A study conducted in 2018 in Ontario found that 76% of pregnant women experience some level of low back pain, pelvic-girdle pain, or a combination of both during pregnancy.
Frequently, pain was reported to increase as the pregnancy progresses. Unfortunately, many people accept this as part of pregnancy where very little can be done to alleviate it. Fortunately, physiotherapy can offer various types of treatments that have shown to be both an effective and safe way to manage pregnancy-related low back and pelvic girdle pain. Taking proper steps to resolve back pain during pregnancy is also beneficial for a healthy postpartum period.
Why do so many pregnant-women experience back pain?
During pregnancy, female bodies undergo drastic changes to accommodate the growing baby. Ligaments that usually stabilize joints in our lower back and pelvis start to loosen up due to hormonal changes. This is to allow the pelvis to widen in preparation for child-birth. In response to loosening ligaments, muscles in the lower back and pelvis can tighten up to help provide additional support to the joints. These muscles are also affected by postural changes that happen as the pregnancy progresses and the baby-belly grows. This imbalance of loose ligaments and tight muscles can lead to pain for many women.
Another important change to note is the effect of the growing weight of the baby on the pelvic floor. The widening pelvis and loose ligaments are less able to provide the necessary support needed for the pelvic floor muscles to engage and stabilize the pelvis. Often times, pregnant women experience weakness in their pelvic floor which can contribute to low back, hip and pelvic pain.
How can physiotherapy help?
FCAMPT physiotherapists conduct thorough assessments whereby they narrow down the cause of the pain and the associated problems that accompany them. They are able to pinpoint muscles that may be tight or weak, joints that may be tight or loose, and nerves that may be affected. They can look at posture and various movements that may be affected by the pregnancy as well.
Once your physiotherapist has identified the main causes of pain or dysfunction, they are able to provide various methods of treatment that can be both safe and effective in relieving pregnancy-related back and pelvic girdle pain. Using hands-on techniques, your FCAMPT physiotherapist would be able to apply the appropriate level of force to release any tight muscles or joints. Often times, restoring the natural balance of how your muscles and joints move and work together can help alleviate pain.
Your physiotherapist will also be able to prescribe appropriate exercises for your pain. Stretches to help restore mobility and flexibility and strengthening exercises to support loose joints may all be part of the repertoire. They can provide you with advice around your exercise program or other activities you may be involved in, and help you make modifications as needed.
If you are suffering from incontinence, pain with intercourse, or increased mobility in pelvic joints are noticed during the assessment, your physiotherapist may advise you to also see a pelvic floor physiotherapist for further assessment. A pelvic floor physiotherapist is specially trained in assessing your pelvic floor muscles and structures through internal palpation of your vaginal and rectal wall. Some FCAMPT physiotherapists may be practising pelvic floor physiotherapists themselves or work closely with one.
One of the main advantages to consulting an experienced physiotherapist, such as an FCAMPT, is the knowledge and advice they are able to provide you in managing your pain. They can give you advice around posture, how to modify your day-to-day tasks to suit your pregnancy and pain, what to avoid, or what to do more of. Pregnancy and low back pain can be a recipe for poor sleep for many women, and your physiotherapist can advise you on positions of comfort.
Other recommendations your physiotherapist may give you to help with your pregnancy-related back pain are aids such as using a belly belt or SIJ brace. They can asses whether this would help your symptoms, and may try alternatives such as taping or a scarf-test to help you decide.
Overall, there are various safe and effective treatments that an FCAMPT physiotherapist is able to provide to help manage your pregnancy-related low back pain. From hands-on techniques to exercises, they can provide you with the education and advice needed to not only have a more comfortable pregnancy, but to also continue to do the activities that are important to you.
About Juanit Fazari
Juanit Fazari, PT is a passionate and seasoned practitioner who aims for high-quality and pain-free living for her patients. After graduating from McMaster University with an Honours Bachelor of Science in Kinesiology and a Masters of Science in Physiotherapy, she went on to earn her designation as a Fellow of the Canadian Academy of Manipulative Physiotherapists (FCAMPT). In addition to manual therapy, she has completed numerous post-graduate courses to enhance her clinical “tool-belt”, including acupuncture and vestibular rehabilitation. After having children herself, she became interested in pelvic floor physiotherapy and now treats as an orthopaedic and pelvic floor physiotherapist. She is the owner of Thrive Physiotherapy on beautiful Locke St. in Hamilton, ON. Find out more about Juanit on her Website, Instagram & Facebook.