Back Pain While Pregnant " Zarah is a 29-year-old female who is five months into her second pregnancy"

Case study ( 10134 views as of October 14, 2024 )

Zarah is a 29-year-old female who is five months into her second pregnancy. She has an active two-year-old running around at home keeping her busy. She is finding herself fatigued, mildly short of breath when she exerts herself and she is having significant pain throughout much of the day in the lower back and pelvis. She has tried stretches, pillows under her knees and sleeping in different positions, but she just cannot get comfortable. She is worried that she won’t be able to tolerate four more months of this, and her mother-in-law is adamant that it’s a sign that there is something wrong with the baby.

Zarah could benefit from a visit to her Family Physician, Obstetrician/Gynecologist and/or midwife. She may be referred to a Rheumatologist and/or Physiotherapist/Massage Therapist and could also benefit from yoga and a consultation with a pharmacist.

Author: Dr. Adam Lund

Back Pain While Pregnant " Zarah is a 29-year-old female who is five months into her second pregnancy"

Case Introduction

Back Pain in Pregnancy Treatment Video

Presented by

Tamarah Nerreter

M.S.

Physiotherapist

Back Pain ( 83 engaged.)

Open and print the educational action plan for conversation with your Healthcare provider.

Treatments

Benefits of Yoga in helping with Back Pain during Pregnancy

Practitioner help from:

Heather Greaves

Yoga Instructor
Exercise to help with Back Pain in Pregnancy

Practitioner help from:

Dr. Sonia Macfarlane

FRCS(C)

Obstetrician
Chiropractic Care for Back Pain in Pregnancy

Practitioner help from:

Dr. Brandon Czekaj

Chiropractor

Treatments

Physiotherapy for Back Pain in Pregnancy

Practitioner help from:

Dr. Stephanie House PT, DPT

Physiotherapist
Back Pain in Pregnancy - Learn How Scoliosis Can Contribute to Back Pain

Practitioner help from:

Dr. Rajwinder Dhillon

Rheumatologist
The Benefits of Massage Therapy in Treating Back Pain During Pregnancy

Practitioner help from:

Ms. Jessica Bouton

Massage Therapist

Conversation based on: Back Pain While Pregnant " Zarah is a 29-year-old female who is five months into her second pregnancy"

Back Pain While Pregnant " Zarah is a 29-year-old female who is five months into her second pregnancy"

Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 10 January 2024

The rectus abdominis is commonly referred to as the "six-pack" muscle due to its characteristic appearance in individuals with well-defined abdominal musculature. It is divided into segments by fibrous bands called tendinous intersections, which give it a segmented appearance. The rectus abdominis plays a crucial role in flexing the trunk, as well as aiding in other movements such as forced expiration, childbirth, and defecation. In addition to the rectus abdominis, there are other important abdominal muscles such as the external and internal obliques, transversus abdominis, and the pyramidalis. Collectively, these muscles contribute to core stability, protect the abdominal organs, and assist in various movements and functions of the trunk.

Reply to: Back Pain While Pregnant " Zarah is a 29-year-old female who is five months into her second pregnancy"
Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 18 June 2023

During pregnancy, women often experience postural changes due to the physical and hormonal adjustments in their bodies. These changes can include an increased kyphosis (curvature) in the upper thoracic spine and an exaggerated lordosis (curvature) in the lumbar spine, resulting in an S-shaped curve. These postural changes can have biomechanical implications and affect the body's alignment and stability. Additionally, the shifting center of gravity caused by the growing baby's weight can lead to increased stress and shearing forces on various joints, such as the sacroiliac joints, pubic symphysis, and thoracic spine. Promoting good posture and maintaining core strength and stability are crucial during the prenatal and postnatal phases. Good posture helps alleviate discomfort and minimize stress on the joints and muscles. However, postnatally, women may experience additional challenges due to the physical strain of labor and breastfeeding, which can impact their everyday comfort and posture. If women are experiencing prenatal or postnatal issues with posture, it is recommended that they seek the guidance of a local physiotherapist. A physiotherapist can provide personalized advice and exercises to address postural concerns, improve core strength, and support the body's alignment during pregnancy and postpartum. They will be able to assess specific needs and provide appropriate recommendations for optimal posture and overall well-being.

Reply to: Back Pain While Pregnant " Zarah is a 29-year-old female who is five months into her second pregnancy"
Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 18 June 2023

If you have had a healthy pregnancy, there are numerous exercises and activities that are generally safe to engage in throughout the duration of your pregnancy. Some popular exercises include yoga, which can help with flexibility and relaxation. Walking is an excellent low-impact exercise that can be easily incorporated into your routine. Going to the gym and engaging in activities such as weightlifting, using a treadmill, or a stationary bike are also generally safe options. Pool-based exercises, such as swimming or water aerobics, are highly recommended during pregnancy as they provide support, are gentle on the back, and can help alleviate discomfort. Certain weight-bearing sports can also be continued during pregnancy, but it's common for individuals to slow down or modify their activity as their pregnancy progresses. Running, tennis, and skiing (for experienced skiers) are examples of weight-bearing sports that may be suitable earlier in pregnancy but may require adjustments or reduced intensity as the body undergoes changes. It's important to listen to your body and pay attention to any discomfort or strain on your joints, back, or hips, as these signs may indicate the need to modify or switch to a different activity. It's always advisable to consult with your healthcare provider before starting or continuing any exercise program during pregnancy. They can provide personalized recommendations based on your specific circumstances and health status.

