Women who are pregnant experience many changes in their body. Many women experience mild to severe low back pain associated with pregnancy. As a matter of fact over 60% of pregnant women experience low back pain during their first or second trimester. The physiologic changes, which occur throughout pregnancy, can dramatically affect the stability of the spine and increase risk of spinal injury. An increasing number of women are waiting until later in life to become pregnant, increasing the need and awareness of this problem. Physiologic changes include an increase in the release of the hormones progesterone, estrogen, and relaxin causing and increased ligamentous laxity resulting in excessive spinal motion. The average woman may gain 26-30 pounds during the course of her pregnancy. The distribution of this additional weight changes the body’s center of gravity, altering the neutral mechanics of the spine. Distention of the abdominal and pelvic floor muscles result in a loss of strength, spinal stability, and bladder control. The abdominal muscles are weakened by fetal stretching, making it essential to begin abdominal strengthening exercises early in pregnancy. Abdominal strengthening may also speed the delivery process and makes women more tolerant of the delivery process.
A physical therapist skilled in spinal evaluation as well as perinatal physiology can effectively treat pregnant women experiencing low back pain. After a thorough biomechanical and spinal evaluation, the therapist will address spinal alignment using manual techniques. A comprehensive exercise program is then designed to address the woman’s specific dysfunctions. A sacroiliac stabilization belt may be prescribed in severe cases of pelvic instability. In addition, correction exercises can decrease diastasis recti, a separation and weakening of the rectus abdominis muscle. The changes of intra-abdominal pressure during pregnancy will also effect respiration. Instruction in diaphragmatic breathing is also an integral part of treatment. Cardiovascular exercise will also improve circulation, cardiovascular endurance, and decrease the occurrence of constipation. Research has demonstrated perinatal exercise can prevent chronic low back pain, a prolapsed uterus, pelvic pain, and urinary incontinence. We recommend consulting your obstetrician before implementing a new exercise program.