Bad back and waiting for baby

Back pain is very common during pregnancy, and even for months after giving birth. In fact, more than one-third of women experience significant back pain during pregnancy. Eighty-five percent of those that experience back pain during their first pregnancy will experience it during subsequent pregnancies. What should be a joyous period, filled with delightful anticipation, turns into an uncomfortable, painful, and sleepless time.

If you plan to become pregnant, it is crucial that you take proactive steps to prevent back pain—even if you have never had back pain before. If you are already pregnant or have recently had a baby, it’s not too late. There are techniques you can learn to prevent and minimize back pain.

Why is back pain so common during pregnancy?

It’s a great question and one that women ask all the time. The answer comes in a few parts.

One reason is a hormone called relaxin. Typically, pelvis ligaments are very taught, creating much needed stability in the pelvis and lumbar spine. As the name relaxin aptly implies, one of the functions of this hormone is to relax ligaments in the pelvis in preparation for childbirth. While relaxed ligaments are important and necessary to safely deliver your baby, an unfortunate side effect is that the pelvis and lumbar spine (low back) can become very unstable. This can lead to conditions such as disc bulges, disc herniations, and SI joint syndrome that can cause serious back pain.

Another cause of back pain is simple mechanics. The increased weight of the fetus during pregnancy can cause significant strain on the low back. Without a specific strength training, these muscles may not be strong enough to counter the additional load from the pregnancy. It’s weak, strained muscles that create pain.

diagram of the pelvis and low spine, along with ligaments

Why is back pain so common after giving birth?

You think, “I’ve given birth, the extra load on my ligaments is gone. But why do I still have back pain?” The reason can also be relaxin—the effects of the hormone can last until breastfeeding has ceased. For many new mothers, this can be several months. Most women (and those around them) don’t realize that during this time, a new mother is at increased risk for low back injury.

The effects of relaxin are further compounded by the act of lifting up a newborn. Repeatedly lifting and carrying extra weight—even just 5-8 lbs. – can be the tipping point.

Last, for new mothers, as for everybody, the lumbar discs (the body’s natural shock absorbers between each vertebra) are at their highest risk for injury during the first hour after waking. As we sleep, our discs fill with water and other liquids. During the first hour of waking, the discs slowly return to their normal size and pressure. Until they reach their normal state, the discs are at a heightened risk of injury.

So, if we combine these factors—an unstable pelvis and lumbar spine due to relaxin, and rushing out of bed to lift extra weight (the baby) repetitively before the discs have had a chance to return to a safe size and pressure—you have the recipe for low back issues. Often, what should be a happy time, leads to disc herniations, a very painful and potentially serious injury.

diagram showing pinched nerve and disc bulge in back
diagram showing pinched nerve and herniated disc
diagram showing SI Joint Syndrome in pelvis, along with healed Sacrotuberous Sprain

The good news: Core strength and endurance relieve back pain

The risk of low back injury and back pain can be significantly reduced by adopting a two- pronged strategy that combines:

  1. Building up core and buttocks muscles to give extra support to the spine.
  2. Learning proper lifting techniques to minimize the risk of injury when picking up your baby.

Developing core strength and endurance enhances the body’s natural support structure for the spine and greatly reduces the chances of developing back pain during or after pregnancy. It is optimal to start a program, such as the BACKFOREVER program, before becoming pregnant but the techniques are also very beneficial even if begun well into the pregnancy.

Note: If you are already pregnant, consult with your doctor about whether this core strengthening program is safe for your stage of pregnancy.

Proper lifting technique

As every new mom knows, repeatedly lifting your baby (and its ever-increasing weight), often when you are very tired, is all part of being a parent. Learning proper lifting techniques is one of the best things you can do for you and your newborn. Low back pain can seriously impact your ability to care for and enjoy your baby. There are a few simple tips that can make all of the difference for a new mother. Learning to lift with the muscles in the buttocks (the gluteal muscles) and keeping your spine in neutral are crucial.

woman demonstrates the proper way to lift

By adopting these strategies, you can significantly reduce your chance of developing back pain during or after pregnancy and increase the joy of bonding with your baby.

Dr. Jeremy James

Dr. Jeremy James founded and was director of the Aspen Club Back Institute in Aspen, Colorado, is the coauthor of the bestselling The Younger Next Year Back Book and earned his Doctor of Chiropractic from the University of Western States. Learn more about Dr. James here.