Pregnancy related low back pain is a common complaint that occurs in 60-70% of pregnancies. and can be defined as pain between the 12th rib and the gluteal folds/pubic symphysis during the course of pregnancy, possibly radiating to the posterolateral thigh, to the knee and calf, but not to the foot. This pain is not the result of a known pathology such as disc herniation and can begin at any point during pregnancy. Although most cases are mild, approximately one third of women experience severe pain. Several factors have been associated with the development of low back pain during pregnancy.
- Mechanical- Caused due to Relaxin Hormone which causes ligament laxity, and therefore can affect the stability of the spine and lead to back pain.
- Hormone- hormonal changes during pregnancy can cause inflammation and pain in the back.
- Circulatory-The expanding uterus can press on the vena cava, particularly at night when the patient is lying down. The pain is possibly severe enough to wake the patient up. This combined with the increased fluid volume from fluid retention during pregnancy leads to venous congestion and hypoxia in the pelvic and lumbar spine.
- Psychosocial -Psychosocial factors can also increase low back pain. Pain-related catastrophizing, depression, pain intensity and time result in an increases in pain interference.
Although there are numerous interventions promoted for low back pain during pregnancy, the most common and widely used is a specific exercise program designed by a physiotherapist. Management includes specific interventions to address pain, weakness, and mobility in the low back region.
Dr.Rashmi Mathur (PT)