Lower back pain during pregnancy should not be considered a natural part of the process that we should be expected to endure. Unfortunately this seems to be a common mindset. While it is true that there are a lot of reasons why LBP would occur during pregnancy - more relaxin in the system leading to more mobility in the joints, changes in spinal curvatures because of the growing baby, the weight of the baby pressing down on the pelvis, and many others - these are all things that can be helped, even during pregnancy. We also know that a woman experiencing LBP during pregnancy is 3x more likely to experience PP depression, so this is a multifactorial issue that cannot be ignored.
Helping moms during pregnancy is unique because her body continues to evolve. I think of the process as being two steps forward and sometimes a small step backward. We continually reassess because the demands on the muscles change constantly. Some of the ways physical therapy can help with low back pain include:
Training the muscles that stabilize the pelvis and spine. The stability muscles (deep abdominals, pelvic floor, multifidi, and diaphragm working together) are the next line of defense after the ligaments. If the ligaments are too loose because of extra relaxin in the system, we want the muscles to be working even more efficiently.
Teaching different ways of movement that will minimize strain on the painful areas, such as getting out of a car or bed without twisting or straining the pelvis.
Improving the pelvic alignment. Often sciatic nerve pain is coming from a muscle spasm that is reacting to an abnormal alignment in the pelvis. Improving alignment >> calmer muscles >> less pressure on the nerve.
The important thing to consider is that there are many possibilities for pain during pregnancy. There is not a “one-size-fits-all” approach as the cause is different between people. Using Youtube or Instagram to self-treat the issue could be helpful, or it could be harmful if it’s the wrong treatment for the issue. Having a physical therapist who is skilled at assessing the pregnant client is necessary to figure out the most effective, efficient treatment.
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Jill Heath is a licensed physical therapist and owner of She PT, LLC. She received a Doctorate of Physical Therapy and B.S. in Exercise Science from Northern Arizona University. During years of practice helping individuals of all ages recover from a variety of conditions, she developed a passion for working with women. She opened She PT, LLC with the purpose of meeting not only the unique physical needs of women, but also empowering women to take charge of their well-being by making care accessible.