With my first child, I assumed that my aching back was par for the course and suffered through it. But my "grin and bear it" attitude became harder to pull off during my second pregnancy, when I was also carrying my 26-pound toddler and tons of baby gear. A combination of stretching, exercise, and my heating pad provided some relief, but I wish I'd known more about how to cut my risk of developing back pain in the first place.
It's a common problem: Between 50 and 80 percent of pregnant women experience a backache largely due to weight gain. Women are supposed to put on 25 to 35 pounds during pregnancy, and nearly half gain even more than that. The added weight is mainly distributed around the belly, which causes your center of gravity to tilt forward. To compensate for this shift, many women over-arch the lower back and round the upper back and head forward, which can lead to back problems.
A second culprit is the pregnancy hormone relaxin, which, as the name implies, relaxes the ligaments throughout the body. As pregnancy progresses, this hormone helps the pelvis expand to make more room for the baby. However, the effects of relaxin aren't just limited to the pelvic area. Ligaments in the spine also loosen up, which forces the back muscles to work much harder.
Sometimes a backache may be a sign of preterm labor. Call your doctor immediately if you experience pain that's centrally located very low in the back and is accompanied by pelvic pressure, spotting, or unusually thick vaginal discharge. For other types of aches, the following prevention and treatment strategies from the experts should help to make you more comfortable.
Pay More Attention to Your Posture
In many cases, an aching back can be alleviated simply by becoming more aware of your body's alignment when sitting and standing. "Keep the chest and head high, hold ears over shoulders, tuck buttocks under, and keep the pelvis more flat, rather than arching your back, to support your additional weight," says Roger Harms, M.D., an obstetrician-gynecologist and author of Mayo Clinic Guide to a Healthy Pregnancy.
Though standing for long periods is discouraged for pregnant women, it's occasionally unavoidable. You can make it less stressful by donning a lightweight walking or running shoe that's wide enough to allow for swelling. "Women should wear shoes that provide shock absorption, stability, and support," says Alicia Silva, a physical therapist and author of Preventing and Managing Back Pain During Pregnancy. Manufacturers such as Born, Naturalizer, and Easy Spirit offer great options.
If you're in a situation that requires you to sit for an extended amount of time, make sure you're in the most supportive position possible: Sit so that your hips and lower back are touching the back of the seat and your knees are bent at a 90-degree angle. It's also a good idea to place a lumbar support pillow between the chair and your lower back. "The pillow will improve your sitting posture by reducing head and neck slouching," explains Silva.
Avoid picking up heavy objects during pregnancy and follow these tips for light-to-moderate lifting: Keep your back straight, bend at the knees, lift with your legs, keep the object close to your body, and avoid a twist and lift motion. If you must twist, turn your entire body and feet to face the new location, rather than swiveling at the waist. (Use the same techniques postpartum when picking up your baby and any of his gear.) Most important, remember to ask for help when you need it. If ever there was a time when people are happy to come to your rescue, it's now.
Regular exercise can help keep your back strong, but be sure to check with your doctor before beginning any type of program. Dr. Harms recommends a combination of stretching and low-impact cardiovascular exercises like walking and swimming. Swimming is especially great during pregnancy: "It gives the muscles that are supporting your extra weight a break and helps with conditions such as varicose veins and ankle swelling," says Dr. Harms.
Sleep on Your Side
Late in pregnancy, you should sleep on your left side so that the uterus doesn't put pressure on the vena cava, a main vein located on the right side of the abdomen that keeps your blood circulating. To help maintain a properly aligned spine, Silva suggests placing a pillow under your tummy and one or two between your knees for support. The Utterly Yours Pregnancy Pillow ($40 and up; utterlyyours.com) gets rave reviews from expecting moms. After all, nothing does a body good quite like a restful night's sleep.
Originally published in the July 2010 issue of Parents magazine.