Pregnancy related Low back and Pelvic girdle pain
By Dr. Casey Tunstall (Osteopath)
While pregnancy is a beautiful and magical thing to experience, it can also be a time where you may feel some pain and discomfort.
Many factors such as fluctuations in hormones, increased laxity of ligaments and altered posture can change how a person moves their body whilst pregnant. These changes most commonly affect the low back and pelvic girdle.
Low back pain
Pregnancy related low back pain can be experienced by about 50% of pregnant women, with 1/3 presenting with severe pain.
Low back pain can present as:
Pain over and around the lumbar spine and/or sacrum
With pain that might radiate down to the foot
Some causes of low back pain in pregnancy include:
Hormonal - causing increased ligament laxity
Mechanical - increased abdominal weight putting more pressure through joints and muscles surrounding the low back
Biopsychosocial factors – causing stress and anxiety
Strategies to reduce your symptoms:
Stretching tight muscles such as your hamstrings, glutes, hip flexors and around your low back.
Engage legs when bending and/or lifting heavy objects.
Sit in seats with sufficient back support and add cushions if needed.
Regularly take breaks from bouts of sitting or standing to avoid the low back muscles becoming fatigued.
Avoid standing with your low back and knees into full extension, instead aim for a slight bend and tuck in your pelvis.
General aerobic exercise such as walking, swimming or water aerobics.
Strengthen the glute muscles with exercises such as glute bridges or squats.
Pelvic girdle pain
Around 20% of pregnant women will suffer from pelvic girdle pain. Pelvic girdle pain is usually more intense during pregnancy than during the post-partum period.
Pelvic girdle pain can present as:
Deep, stabbing unilateral or bilateral pain
Recurrent or continuous
Pain between posterior iliac crest and gluteal fold
Possibly radiating the posterolateral thigh, to the knee and calf (NOT to the foot)
This pain can feel worse with:
Standing on one leg
Getting into/ out of cars and bed
Rolling over in bed or lying flat on your back
Standing from sitting or squating
This pain can occur due to:
Changes to posture and center of gravity with increased weight of breasts and belly.
Altered hormone levels of Relaxin, Oestrogen and Progesterone increase laxity of ligaments that support the pelvis.
Increased pressure on the pelvis with the growth of your baby leading to joint irritation and inflammation of the sacroiliac or pubic symphysis joints
Strategies to reduce symptoms:
Move both legs together when getting out of bed or the car
Try wearing satin PJs or bed sheets to make it easier to roll out of bed
Sleep with a pillow in between your knees and under your belly to keep the pelvis in a neutral position while you sleep
Avoid sitting cross-legged
Strengthening pelvic stabilizers (glutes)
Pregnancy belts worn temporarily can support your pelvis for moments of need
How can osteopathy help?
The osteopathic approach in pregnancy is designed to support the mum and the changes they experience throughout their body. As everyone's pregnancy journey is unique our osteopaths will assess how your body is moving and choose a variety of direct and indirect techniques to help ease pain felt throughout the lumbar spine and pelvis.
With manual therapy we can help decrease pressure, pain and discomfort felt at the low back and pelvic girdle, whilst further helping to increase or maintain available range or motion at your hips and pelvis. Additionally, throughout treatment we can provide guidance and education surrounding best movement practices, nutrition, and adjunctive therapies to best support our soon to be mums. We understand each pregnancy is different and therefore will tailor treatment to your individual needs.
Note: that any information provided throughout a consultation with our Osteopaths does not substitute treatment with your obstetrician or midwife. For any further information reach out to the team and ask about our pregnancy booklet.
Katonis, P., Kampouroglou, A., Aggelopoulos, A., Kakavelakis, K., Lykoudis, S.,
Makrigiannakis, A., & Alpantaki, K. (2011). Pregnancy-related low back pain. Hippokratia, 15(3), 205–210.