Women commonly suffer from back or pelvic pain during and after pregnancy. An article in the European Spine Journal reports that 45% of pregnant women have mild symptoms, 25% experience serious pain, and 8% are severely disabled from back or pelvic pain. In postpartum women, 80% have mild symptoms and 7% have serious problems. Interestingly, this condition baffles many doctors, leaving many patients with chronic pain during and after pregnancy. We see women in our office who have dealt with years of disabling pain that left them unable to participate in many of their favorite activities.
Pregnancy-related back and pelvic pain are due to pelvic girdle relaxation. During pregnancy, a woman’s body secretes a hormone called relaxin, which causes ligaments to loosen. Ligament laxity is normal during pregnancy. This allows the baby to pass through the birth canal. The pelvic and the sacroiliac joints have to expand for the delivery. The mobility is actually increased by about 33%! But if the ligaments stay stretched out, this leads to chronic pelvic and sacroiliac instability. The continued stress on the body as the mother cares for her baby around the clock can limit her ability to obtain enough restorative sleep and can create a vicious chronic pain cycle.
When a woman carries the growing baby on her hips, it also aggravates sacroiliac laxity and pain. Many months are required after pregnancy for the joints to get their strength back, and the added stress of poor posture hinders the healing process. Prolotherapy is an available option that directly triggers ligament repair to combat joint instability for both pregnancy and postpartum back and pelvic pain. When the ligament tissue is stronger, the demands on the body can be met without producing debilitating pain and without interfering with the birthing process.
How does back pain during pregnancy develop?
The ligaments between the pelvic bones begin to soften and joints to loosen during pregnancy in preparation for the baby’s passage through the pelvis. These changes result in mobility of the joints in the pelvis, joints which haven’t moved very much since about the age of three. This movement in the joints can cause considerable discomfort on either side of the lower back, often with walking, and especially when going up and down stairs. During the second trimester, the uterus becomes heavier and changes the woman’s center of gravity. Gradually — and perhaps without being aware of it — women begin to adjust their posture and the way in which they move. These compensations can result in back pain, strain or other injury. The separation of the muscles along the front of the abdomen during pregnancy may also contribute to back pain during pregnancy. These two parallel sheets of muscles run from the rib cage to the pubic bone. As the uterus expands, they sometimes separate along the center seam, which can make the back pain worse.
When back pain does not resolve during or after Pregnancy
Mild low back pain during pregnancy is usually treated with adjustments in habits and patterns, such as changing one’s sleeping position, carrying and lifting objects carefully and correctly and, with a doctor’s guidance, continuing any exercise program, and possibly adding abdominal and back-strengthening exercises. However, while this may relieve some of the discomfort, chronic low back pain is not so easily addressed.
In most cases, medication is not a treatment option for chronic low back pain during or after pregnancy. Supportive garments may be recommended, as well as spot treatments such as heat and cold. If the pain persists or the woman develops any radiating pain, numbness, tingling or weakness in the legs, she might be referred to a spine physician with expertise in women’s health issues and/or pregnancy related disorders.
The problem with these approaches to chronic back pain during and after pregnancy is that they do nothing to address the underlying problem – the naturally weakened and softened ligaments of the sacroiliac joints.
Treating Back Pain During and After Pregnancy with Prolotherapy
In our experience, a great approach to relieving chronic low back pain that may occur during or linger after pregnancy, if all other conservative treatments have proven unsuccessful, is to strengthen the ligaments of the sacroiliac joints with Prolotherapy. Comprehensive Prolotherapy strengthens the joints to relieve the pain, but does not interfere with the birthing process. It is the treatment of choice for chronic low back pain during pregnancy and can make it much more bearable. In addition, we want to emphasize that it normally takes many months for the sacroiliac joints to regain their normal strength after a pregnancy. Because carrying a baby on the hips places undue stress on this area during this time, we strongly discourage this practice.
Prolotherapy offers the most curative results in treating chronic back pain. It effectively eliminates pain because it attacks the source: the fibro-osseous junction, an area rich in sensory nerves. When this tissue is strengthened, long term pain relief can be achieved. In our experience, this makes a new mom much happier to be able to take care of her child without disabling back pain.