I treat a lot of patients that present to me with spinal and pelvic pain during pregnancy. The predominant reasons for pregnancy pain are due to massive changes to the shape of the spine as well as the pelvis over a relatively short period of time – 9 months. These changes occur in order to accommodate for the growing foetus. In addition, there are many hormonal changes. In particular hormone Relaxin allows some of these changes to occur. It is released by the ovary and placenta and allows the ligaments to loosen and helps the body to accommodate for some of the changes.
The hormone Relaxin means the muscles need to work harder to help support the ligaments that have become softer, therefore muscles can become tender, tight and painful. This can occur anywhere in the spine – neck, upper and lower back. Furthermore, it is important that the posture does change during pregnancy. The pelvis needs to tilt forward usually causing a deeper curve in the lower back. These changes can compress the facet joints and discs as well as the sacro-illiac joints in the pelvis. It can cause the ligaments to be on pull especially the round ligament. The round ligament is a thick ligament that supports the womb whilst the foetus grows. It needs to stretch whilst the womb and baby grow and can be a common source of pain.
Treatment is gentle, usually with the patient lying on their side with pillows that support her and make her comfortable. Gentle movement of the stiff joints are encouraged as well as massage to help ease of tight muscles. If there is a restriction in a joint mainly in the upper back then this will be released if appropriate. Physiotherapy and osteopathy aim to facilitate the body in the changes that need to occur during pregnancy. Lots of advice is given to help make journey of pregnancy as enjoyable as possible.