Many women develop musculoskeletal back pain during or following pregnancy.  The cause of this pain is typically multi-factorial, but it often can be reduced or even relieved with proper training by a skilled physical therapist.  Women that are planning to become pregnant can also take preventative measures to decrease the likelihood of developing back pain. 

The factors that contribute to the development of back pain during pregnancy include hormone changes, weight gain, and altered postural alignment that are all normal symptoms of pregnancy.  When a woman is pregnant hormone changes enable to her successfully carry and deliver her baby.  One effect of these hormonal changes allows ligaments in her body to stretch.  (Ligaments connect bones and are the core building blocks of joints.)  This needs to specifically occur in the pelvic joints in order for a woman to be able to deliver her baby through the pelvis.  It is not just the pelvic joints that become "loose" though.  All joints are affected, including back or intervertebral joints.  As these joints become more flexible, they also become more vulnerable to injury, especially if a woman is not utilizing proper postures and movements (or body mechanics) as she functions throughout her day. 

Another contributing factor to the development of back pain during pregnancy is that women gain weight rather quickly over a nine month period of time. This rapid weight gain along with the enlarged abdominal girth, create an increase in the normal low back (or lumbar) curvature and puts increased stress and compression on intervertebral joints.  This could lead to symptomatic nerve compression, such as leg pain, numbness, tingling, and/or weakness.

With the increased abdominal girth, hips often turn outward and some muscles shorten while others such as the abdominals lengthen.  Therefore, these muscles are unable to contract and support a pregnant woman's body as efficiently.  These changes alter the woman's center or balance and lead to a change in movement patterns, such as a "waddling" type walk.  This can make a woman clumsy and more likely to fall and sustain traumatic injury to the back or even other joints. 

Obviously not every woman experiences back pain during pregnancy, and there are preventative measures that can be taken to try to improve the likelihood of experiencing a comfortable and healthy pregnancy.  Maintaining an ideal weight prior to conception is most helpful.  Also try to work on good postural habits and body mechanics, such as trying to maintain a normal (or neutral) spinal alignment when sitting, standing, lifting, and reaching.  It also helps to work on strengthening the core abdominal, trunk, back, hip, and shoulder blade (or scapular) muscles prior to conception.  This is especially important if there is already a past medical history of back pain. 

Post-partum exercise is also important in trying to prevent back pain.  A woman should not start exercise until her obstetrician/gynecological professional recommends it though.  A good exercise regime should include cardiovascular exercise for at least 30 minutes 3-4 times per week, which should help with gross body toning and conditioning and assist a woman in returning to her ideal weight.   This may include walking, (which can be done with a stroller), jogging, bicycling, swimming, and aerobic classes.  Post partum exercise should also include core abdominal, trunk, back, hip and scapular strengthening and toning exercises.  This should help a woman to regain good joint stability and posture, which should ultimately enable a woman to efficiently lift and care for her new baby. 

Pregnancy is typically a time of planning and excited anticipation.  A woman's body endures a lot of musculoskeletal changes during this time though, which can be stressful and at times painful.  Fortunately preventative measures can be taken to try to keep a woman's body healthy and comfortable during and following her pregnancy.  A physical therapist has both the knowledge and skills to help a woman work towards pre-conception and post-partum goals as well as treat pain that may arise during or following her pregnancy.