Keep backache at bay

Backache is one of the most common ailments during pregnancy. Fortunately there are many things that can be done to prevent or decrease the symptoms of an aching back. Postural correction, exercise and pregnancy support devices can all help to ease the load on your back.

You will need all the strength and energy you can muster once your little bundle arrives.

In early pregnancy the baby rests on the mother’s hipbones, which are very strong and can support the extra weight. As the baby grows, the weight moves forward over the pubic bone. Gravity adds further stress on the back as it pulls the weight downward. 

Hormonal changes

When you become pregnant the rapid changes your body undergoes is all due to the increased amounts of hormones released throughout your body.

Specific hormones act on your connective tissue (ligaments and tendons), which allows room for the expanding uterus and will allow the pelvis to open up to maximum during labour. But these hormones also make your body more vulnerable to stress and strain.

Postural changes

Although every single system in your body is affected by pregnancy, none are as visible as the changes that occur to your skeleton. A pregnancy-related backache can begin as early as the end of the first trimester. As the pregnancy progresses, and the centre of gravity of the body moves, the natural curves of the spine become much more pronounced and there is more “drag” on your spine.

Abdominal muscles

The abdominal muscles in response to the growing uterus often weaken and separate due to the amount of stretching they need to undergo. It makes sense that they do not supply the same amount of support from the front. This separation is known as rectus diastisis.

Pelvic floor muscles

The pelvic floor muscles from below, strains to support the extra intra-abdominal weight. The back muscles are often left to compensate for the abdominals in holding the spine erect – leaving them tight and stressed. This can lead to your pelvis becoming abnormally tipped forward.

Standing on the balls of your feet

To compensate for this you may naturally respond by standing on the balls of your feet and bringing your head and shoulders forward. This results in not only your lower back muscles taking strain, but also the muscles in your neck and upper back.

Hamstring muscles

Shortened hamstring muscles also contribute to lower back pain. This is bad news for your back, which is left “holding the baby”.

Achieving better posture

Becoming more aware of your posture and how you move, sit and stand every day will improve matters. Improving your posture is vital. Body mechanics more than hormones are to blame here.

Many women will not suffer from backache in early pregnancy, but most women will have a bout of it towards the third trimester. Certainly in the last weeks it is one of the most common complaints heard from pregnant women.

Women who are more at risk

Women who are overweight to start with may experience a lot of backache early on in pregnancy, as would women with a history of backache due to spinal disorders such as scoliosis.

Sort out your backache

• Maintain good posture and don’t hunch and slump all the time.
• Exercise and strengthen the muscles of the lower back as well as the abdominals and the pelvic floor. Yoga-type stretching is beneficial for shortened muscles. Static stretching is preferable to “bouncy” stretching.
• If you spend a lot of time sitting down, ease the strain by placing two telephone books in front of your chair, under your feet. This will raise your knees to a level higher than your hips and thus relax stiff lower back muscles.
• Try to avoid standing for long periods of time, and when you do, be sure to place one foot onto something like a low stool or the bottom of a grocery trolley.
• When sleeping, use pillows to keep one or both hips slightly flexed. Place a small pillow between your knees.
• Apply a heated pad or pillow or a covered hot water bottle to the area that is hurting.
• Pelvic tilting whether in the upright position, lying down, sitting or on all fours, is a great way to relieve pain and stretch the lower back muscles.
• A visit to a physiotherapist, chiropractor or an osteopath may be in order if the pain is persistent.
• Develop good body awareness. Think about how you move your body through space. Keeping the pelvis in a neutral position (not tipped forward) is probably the most important step towards preventing muscle strain, poor posture and backache. The best body habit you can develop is relaxation.
• Although back pain is the most common of the pregnancy niggles it is easily managed if you make a concerted effort to change some of your bad postural habits, become fitter and stronger, and learn how to RELAX, so there is no added strain on your body, before and after pregnancy.

Simple stretches

A daily programme of the following stretches can help to relieve much of your back pain. They should be held for at least seven to 10 seconds

Problem area: Lower back muscles

Knee to chest stretches – in a side-lying position, clasp your thigh behind your knee, slowly bringing it up to the chest around your belly. Hold for 10 seconds. Repeat 4 times.

Problem area: Pyriformis, a small muscle in the buttocks that externally rotates the hip

Lie on your back and bring 1 knee up towards your belly. Bring the knee across the body and under your belly, applying slight pressure with your opposite hand. Hold for 10 seconds and repeat on the other side. Do this twice on each side.

Problem area: Hip flexor muscles

Kneel with one foot flat on the floor with your bent knee directly above the ankle. While maintaining a pelvic tilt, move your weight forward towards the bent knee and feel the stretch on the front of your leg with the knee on the floor.

Problem area: Lower back muscles

Pelvic tilt on all fours with your head in a straight line in the natural extension of your spine and your hands placed directly under your shoulders. Slowly tuck your tailbone in and bring your pelvis into your body, rounding and pressing your back upward as if you were an angry cat. Hold for 10 seconds and release. Repeat for as often as you like.

Problem area: Cervical spine extensors, located near the base of the skull

Chin tuck – maintain a straight spinal alignment while tucking the chin in towards the body.

Problem area: The front of the shoulders

Clasp hands behind the back with palms facing each other. Pull up while pulling back with the shoulders.