I’ve been very fortunate to be able to work with my patients throughout all stages of their motherhood – starting from the pre-natal period (providing pain-relief in a safe and gentle manner) to post-natal period (ensuring that their optimal level of function is restored after delivery). As moms enter the exciting stage of expecting a new baby, this excitement may be curtailed (briefly!) with an air of concern in her voice asking: “Why am I experiencing discomfort in my low back/neck/shoulders during pregnancy when I’ve never even had these concerns in the past?” You may even identify with this question since you are definitely not alone. A study in the journal Orthopedics reports that 50 to 90% of pregnant women will most likely experience back pain.
Why are these statistics so high? Let’s take a brief look at the major biomechanical and physiologic changes occurring at different points of motherhood that may manifest as back, hip, neck, shoulder or neck pain:
During Pregnancy: there are (3) curves naturally present in our spine – in the neck, mid-back and low back. The significant weight gain in the abdominal region accentuates the loading through the individual bones (vertebrae) in the lower back. The corresponding curve becomes accentuated and the joints have a greater potential of becoming inflamed and causing pain. The same phenomena may occur in the upper-back/neck region as the increased weight in the chest area may strain the supporting mid-back musculature. Since muscles attach to bones, any prolonged strain in the muscles is also going to have a consequence on the normal movement of the joint.
Furthermore, throughout the skeletal system, we have fibrous tissue bands that behave like rubber bands to connect two bones together, known as ligaments. Ligaments typically ensure that just the right amount of movement at a given joint is occurring to allow for pain-free bending/twisting/leaning. During pregnancy, there is an increase in the hormone relaxin, which causes the ligaments of the pelvis and back to loosen in preparation for delivery. Consequently, this hormone also allows for excessive motion at the other joints in the body. The body’s response may be that of inflammation and pain as it tries to stabilize the excessive movement.
Post-Delivery: Low back pain may persist as the rapid weight loss after delivery leads to an equally rapid off-loading of the natural curve in the low back. The decline in relaxin causes the ligaments to stiffen which may lock the sacroiliac joint in a less than optimal position, and give rise to discomfort when bending over to pick up baby, or taking a step after getting out of chair.
Infant/Toddler years: There are a multitude of repetitive ‘mommy-related’ activities such as getting in and out of the car, nursing, carrying your toddler, vacuuming that can strain your back.
Considering the immense transformations that occur in the body in order to house and nurture the fetus, it probably doesn’t seem mysterious anymore as to why expectant mothers may experience some “growing pains” during the peri-natal period. Even though the body is pretty amazing at compensating and adapting, when it comes to pregnancy, there is somewhat of a disconnection between the speed of adaptation and the rapid postural changes of carrying the baby. With timely treatment and awareness of potentially aggravating activities in day-to-day life, you can ensure that these temporary ‘growing pains’ remain temporary and you can go on being the best mom you can be, in comfort.