joint position is vital for back health, especially when you are pregnant or already taking care of your little one. Modifications, depending on the stage of pregnancy and health of the individual should be taken into consideration when creating a treatment plan. As a Chiropractor and mom of a 20 month old, I know what demands your body goes through and believe me, prevention is the name of the game!
    • @ShirleyG and @Joy core exercises are an essential component to overall back health, regardless of whether you're pregnant or not. :) Having said that, an evaluation by your health care provider should be done as your stage of pregnancy, general health, and previous health concerns should be addressed prior to commencing any program.
    • Building up core strength before pregnancy would be a good idea.
    • What is the best way to build core strength - are there particular exercises you would recommend ?
  • Treatment by a qualified Registered Massage Therapist is a greatly successful tool to help decrease the overall amount of discomfort throughout a pregnancy. Shifting of the joints, ligaments, and soft tissue during your pregnancy can cause intense local pain, referral pain, and can aggravate pre-existing conditions. The manual manipulation of the areas can help with immediate relief! We address the immediate symptomatic areas while taking the necessary precautions that are specific to treating pregnancy (inducing labour is not listed as a precaution when it comes to pre-natal massage therapy; we place the patient in the position she is most comfortable in, but if there is no preference then positioning her on the left side is the safest to avoid compression of the iliac artery. It is important to tell your RMT if you has gestational diabetes or high blood pressure due to the pregnancy). In addition to the one on one treatment, I think it's important to teach moms about self massage to the breasts and/or belly, home care, as well as activities in their area that they would benefit from. Massage has been used to help decrease overall stress levels, but I would recommend incorporating yoga into a mom's treatment plan. My last patient was a healthy mom of two and pregnant with her third. I treated her all the way into her last trimester (our last appointment was actually the day before she had her healthy baby boy!). Our treatments helped her chronic symptoms of her ribs and sacrum coming out of alignment, but what she said really helped with the overall discomfort and stress was her daily yoga practice. I'm always very honoured to be treating a pregnant mamma! I grew up as the oldest of seven siblings, so I've seen my fair share of big bellies :). There's a tremendous amount of benefit when massage therapy is incorporated as apart of the pregnancy plan and should be taken full advantage of! It's a great feeling to be able to provide such immediate and sustainable relief- carrying a baby is hard work, to say the least, and to get to make it easier on the mom is extremely rewarding! It's a win, win :)
    • Why is it important to let your RMT know if you have gestational diabetes or high blood pressure due to pregnancy? Are these affected by massage?
    • I wish I had seen an rmt like you during pregnancy! The one I saw was awful!
  • I had a lot of back and hip pain during pregnancy and I think it was due to the great deal of weight I gained. I wish I had been more careful.
  • While pregnant I was carrying the baby towards my back. I had pain in my back, hips and found it hard to sleep. My doctor suggested strengthening my core through yoga which really helped.
    • I would be interested in the core exercises you were given during pregnancy.