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Dr Duncan

Back pain in pregnancy

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Our spines do a great deal of hard work during the course of our lives and yet, for many people, we don’t take any notice of it until it starts to play up!

The spine, or axial skeleton, is the flexible rod to which our limbs, as well as  the body’s three major body cavities – the skull, the thorax and the abdomen - are attached. To allow the maximum efficiency in movement and load bearing, the spine has three curves when viewed from the side: the cervical (neck) and the lumbar spine curve backwards, and the thoracic section curves forward.

spine-curves-test

Ref: http://www.anatomy.tv/StudyGuides/images/spinecurvestest.jpg

The spine is made up of 24 individual vertebrae that are separated by fibrous discs. These discs allow room for the nerves to comfortably exit from the spine as well as providing “shock absorbers” to the spine when it is weight bearing.

By the time a woman gets to the child bearing age, her posture has become a subconscious “thing” that she would rarely think about. But with pregnancy comes:

  • Weight increase
  • Loosening of ligaments due to the effect of increasing hormone levels
  • The centre of gravity moving forward with the enlarging womb
These three events combine to cause the spine to operate in a new way with increased pressure on the back muscles to hold the person upright. If the woman already has a “back problem”, it is highly likely that things will get worse during the course of her pregnancy. So the first lesson is to care for your back at all times and in all ages, because when it goes wrong, life can become quite miserable!

The principles of good back care

This revolves around maintaining a good posture and the key to this is literally to “Stand Tall”. Imagine that someone has put their hand on the crown of your head whilst you are sitting or standing: if you push up against the imagined hand, then your spine will straighten and your posture will improve immediately. It’s that simple and that effective and it is something everyone should be doing – spread the word!

Two other simple tips to help with posture are, to not be afraid to hold your chest high and keep your shoulders back and relaxed. If you have to stand for long periods then try resting one foot on a small stool and alternate your resting foot every so often.

To help tone up tummy muscles, I recommend using a “fit ball”. These can be purchased at a reasonable cost for home use and there are plenty of good web guides on how to use them correctly – have a look.

where you can find a number of exercises to choose from. Remember that if you have a pre-existing back or health problem, then you should check with your Doctor before you embark on any new exercise program.

Back pain in pregnancy.

Often a back ache will disappear of its own accord, but should it persist and make you think that you need to take pain killers or go to a Physiotherapist, then you should check with your treating Doctor and get an accurate diagnosis before embarking on any “self inspired” treatment. Once the feeling is that your back ache  is due to the effects of pregnancy, then the following may help in reducing your discomfort.

Good posture. As mentioned above, stand tall, sit tall and don’t be afraid to lift your expanding chest!

Care with lifting. Hormones will have loosened the ligaments in your pelvis and spine so be doubly careful when lifting – especially putting young children into car seats. And when doing the shopping, use the trolley to take bags back to the car, and load it into the boot and not into the back seat, as lifting and stretching forward leaves the back in its most vulnerable situation.

Shoes. Now is not the time for those “killer heels” unless you want a “killer pain” in your back! Flat comfortable shoes with appropriate arch supports are the best. Save the fashion apparel until after the baby is born!

Try a hot pack. These are very efficient and safe as long as you obey the instructions –please don’t be tempted to over-heat them as they can scald the skin if too hot! But a hot pack applied to the affected area will often reduce muscle spasm and reduce discomfort. Local massage is also very helpful and I remember an Indian midwife teaching me during one of my wife’s pregnancies how to massage my wife’s back, which she charitably informed me proved to be a great relief. It also allowed me to feel useful at a time when we males can often feel like an extra leg on a dog!

Night-time. Sleeping on your side with a pillow between your knees will help in the later stages of pregnancy, when the nights appear to be getting longer and less restful. And that hot pack can come in useful too, especially in winter.

Keep fit. Even though in the later stages of pregnancy, going for a walk seems like a bridge too far, it will help! Being upright and walking also helps “settle” the baby’s head in the pelvis, so that it is “in position” for when labour starts in earnest.

Finally, medications. Doctors are aware that even the simplest of medications can occasionally have unexpected side effects, and that is why they are reluctant to give any during the course of pregnancy. But if simple analgesia might be useful in helping reduce the discomfort of ongoing back pain, then discuss it with your treating Doctor to weigh up the pros and cons.


Article written by Dr. Duncan Jefferson. More articles here. For more information on health care and private health cover, visit HBF Insurance at www.hbf.com.au.

The content of these articles is not tailored for any particular individual's circumstances. The author does not take into account your physical condition, medical history or any medication you may be taking. Any advice or information provided by the author cannot replace the advice of your health care professional. The views expressed in this article are those of the author and do not represent those of HBF unless clearly indicated.