Reply to: Back Pain While Pregnant " Zarah is a 29-year-old female who is five months into her second pregnancy"
Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 06 December 2019

The primary cause of Back Pain in pregnancy is due to the hormone “relaxin” being released. This hormone causes you to change your center of gravity and alters joint stability. Being pregnant, there will be more weight out in front of you from the baby. To accommodate this weight, people typically will lean back and compress the lumber spine causing pain. If you are interested in treatment for Back Pain, seeing a Physiotherapist could help.

Reply to: Back Pain While Pregnant " Zarah is a 29-year-old female who is five months into her second pregnancy"
K. Michael 15 September 2015

A former co-worker of mine wore a brace type device while pregnant. She had severe back pain and was barely able to walk . The brace helped provide support for her lower back and stomach. Would this type of thing help with back pain Zarah describes ?

Reply to: Back Pain While Pregnant " Zarah is a 29-year-old female who is five months into her second pregnancy"
- Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 14 April 2022
  
  Back pain symptoms can be mild or severe, and cervical (neck pain), thoracic (middle back pain), lumbar (lower back pain) or tailbone/sacral (coccydynia). Lumbar back pain is the most common type.
K. Michael 15 July 2015

One thing to keep in mind is that back pain doesn't always end with delivery. She should continue her back pain regime after the baby is born, as her body recovers

Reply to: Back Pain While Pregnant " Zarah is a 29-year-old female who is five months into her second pregnancy"
- K. Michael 30 August 2015
  
  Shirley how long did it take for your back pain to go away after your baby was born ? I found that I had back pain when standing or sitting for long periods for about 6 months after my pregnancy
- ShirleyG 15 August 2015
  
  I did not have back pain prior to pregnancy. After my son was born I found it difficult to sleep and sit for long periods of time, as my back would ache. Spoke to the doctor and he said this was common and I needed to move around and stretch my back more.
Joy 14 May 2015

I greatly benefitted from massage therapy and yoga during and after my pregnancies.

Reply to: Back Pain While Pregnant " Zarah is a 29-year-old female who is five months into her second pregnancy"
Dr. Jason Kur MD,FRCP Rheumatologist, Vancouver, BC 23 April 2015 Artus Health Centre

There are some very important considerations with pregnancy. If you do have rheumatoid arthritis and are on medications, some of those medications are unsafe in pregnancy and as a result, you need to talk to your doctor about those medicines.

Reply to: Back Pain While Pregnant " Zarah is a 29-year-old female who is five months into her second pregnancy"
- Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 14 April 2022
  
  Back pain causes include injury or activity, arthritis, back strain, sciatica, poor posture, aging and scoliosis.
- K. Michael 30 June 2015
  
  Healthymama that's great advice. There are lots of ways to modify your routines to help back pain. Something like resting your foot on a stool while washing dishes can ease back strain.
- Healthymama 14 May 2015
  
  She should learn some proper ways to pick up or help with her toddler that will put less strain on her back.
Dr. Maziar Badii MD, FRCP Rheumatologist, Vancouver, BC 23 April 2015 Artus Health Centre

In fact, up to 50 percent of women experience back pain during their pregnancy. Sometimes this back pain can be mild. It can sometimes be so severe that it may interfere with their work, or with their day-to-day activities. It may even predispose back pain during future pregnancies.

Reply to: Back Pain While Pregnant " Zarah is a 29-year-old female who is five months into her second pregnancy"
- Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 14 April 2022
  
  Lumbar Discectomy and Laminectomy are procedures that treat the condition sciatica, which is caused by a bulging or herniated disc.
- Dr. Grant Lum MD, CCFP, Dip Sport Med Sports Medicine Physician, Richmond Hill, ON 20 February 2017 Athletic Edge Sports Medicine
  
  Management and treatment of back pain during pregnancy are mostly entered around modifying physical tasks and positioning, resting (sounds great right?) and exercising within certain parameters
- Healthymama 14 May 2015
  
  I definitely experienced back as well as hip pain during my pregnancy.
- Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 26 April 2015
  
  A good stretching program can be very beneficial if you are pregnant and experiencing back pain. Consult your local athletic therapist or trainer if they are experienced and training in stretching pregnant women.
Gordon Bohlmann Physiotherapist, Vancouver, BC 08 April 2015 Marpole Physiotherapy Clinic

Being male, I will never experience being pregnant with a sore back, but I know that it's the last thing any pregnant woman wants. Treatment can be somewhat challenging because its uncomfortable to lie prone, but in general the pain is associate with postural changes and spinal loading patterns as a result of the changes to body morphology associated with a growing baby. The good news is that in the greater majority of cases these changes reverse after delivery. Management and treatment of back pain during pregnancy are mostly entered around modifying physical tasks and positioning, resting (sounds great right?) and exercising within certain parameters. Contact your local physiotherapist who can provide sound advise and appropriate treatment strategies.

