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Managing back and pelvic pain during pregnancy

By Jessica Ewing, Founder - moofitmoofit

There is nothing quite like being pregnant and feeling those amazing kicks and rolls in your tummy. Everyone keeps commenting on how thick your hair is and your pregnancy glow but for many of us as your belly grows so does the feelings of discomfort.

It's not unusual to feel uncomfortable during pregnancy at some point! From no longer being able to sleep on your tummy, general aches and pains or feeling like you have run a marathon after attempting to tie your shoelaces! Our bodies undergo so much change physically and physiologically and it truly is amazing how it adapts to accommodate a growing baby [or babies] and prepare for labour and birth. When it comes to pain during pregnancy some common conditions are caused by these changes.

Lower back pain

  • Aches and pains
  • Sacro-iliac joint pain
  • Sciatica

Pelvic pain

  • Pubic symphysis dysfunction 
  • Pelvic girdle pain

What causes back pain during pregnancy?

Lower back pain is defined as pain between the twelfth rib and the gluteal fold (the crease separating the buttocks from the thigh) and can hit at any time but is more common in the second and third trimesters. It's estimated that at least 50% of women will experience lower back pain at some point in their pregnancy and It is often related to the changes in your centre of gravity [ the point at which all parts of your body are balanced]. Your centre of gravity changes and shifts forwards as your belly and baby grows. This has a domino effect and pushes the pelvis forward (anterior pelvic tilt), causing an increased arch in the lower back (lordosis). General aches and pains are common during pregnancy as your entire body changes and adapts to the structural changes and the growing baby inside of you however these can normally be managed with rest, popping your feet up, a heat pack or nice bath. When pain persists and you just can't seem to get on top of it, it could mean you might be suffering from one of the other common lower back pain conditions.

What is pelvic pain?

Pelvic pain is defined as pain experienced between the sacroiliac joints where the hip bones (the ilium) meet the tailbone (the sacrum) and the gluteal fold (the crease that separates the buttocks and the thigh or in the symphysis pubis (the joint located between the left and right pubic bones at the front of the pelvis, above external genitalia). Two common types of pelvic pain can occur during pregnancy and these are sacro-iliac joint pain and symphysis pubis dysfunction,

Sacro-iliac what?!

There are two sacroiliac joints in the pelvis one on the left and one on the right side, where the hip bones (the ilium) meet the tailbone (the sacrum). In between these joints is connective tissues and pain here is often described as “a pain in my butt” or “sciatica” and often sacroiliac joint pain and sciatica are easily confused. Sciatica affects a large nerve called the sciatic nerve that extends from the lower back down the back of each leg. This causes pain to originate in the lower back but radiate down the back of the leg.

Symphysis pubis dysfunction (SPD) occurs often in the second to the third trimester and usually present as a shooting type pain in the front on the pelvic (crotch) which is why It is often referred to as lighting crotch! During pregnancy, the joint that connects the pubic bones (pubic symphysis) begins to widen in preparation for delivery which can cause instability of the pelvis and in some women pain. Women often have radiating pain in the lower abdomen, back, groin, thigh or leg. Pain is exacerbated by movements, walking or unilateral (single leg) exercises such as lunges or step-ups. Even daily tasks can become difficult such as getting out of bed or rising up from a chair. SPD is commonly associated with pelvic girdle pain (PGP), and the terms are often used interchangeably however pelvic girdle pain describes pain at the back of the pelvis.

What is the best way to manage back and pelvic pain during pregnancy?

To manage your symptoms, you can try a heat pack, warm bath, support garments (like Active Truth Mama Full Length Pregnancy Tights) or a support belt (if recommended by your health care provider). Modifying how you perform your day to day tasks and exercises can also be beneficial like sitting down to put shoes and socks on or ensuring your get up and down from the floor and bed correctly. This involves lying onto your side first, pushing up with your hands and bringing the legs around with knees together. At night placing a pillow between your legs whilst laying down to support your top leg helps to reduce instability and elevating your top leg on a pillow keeps the hips square relieving pressure from the lower back.

Other options may be hands-on treatment from your physiotherapist or a support belt (which your physio can help fit you with) to help take some weight from your belly and keep the pelvis stable.

One of the best ways however to manage your low back pain is to exercise and keep moving! Which sounds counter-intuitive when you are in pain right!? But most women with SIJ and pelvic pain will benefit from strength training. Having a pre and postnatal coach or women's health physio create an individualised program for you to strengthen your body and help minimise pain but also help you find ways for you to exercise that doesn't exacerbate your pain is key!

My top tips for helping to manage pelvic pain and back pain in pregnancy:

- See a physiotherapist for assessment and diagnosis

- Work with a pre and postnatal fitness coach for your exercise programming

- Keep the knees together as best you can to keep stability in the pelvis

- Avoid any unilateral exercises if they increase your symptoms like split squats, lunge variations, step-ups as these create pelvic instability

- Go for exercises that challenge your glutes (buttocks), abdominals, upper and lower body so you can increase the stability in your back and pelvis.

- Work on your mobility with exercises like cat/cow, hip circles, pelvic tilts on a fit ball, open book, knee rolls and

- For additional support try some compression garments like Active Truth Mama Full Length Pregnancy Tights!

Written by Jessica Ewing founder of moofitmoofit.com.au

Jess is an online pre and postnatal fitness coach. She founded moofitmoofit after the birth of her first son after navigating her own postnatal journey. Jess knowns firsthand how hard it is to find quality information related to health and fitness, particularly throughout pregnancy and postpartum. She provides women with evidence-based resources and a customised fitness approach to help tackle this overwhelming and unfamiliar chapter in life.