Back pain during pregnancy

Traditionally accepted as inevitable, low back pain is the most common complaint during pregnancy (1). One study found that 86% of women who were 36 weeks pregnant had difficulty doing a simple sit-up (2). In the scientific literature, the back pain most frequently encountered in women is that of the lumbosacral region (3).

Risk factors for back pain / discomfort during pregnancy

• Women who have had lower back pain (unrelated to pregnancy)
• Women who smoke
• Women with exhausting occupations
• Women with natural lumbar hyperlordosis
• Women who have ever been pregnant
• Young woman
• Small size women

Ligamentous hyperlaxity, increased weight and changed posture seem to be the three causes of back pain that almost half of women experience during pregnancy.

Hyperlaxité Ligamenteuse

During pregnancy the ovaries and later the placenta secretes the hormone relaxin which, as its name suggests, prepares the body for the expansion of the volume occupied by the fetus and also for childbirth. The ligament is important for joint support and in some women, the joint may be traumatized if there is a lack of muscle tone to balance this lack of ligamentous support. There will then be micro tears of the ligaments and / or muscle fatigue which they are not used to or adapt poorly to this overload.

Change of posture

In pregnant women, the body’s center of gravity is shifted anteriorly. In effect, this will have the effect of increasing the lumbar and cervical curves forward and dorsal backward. The lumbar and cervical extensor muscles as well as the pectorals will be shorter and contracted, therefore subject to micro-tearing. In contrast, the lumbar and neck flexion muscles will be relaxed and loose. This lack of harmony between them will be the source of joint slippage, especially in the lumbosacral and sacroiliac region as well as the lumbar facet joints.

An increase in the lumbar curve will cause:

• A forward tilt of the pelvis (flexion)
• An increase in the lumbosacral angle.
• The psoas will be shorter
• The shorter extension muscle.
• The abdominals will be lengthened and will lose their supporting forces.

In the scientific literature, the back pain most frequently encountered in women is that of the lumbosacral region (6). Ligamentous hyperlaxity, increased weight and changed posture seem to be the three causes of back pain that almost half of women experience during pregnancy.

Change of posture

Indeed, an increase in lumbar and cervical lordosis will have the effect of having the lumbar and cervical extensor muscles in permanent hyper contraction. On the other hand, the flexion muscles of the cervical and lumbar regions lose their vitality enormously.

In the scientific literature, the back pain most frequently encountered in women is that of the lumbosacral region (7). The myofascial nodes of the psoas muscle will be responsible for the pain felt in the lower back and buttocks.

Référence

1. Mantle MJ, Greenwood RM, Currey HL., Rheumatol Rehabil. 1977 May;16(2):95-101. Backache in pregnancy.
2. Daly JM, Frame PS, Rapoza PA. Sacroiliac subluxation: a common treatable cause of low back pain during pregnancy. Fam Pract Res
3. Berg et al., 1988; Fast et al., 1987; Mens et al., 1996.
4. Mantle MJ, Greenwood RM, Currey HL., Rheumatol Rehabil. 1977 May;16(2):95-101. Backache in pregnancy.
5. Daly JM, Frame PS, Rapoza PA. Sacroiliac subluxation: a common treatable cause of low back pain during pregnancy. Fam Pract Res
6. Berg et al., 1988; Fast et al., 1987; Mens et al., 1996.
7. Berg et al., 1988; Fast et al., 1987; Mens et al., 1996