Lower Back Pain During Pregnancy and How Physical Therapy Can Help

 

By Kelly Ann Young, Physical Therapy Assistant

At some points throughout your 9 month pregnancy, you may experience periods of aches and pains. One of the most common areas to experience pain while pregnant is in the lower back. In fact, as many of 80 percent of pregnant women will experience lower back at some point during their pregnancy. (http://www.spine-health.com) It can be due to your growing belly placing additional weight on ligaments and joints, due to the hormone changes which stretch out ligaments and make joints more unstable, or while your body is preparing for childbirth itself. You do not need to suffer in pain throughout your pregnancy and physical therapy can help.

Physical therapy can often help to alleviate this type of pain by working on improving posture, strengthening abdominal and lower back muscles, stretching any tight joints or muscles, and providing pain relief through massage. 83% of those women who suffer from low back pain have decreased pain symptoms following physical therapy intervention. (Albert 2002) In addition to relieving back pain, physical therapy prior to delivery can strengthen muscles to ease labor and make the birthing process less difficult.

If you don’t opt for physical therapy, exercise should be considered, even if you were not exercising regularly before pregnancy. “It can help ease or prevent back pain and other discomforts, boost your mood and energy levels, help you sleep better, prevent excess weight gain, and increase stamina and muscle strength. Exercise during pregnancy might also reduce the risk of gestational diabetes and pregnancy-related high blood pressure, as well as lessen the symptoms of postpartum depression. (www.mayoclinic.org) Always be sure to gain medical clearance from your physician before starting an exercise program.

Below are some guidelines regarding exercise during pregnancy. These are contraindications, relative contraindications, and recommendations on exercise from the American College of Obstetrics and Gynecology (ACOG)released in 2002.

Contraindications for Exercise During Pregnancy:

Hemodynamically significant heart disease
Restrictive lung disease
Incompetent cervix or cervical cerclage
Multiple gestation with risk for preterm labor
Persistent second or third trimester bleeding
Placenta previa after 26 weeks of gestation
Premature labor during the current pregnancy
Rupture of membranes
Pregnancy induced hypertension

Relative Contraindication for Exercise During Pregnancy:

History of sedentary lifestyle
Intrauterine growth retardation
Poorly controlled hypertension
Poorly controlled seizure disorder
Poorly controlled insulin-dependent diabetes
Severe anemia
Chronic bronchitis
Maternal cardiac arrhythmia
Poorly controlled thyroid disease
Extremely overweight (morbid obesity)
Extremely underweight (BMI 12)
Orthopedic limitations
Heavy smoker

Exercise Recommendations During Pregnancy:

Avoid scuba diving, high altitude activities, activities with risk of fall, activities with risk of abdominal trauma.

FITT principle (frequency, intensity,time, and type)

For sedentary women:
Frequency = minimum of 3 per week
Intensity = moderately hard perceived exertion (PE)
Time = 30 minutes
Type = low impact

For regular exercisers:
Frequency = 3 to 5 per week
Intensity = moderately hard to hard PE
Time = 30 to 60 minutes
Type = low impact and any prior safe activities

For elite athletes:
Frequency = 4 to 6 per week
Intensity = 70% to 80% maximum heart rate or hard PE
Time = 60 to 90 minutes
Type = competitive activities as tolerated during pregnancy

Photo Credit: Flickr/TajaTaja

 

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