Pregnancy & Pain – The common issues faced by expectant mothers

Pregnancy brings joy, but has its woes as well. Painful problems like lower back pain and incontinence commonly plague expectant mothers with discomfort, but what’s worse is if they are ignored and remain unattended to.

In this series, our Principal Physiotherapist, Sylvia Ho discuss extensively the common issues faced by expectant mothers, how to identify them and what physiotherapy can do to ease the symptoms and ultimately, pave the way to a more comfortable pregnancy and subsequent childbirth.

Pregnancy problem: arched back posture

In our Posture Series, we explored the arched back or kyphotic-lordotic posture that is characterised by a severely arched back that is caused by a forward centre of gravity, a pushed-back chest and a downturned pelvis.

What causes this posture?

Specifically in the case of pregnant women, this posture is caused by a forward shift in her centre of gravity, due to a load, i.e. the baby bump. Consequently, a pregnant woman inadvertently counters this forward centre of gravity by leaning backwards.

Why does this cause lower back pain?

The arched back posture compresses the lumbar spine, due to the increased load on the spine by the baby bump. Weakened abdominal muscles (rectus abdominus) facilitate this posture, while the corset muscle (transverse abdominus) — expanded during pregnancy — decreases stability in the lumbar spine and pelvis.

In addition, the ligaments in the spine lax as a result of hormonal changes in preparing the body for delivery, further contributing to the prevailing instability.

Why should I treat my lower back pain during pregnancy?

Ultimately, it is to ensure a comfortable pregnancy that is as pain free as possible. Furthermore, untreated lower back pain can persist in the post-natal period and even in subsequent pregnancies. Plus, your strength and stability will make it easier for you when caring for your newborn.

Don’ts to prevent arched back posture

• Wear heels, which can lead you to compress your spine further.
• Sit on the edge of a chair without resting your back fully on the backrest.
• Use arched support for the lower back.
• Carry older children or heavy objects, which will increase your load and exacerbate the lordosis.

Dos to prevent arched back posture

Exercises such as:

• Post-pelvic tilts (or known as the backward pelvic rock).
• Single knees-to-chest hugs to round your back.
• Kegel exercises to strengthen the pelvic floor.
• Basic transverse abdominus exercises (only if you’re in your first and second trimesters).

Physiotherapy treatment

Physiotherapy helps with specific exercises to train and connect with your body better. It is highly recommended that expectant mothers consult with a professional physiotherapist, who can guide you in the specific exercises.

It is best that you do so as soon as you’re in your first trimester, so as to strengthen the targeted muscles early on. A heavier load will hinder any progress in training the correct muscles and will have minimal effect on your pregnancy pains.

References

1. _{Norén, L., Östgaard, S., Johansson, G., & Östgaard, H. C. (2002). Lumbar back and posterior pelvic pain during pregnancy: a 3-year follow-up. European spine journal, 11 (3), 267-271.}
2. _{NWUGA, V. C. (1982). Pregnancy and back pain among upper class Nigerian women. Australian Journal of Physiotherapy, 28(4), 8-11.}
3. _{Bullock, J. E., Jull, G. A., & BULLOCK, M. I. (1987). The relationship of low back pain to postural changes during pregnancy. Australian Journal of Physiotherapy, 33(1), 10-17.}
4. _{Perkins, J., Hammer, R. L., & Loubert, P. V. (1998). Identification and management of pregnancy‐related low back pain. Journal of nurse-midwifery,43(5), 331-340.}