Lower backache is a predictable event in almost all pregnancies. There are several contributing factors at work here, including hormonal and physical changes. Some of the hormones released during pregnancy soften the connective tissue (ligaments and cartilage) that hold bones to one another and also pad the joints between bones. With the softening there is more movement and irritation in the joints between bones. Since most of the weight of the upper torso (head, chest, arms and abdomen) is transferred to the joint where the spine connects to the pelvis, there is often an achy pain in the lower back.
The increasing size of some body parts puts weight-related strains on the muscles and bones of the back. The enlarging uterus has ligamentous attachments to the bones of the pelvis, many of which attach to the sacrum, the fused vertebrae which are the bottom of the spine and also the back of the pelvis. Most complaints of backache in pregnant women involve the sacrum and its joints with the vertebrae above and the pelvic bones to the sides. Women with large breasts may also experience pain in the upper back and neck as the breasts become larger during pregnancy.
There are several things you can do to help your back feel better. First of all, realize that you can injure your back easily during pregnancy. All those rules about lifting and body mechanics apply more so during pregnancy. Do NOT bend over from the waist to pick something up…….go down with your knees bent and keep your back perpendicular to the ground. Do what weightlifters do before you pick up something off the ground……gently roll your head back and look up as you lift with your legs. If you have to pick up anything weighing more than 10 pounds (like small children), bend your legs as you go down, pull the weight closer to your body, and then look up as you lift with your legs. If you think something might be too heavy to lift, it probably is. If your job requires that you lift considerable amounts of weight, consult your doctor or midwife about the possibility of injury. S/he may want to restrict the amounts you may lift. Also, get into comfortable, flat shoes. Avoid shoes with narrow toes and high heels.
In addition to good body mechanics, make sure that you gently stretch out if you’ve been sitting or lying for a while. Early in pregnancy, you may stretch the muscles of your back by reaching your arms above your head, and by gently bending over for toe touches. Bending over later in pregnancy make take a bit more effort. Contrary to a popular notion, you will NOT cause the cord to wrap around the baby’s neck by reaching above your head. To stretch the muscles of the lower back, place your back against a wall and roll your pelvis out so that the curve in the lower back is straightened out. You can also perform this stretch with “pelvic rocks”. The pelvic rock is done by getting down on your hands and knees, and gently arching and bowing the back.
One of the best remedies for back pain (and other weight-dependent aches) is submersion in water. The human body is approximately the same density as water. So, when the body is submersed in water, the effects of gravity disappear. The stress on joints and stretched soft tissue is temporarily relieved. This allows these body parts to receive better blood flow. Inflammation is reduced, and so is the discomfort.
Pregnant women should not use hot tubs (or saunas), especially in early pregnancy. Hyperthermia, a high core body temperature, is a suspected teratogen. Most hot tubs maintain water temperature in the 103-106 degree-Fahrenheit range. When totally submersed in temperatures this high, the body’s core temperature rises fairly quickly. However, if you can cool a hot tub down into the 90-98 degree-Fahrenheit range, you may soak as long as you want.
One other warning…..if you develop back pain on the right side, about half way up the back AND you develop a fever or begin to get chills or aches, call your doctor or midwife. Kidney infections almost always occur in the right kidney during pregnancy.