5 Tips to reduce Back and Pelvic Pain during Pregnancy

Are you pregnant and experiencing pain in the low back and/or pelvic region? Are you experiencing difficulty moving throughout your day, rolling over in bed, getting in and out of a car, managing work and household tasks? Have you been told that it’s just related to “pregnancy hormones,” “it’s just a part of being pregnant,” “you’re pelvis is unstable and you must be very careful.” If this sounds familiar, read on.

This is common, 46-58% of pregnant women experience this, which makes it seem like it’s “just a normal part of being pregnant”(1).

WHAT IS PREGNANCY RELATED PELVIC GIRDLE PAIN

Pelvic girdle pain (PGP) is defined as a specific type of low back pain that can occur with or without additional low back pain. Pregnancy-related PGP is a specific category of PGP impacting women in the perinatal period and differs in its etiology as it is related to pregnancy and associated biopsychosocial influences. This means we need to consider mechanisms outside of the biomechanics, such as the stress system (HPA axis) and associated coping, inflammatory load, sleep quality, and status of the gut microbiome (2-6). To sum this up, we need to look at a number of different issues that could be contributing to your pelvic girdle pain, but there is help and you do not have to just deal with it as a side-effect of being pregnant.

There are some things that you can try at home (see below). Additionally, it is important to speak with a Pelvic Health Physiotherapist to obtain an accurate diagnosis (ie. ensuring that it truly is pregnancy related PGP) and learn about interventions that are right for you, as well as, working with you on optimal movement strategies.

HELPFUL TIPS:

1. Don’t “sit like a lady,” while sitting, allow the knees to drop outwards, you can cross your ankles to help relax the legs in this position.

2. While lying down try these positions:

   • Side lying with the upper hip slightly backwards with respect to the lower hip,

   • Side lying with both feet on the bed

   • Side lying with a pillow between the legs

   • Lying on your back with the legs turned outwards

3. While standing, try to stand with equal weight distribution through both feet, ie. avoid hang on one hip

4. Rost Moves Mamas App (it’s free!)

5. Many women with PGP have overactive pelvic floor muscles, so pelvic floor relaxation can be helpful. Depending root cause for an overactive pelvic floor muscles, there are a number of ways to work on this. For example deep breathing, specific stretches, biofeedback training, manual therapy.

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References:

1. Rost CCM, Jacqueline J, Kaiser A, Verhagen AP, Koes BW (2004) Pelvic pain during pregnancy. a descriptive study of Signs and symptoms of 870 patients in primary care. Spine 29(22): 2567-2572.

2. Clinton S, Newell A, Downey P, Ferreira K (2016) Pelvic girdle pain in the antepartum population: Physical therapy clinical practice guidelines linked to the international classification of functioning, disability, and health. section on women’s health and the orthopaedic section of the American physical therapy association.

3. Bergström C, Persson M, Mogren I (2016) Sick leave and healthcare utilization in women reporting pregnancy related low back pain and/or pelvic girdle pain at 14 months postpartum. Chiro& Man Ther 24: 7.

4. Smith MC, Ramirez LO, Clarke G, John FC, Higgins MF, et al. (2017) Stress reduction therapy improves symptoms of pregnancy-related pelvic girdle pain and reduces salivary cortisol. Irish Pain Society Annual Research Conference, Aug 26th, Galway, Ireland.

5. Felice VD, Moloney RD, Cryan JF, Dinan TG, O’Mahony SM (2015) Visceral pain and psychiatric disorders. Mod Trends Pharmacopsychiatry 30:103-119.

6. O’Sullivan PB, Beales DJ (2007) Diagnosis and classification of pelvic girdle pain disorders – Part 1: A mechanism based approach within a biopsychosocial framework. Man Ther12(2): 86-97.