Low Back Pelvic Pain During Pregnancy
During pregnancy the female body undergoes many changes, such as the release of a hormone called ‘relaxin’, which relaxes the ligaments to prepare the body for childbirth. These changes are necessary and usually beneficial. However, in some cases women can develop low back and pelvic pain during pregnancy..
A Physiotherapist and Massage Therapists specialize in the treatment of low-back and posterior pelvic pain during pregnancy.
Low back pain in pregnancy can be divided into 2 categories: 1) low back pain and 2) posterior pelvic pain.
Lower back pain refers to pain felt in the region bounded:
- Superiorly by an imaginary line through the inferior margin of the last thoracic spinous process.
- Inferiorly by an imaginary line through the posterior sacro-coccygeal joint.
- Superolaterally by vertical lines tangential to the lateral borders of the lumbar erector spinae and inferolaterally by imaginary lines passing through the posterior inferior iliac spines.
In most cases, the etiology is the same as that of lower back pain in non-pregnant individuals.
Posterior Pelvic Pain
Thought to arise from the pelvic joints and is defined by the following criteria:
- A stabbing like pain in the buttocks, L5-S1 area, possibly extending to the posterior thigh or knee, but not into the foot.
- Free movement in the hips and spine and no nerve root syndrome.
- Pain when turning in bed.
Women with posterior pelvic pain when compared to those with lower back pain, report a higher pain intensity, are more disabled, are more difficult to treat and have a worse prognosis.
The single greatest risk factor for low-back pain in pregnancy, is a history of low-back pain prior to pregnancy. This includes low-back pain prior to the present pregnancy, before the first pregnancy and during previous pregnancies.
Treatment may include the use muscle energy techniques, soft tissue massage, joint mobilization or exercises for low back –pelvic synergy and postural stability. Often a stiff thorax may also need soft tissue work and joint mobilization, as well as, breathing exercises.