From the Guidelines
Managing back pain during pregnancy involves a combination of non-pharmacological approaches and safe medications when necessary, with regular physical activity, such as pregnancy-specific exercises, being a crucial component. According to a recent study 1, regular moderate-intensity prenatal physical activity throughout pregnancy can reduce the risk of preterm birth and gestational diabetes without any risk of adverse fetal outcomes. This is particularly important for women who are categorised as overweight or obese, as they are at a higher risk of developing gestational diabetes mellitus, gestational hypertension, pre-eclampsia, and macrosomia.
Some key non-pharmacological approaches include:
- Regular physical activity, particularly pregnancy-specific exercises like pelvic tilts, swimming, and prenatal yoga, to strengthen back muscles and improve posture
- Proper body mechanics, such as bending at the knees when lifting, maintaining good posture, and avoiding standing for prolonged periods
- Supportive devices, such as pregnancy support belts, maternity pillows, and proper footwear, to provide relief
- Heat therapy with warm (not hot) compresses and gentle massage to relax tense muscles
For medication, acetaminophen (Tylenol) is generally considered safe at regular doses (500-1000mg every 6 hours, not exceeding 4000mg daily) for short-term use. However, NSAIDs like ibuprofen should be avoided, especially in the third trimester. Physical therapy focusing on pregnancy-specific techniques can be beneficial for persistent pain. Adequate rest, sleeping on the side with pillows between the knees, and stress management techniques like meditation can further reduce discomfort. These approaches help manage back pain by addressing the biomechanical changes, hormonal effects on ligaments, and increased weight-bearing that occur during pregnancy, as highlighted in a study on low back and pelvic girdle pain 1.
From the Research
Recommendations for Managing Back Pain in Pregnancy
The following are recommendations for managing back pain in pregnancy based on existing research:
- Exercise, such as strengthening exercises, sitting pelvic tilt exercises, and water gymnastics, can help reduce back pain intensity and back pain-related sick leave 2
- Alternative and complementary methods, such as acupuncture, physiotherapy, and pillows, can also provide relief from back pain 2, 3
- Non-pharmacological interventions, including exercise, manipulation, ear acupuncture, Kinesio tape, and transcutaneous electrical nerve stimulation (TENS), have been found to be effective in reducing low back pain in pregnant women 4
- Lumbar stabilization and stretching exercises can help reduce pain, improve postural stability, and increase trunk muscle activation in pregnant women with low back pain 5
- Standardized stretching postural postures have been found to be a safe and efficient non-drug therapy for treating low-back pain during low-risk pregnancy 6
Key Findings
- Back pain is a common complaint during pregnancy, affecting more than two-thirds of pregnant women 2
- The pain can interfere with daily activities, work, and sleep, and can have a significant impact on quality of life 2, 6
- A combination of exercise, alternative and complementary methods, and non-pharmacological interventions can provide effective relief from back pain in pregnant women 2, 3, 4, 5, 6
Interventions for Back Pain in Pregnancy
- Exercise:
- Strengthening exercises
- Sitting pelvic tilt exercises
- Water gymnastics
- Alternative and complementary methods:
- Acupuncture
- Physiotherapy
- Pillows
- Non-pharmacological interventions:
- Manipulation
- Ear acupuncture
- Kinesio tape
- Transcutaneous electrical nerve stimulation (TENS)
- Lumbar stabilization and stretching exercises
- Standardized stretching postural postures