Pregnancy related back pain is a common complaint that occurs in 60-70 percent of pregnancies. This is mainly caused by the increased release of the hormone Relaxin which causes ligament laxity and therefore can affect the stability of the spine and lead to back pain.
During pregnancy the enlarged gravid uterus changes the load and body mechanics. It shifts the centre of gravity forwards, increasing the stress on the lower back. This increases the natural inward curvature (lordosis) which increases the mechanical strain on the lower back. It also puts extra stress on the intervertebral disc, increasing overall compression on the spine.
Another cause is the increase in the weight during pregnancy. On average, 10-15 kg of weight is gained during pregnancy. This increases the amount of force placed across joints, changes the centre of gravity, and forces the patient into an anterior pelvic tilt. This results in the hyper lordosis of the lumber spine due to which stress on intervertebral disc, ligaments and joints increases, causing joint inflammation.
In addition, abdominal muscles are stretched to accommodate the expanding uterus. Due to this the muscles become tired and lose their ability to maintain normal body posture, causing the lower back to support the majority of the increased weight on the torso.
Pregnancy related back pain can be managed using a variety of interventions but physiotherapy is an ideal option. Physiotherapy is an effective way of minimising musculoskeletal back pain and dysfunction during pregnancy. A physiotherapist after a thorough examination and evaluation will design an exercise programme that will safely restore strength to the core muscles as well as guide the pregnant woman in both weight bearing and non-weight bearing exercises for a healthy pregnancy and birth.
The exercise programmes designed by a physiotherapist, such as pelvic floor muscle strengthening, general strength training, endurance exercises, balance training, etc, decrease pain and improve body functions. Besides exercise, a physiotherapist uses various techniques and modalities such as low intensity transcutaneous electrical nerve stimulation, posture correction training, spinal manipulation, massage, etc, to combat back pain induced by pregnancy.
Women with back pain and other musculoskeletal issues induced by pregnancy should consult a physiotherapist to identify the exact underlying cause and to receive an effective treatment plan. Physiotherapy is a better option to combat such issues during pregnancy rather than medications and surgery.

—The writer is Senior Physiotherapist at Modern Physiotherapy Clinic and Rehabilitation Center, Kulgam. Mobile no. 6005887394. Email: [email protected]

Dr Rouf ul Majeed