Reply to: Back Pain While Pregnant " Zarah is a 29-year-old female who is five months into her second pregnancy"
- K. Michael 09 July 2015
  
  A physiotherapist should be able to advise ways to change her daily routine to avoid further stress on the back.
- Healthymama 14 May 2015
  
  Could a physiotherapist offer advice on how to manage the toddler without straining the back?
T.Brown 02 April 2015

If she is working at a desk, she should consider getting an ergonomic assessment. As her body is changing, she may need to change her set-up to alleviate her back pain.

Reply to: Back Pain While Pregnant " Zarah is a 29-year-old female who is five months into her second pregnancy"
- Healthymama 14 May 2015
  
  Yes just a simple prop for her feet can make a huge difference.
T.Brown 02 April 2015

If she is comfortable, she could take her mother-in-law to her next midwife/OB appointment. Sometimes it helps to hear it from the professional. And will alleviate the extra stress of having her MIL worried about the health of her baby. Stress can make it hard to relax enough to let pain subside.

Reply to: Back Pain While Pregnant " Zarah is a 29-year-old female who is five months into her second pregnancy"
- Healthymama 14 May 2015
  
  That's a good idea, sometimes people need to hear it from a professional before they believe it!!
Joy 29 March 2015

How would the mother's aches and pains be related to the health of the baby?

Reply to: Back Pain While Pregnant " Zarah is a 29-year-old female who is five months into her second pregnancy"
- K. Michael 12 August 2015
  
  Some people believe that a painful pregnancy is nature's way of telling you there is something wrong with the baby. It's an old wive's tale
- Healthymama 14 May 2015
  
  That's a good question!
Chantal Sayers Vancouver, BC 18 February 2015

One of the things that I wish I had tried in my pregnancies was prenatal yoga. I do a lot of yoga now and it is great for mind and body. A nice gentle stretching routine might be good for the back during pregnancy.

Reply to: Back Pain While Pregnant " Zarah is a 29-year-old female who is five months into her second pregnancy"
- Dr. Maziar Badii MD, FRCP Rheumatologist, Vancouver, BC 23 April 2015 Artus Health Centre
  
  There's some very simple, common sense-type of things that everyone can do that can both facilitate the positive physiological factors and protect the back against pain, discomfort as the pregnancy progresses.
- T.Brown 02 April 2015
  
  I did, I really enjoyed it. It helped with all kinds of pain in pregnancy, as well as being a nice time to connect with the being I was growing.
- Healthymama 19 February 2015
  
  Me too.. I always meant to do prenatal yoga but it never happened!
Mariana Paz Physiotherapist, Thornhill, ON 06 February 2015

It would be wise to see a physiotherapist or a chiropractor for a back assessment before she enters the third trimester, where there will be more precautions to take when it comes to moving and exercise. Since she is running after her 2 year old, she is probably doing more bending and lifting that may aggravate the lower back. The latter in combination with the extra weight from the baby and the general instability/laxity in all the joints that is a normal consequence from the circulating pregnancy hormones, can be causing her lower back pain. So, first step would be to assess the back and see if there is a mechanical component that can be addressed with a simple exercise. Second, improve her body mechanics when 'running' after her toddler and doing house chores or whatever. Thirdly, start core exercises to provide joint stability within the vertebral column - stability ball exercises and Pilates would be great.

Reply to: Back Pain While Pregnant " Zarah is a 29-year-old female who is five months into her second pregnancy"
- K. Michael 08 March 2015
  
  Also an occupational therapist can help teach her some ways to do things around the house that are less stressful on the back. Something as simply as resting your foot on a stool while doing dishes removes strain on the back by shifting your center of gravity
- Healthymama 19 February 2015
  
  I would watch the weight gain in third trimester too. I gained too much in mine and it really affected my back.
- Ms. Sarah Ware RD Registered Dietitian, North Vancouver, BC 06 February 2015
  
  A physiotherapist mentioned to me that some women with back problems prior to pregnancy may find some relief as the baby grows as the baby acts like a splint for the core area. Have you had this experience with clients?
Chantal Sayers Vancouver, BC 04 February 2015

When I was pregnant I tried my best to get regular exercise but also went for pre-natal massage. It was really helpful not just for my body but for my mind. If anyone is experiencing back pain in their pregnancy I would highly recommend seeking out a massage therapist that caters to pregnant women.

Reply to: Back Pain While Pregnant " Zarah is a 29-year-old female who is five months into her second pregnancy"
- T.Brown 02 April 2015
  
  I had massage with 2 of my pregnancies and it helped with pregnancy pain. Someone with back pain in pregnancy could definitely benefit.
- Joy 29 March 2015
  
  Massage during my pregnancies helped me immensely.
- Healthymama 19 February 2015
  
  I saw an rmt who had no experience with pregnancy and he was totally freaked out! I would definitely ask ahead of time!