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Back & Pelvic Girdle Pain

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Symptoms

Upper backache, lower backache, pelvic girdle pain, pubic pain, sciatica, neck pain, headaches.  Pain in the pelvis, buttock, and lower extremity.  Pain across hip joints, thigh bones or close to the sacroiliac joints extending to the gluteal area.    Pain can be shooting, pulsating or burning. It can be aggravated by movement, especially walking or anytime up to unilateral weight.  Pain can restrict capacity for sitting, standing or walking. 

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Some women report a click, snapping sounds or a grinding sensation felt within the symphysis pubis.  

 A waddling gait with short steps may develop to decrease hip motion and avoid pain. 

Why it Happens

Hormonal influences of progesterone and relaxin soften the ligaments and joints.   Lower backache and Pelvic girdle or Sacroiliac joint pains are caused by shifts in a woman’s center of gravity  and counterbalances as pregnancy progresses to accommodate a growing uterus.   The increased weight of breasts, postural factors and extended sitting can cause upper backache.  The cartilage connecting the symphysis pubis to the 2 halves of the pelvis widens in preparation for birth under hormonal influences, sometimes creating a diastasis.

Relief Measures

Goal is to promote comfort and decrease any other neurologic symptoms in the lower extremities.  

  1. Pelvic floor and pelvic tilt exercises to strengthen core body muscles,  improve trunk stability and  keep the back muscles stretched reducing back pain. 

  2. Yoga: cat & dog stretches & muscle stretches targeting the hamstrings, gluteal muscles & hips.   www. Glo.com 

  3. Swimming or aquatic therapy relieves joint and muscle pressure by providing a weightless environment and has been effective in relieving and reducing pregnancy-related back pain.

  4. Use of heat packs or ice.

  5. Chiropractic manipulation from an experienced chiropractor in the care of pregnant women.   [Link to Pregnancy Partners].  

  6.  Be aware of posture and  stand straight with hips pulled forward. 

  7.  Avoid standing for long periods of time.   Place one foot on a low stool if prolonged standing is unavoidable. 

  8. Use proper body mechanics when lifting.

  9. Sleep on a mattress that offers support. 

  10. Rest/Sleep on side lying position on contralateral side of affected leg with pillows propped under the uterus and between the knees or use a body pillow.

  11. Wear low-heeled shoes; avoid high heels as they strain the lower back muscles. 

  12. Acupuncture can effectively relieve pregnancy-related pelvic and back pain.  

  13. Supportive maternity bras, belts, binders, or garments such as the BellyBraⓇ provide support to abdominal muscles, improve low back pain and decrease shoulder and back pressure.

  14. Pregnancy Massage.   [Link to Pregnancy Partners].

  15. Sacroiliac belt that fits around the hips to reduce symphysis pubis movement. 

  16. Short term use of acetaminophen can be used in all trimesters of pregnancy.  

  17. Also see in your client portal ACNM’s Back Pain in Pregnancy.  

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