Managing Pregnancy Low Back Pain

Low Back Pain (LBP) is the #1 most common discomfort women feel during pregnancy (in fact about half of women will experience it).  It is so ubiquitous that it may seem inevitable that you will develop it during pregnancy. However, by understanding its causes, you will be better positioned to adjust certain habits in order to minimize its effects (or perhaps avoid it altogether).

Why is LBP so common during pregnancy?

There are several factors that can lead to various degrees of LBP during pregnancy.  Here are some of the key ones:

  • Alignment Changes:  One of the biggest causes of LBP is the alignment shift created from your growing belly tipping your pelvis downward, pulling your lower back into an excessive arch. This position compresses the tissues in the lower back, making them tight and uncomfortable. Learn more about pregnancy alignment shifts.
  • Shift in Center of Gravity:  The other “fun” side effect of your growing belly is that it actually changes your center of gravity.  In a non-pregnant individual, the center of gravity lies just below the navel.  However, during pregnancy, the growing belly shifts this center of gravity out and up.  When this happens, the muscles in the back of the body have to work harder to prevent you from falling forward. So, they are in constant tension.  Couple this with the alignment shift noted above, and you can see the potential for discomfort, especially as the day goes on.
  • Hormonal ChangesRelaxin is a hormone that increases throughout pregnancy.  As its name indicates, it’s responsible for a softening of all the soft tissues in the body. The purpose is to allow the pelvis to widen to adapt to the growing baby and to facilitate an easier labor. However, the down side of this pelvic loosening is that it decreases stability in the pelvic region, making it more difficult to resist the shift in center of gravity.

  • Weak Deep Core and Glutes: The deep core muscles (especially the “Core Canister” muscles) and glutes help to stabilize the spine and pelvis.  Strong core and glute muscles can help resist the alignment shifts that pull the lower back into the excessive arch, and therefore can help alleviate a great deal of tension from the lower back.  If these muscles are weak, however, they cannot help in counteracting all the stresses listed above, and LBP is in a position to thrive.

How to Manage Lower Back Pain

Despite seeming inevitable, there are many proactive steps you can take to minimize your chances of experiencing with LBP, or perhaps prevent it altogether.

  • Find Neutral Alignment: First, it is imperative that you get your body into a better “neutral alignment” position. The anterior pelvic tilt that you likely spend the most time in must change. Read this post on neutral alignment to learn how to find a more optimal position.
  • Learn to Breathe (properly): While it may seem insignificant, the key to building a strong and properly functioning core all comes down to the way you breathe.  Proper breathing activates the “Core Canister” muscles — regulating intra-abdominal pressure, improving deep core strength, and relieving the stress from the lower back.  If you can master 360° Breathing to the point where it becomes your natural breathing strategy, you’re essentially doing over 20,000 reps per day of one of the best core exercises there is.
  • Mobilize “Stuck” Tissues: Gentle mobility work can be very helpful in alleviating tension in the lower back.  One common way to mobilize tissues is with the “Cat-Cow” exercise.  However, most people do this movement in a way that does not maximize the stretch to the lower back.  Watch this Cat-Cow Video to see how most people perform the movement and learn a slight variation to maximize the stretch to the lower back (thereby alleviating more tension). Try doing 6-8 reps, inhaling on the Cow and exhaling on the Cat.
  • Avoid Provocative Positions: This one is obvious but worth mentioning. If something hurts, don’t do it. Even if you think you should fight through discomfort for the long-term benefit of doing certain activities, don’t.  Bent over Rows and Reverse Flyes are good examples of movements you may need to modify during pregnancy.  Both are highly beneficial in counteracting the rounded shoulders posture so common in expecting and new moms, but the bent over position can place too much pressure on the lower back as the belly grows.  Watch this Bent Over Row Modification Video and this Reverse Flye Modification Video to learn how to modify the movements to get all the benefits without the stress to the lower back.
  • Change Your Loads: Lowering the amount of weight you are using during strength training is one great strategy to make your back do less work. Another way is to lower the position of the load. One example would be to hold the weights down by your sides when squatting, as opposed to holding them in a rack position (in front of your chest). As a rule of thumb, the higher you lift a weight above you, the more your core (read: low back) will have to work. So keep the weight down for a happier back.

Want more personalized help?  Consider working with one of our New York City-based in-home personal trainers. They are experts in managing all types of pregnancy-induced pains and injuries.  Outside our service area?  Check out our Find a Professional Page to see if there is a PROnatal Certified Professional near you.

For more assistance in managing your back pain, find a certified prenatal massage therapist, acupuncturist, or chiropractor in your area. Having another pair of helping hands can go a long way towards bringing relief to a body working hard to grow a little one.