If you feel like you’re falling apart when you’re pregnant because of your back pain, it’s probably because you technically are.

No alarm, I will explain.

I am Dr. Devyn, your local pelvic health physical therapist, here to teach you about back pain during pregnancy.

So although back pain during pregnancy may seem normal because it’s typical, it’s definitely something that can be addressed and improved upon.

And it should also be evaluated by a medical professional. It’s not something that you should just try to fix on your own.

In this post, I’ll describe some common causes of lower back pain but, more importantly, what you can do about it!

Reason #1: Your Hormones Are Changing

There are a couple of reasons why our back hurts when we are pregnant.

One of the biggest reasons is that when we are pregnant, our body falls apart.

And what I meant by that and what I mean by that is that when you’re pregnant, your hormones cause your ligaments that are normally very taut and hold your bones together with muscles.

Or they work along with muscles I should say, to hold your bones together, they end up getting very lax and loose.

When a woman becomes pregnant our bodies start to produce a hormone called “relaxin”. Relaxin is released so that your pelvic can expand.

Without this hormone, it would be hard for us to expand and carry our babies.  But, while relaxin does have benefits, it also can cause lower back pain. This can cause lower back pain and sacroiliac joint pain because the ligaments are being stretched out.

So if you can imagine the structure that holds your bones together becoming lax and loose, you’re going to become very unstable, almost like you’re falling apart. So that’s what I meant by falling apart. Along with that, your muscles tend to weaken just because of the different change in your center of gravity, as well as your activity level. So that’s what we’re going to get into. How can we prevent this back pain? And if we do have back pain, how can we improve upon it? Especially when we’re pregnant, because it may not be as easy as addressing back pain when you’re not pregnant.

Reason #2: Your Posture is Changing

So a couple of considerations.

The first consideration is always posture.

Even knowing all that I know as a pelvic health physical therapist and a physical therapist of orthopedics, I was prone to having poor posture, especially when I wasn’t thinking about it. So there’s a couple of selfies of me when I was pregnant, or post pictures where it looks like I have pretty good posture, but then there’s a couple of candid pictures of myself that I’ve seen where my posture was lacking.

So a couple of considerations. The first consideration is always posture. Even knowing all that I know as a pelvic health physical therapist and a physical therapist of orthopedics, I was prone to having poor posture, especially when I wasn’t thinking about it. So there’s a couple of selfies of me when I was pregnant, or post pictures where it looks like I have pretty good posture, but then there’s a couple of candid pictures of myself that I’ve seen where my posture was lacking.

Reason #3: Your Glutes Are Weak

And what that means, what typical pregnancy posture is, because of the fetus growing in this direction, it pulls on your body in different ways. And what our body tends to do is it tends to stick our butt out with the belly forward. It tends to excessively arch our back, and then we tend to round our head forward and sway backward.

Now it’s hard to pretend to make those postural changes. So I’ve included a picture of me caught off guard while setting up my nursery for my little one. And you can see the exact posture I just explained. So a couple of things to think of when you are pregnant, especially as your uterus and your belly are growing, and your baby is growing is one, keep your glutes engaged but not clenched. So clenching our butt really tight is not going to help, but keeping our glutes engaged is going to keep us from swaying forward into this arched back.

So engage your glutes. I always usually think of opening up my hips, because that prevents me from clenching down on my glutes. So we don’t want to clench on our glutes or our pelvic floor. The other thing you can think of is to keep your shoulders stacked over your hips. And that’s going to be easier said than done, especially as your weight changes and biases that forward position. That’ll also help you keep your shoulders open.

Reason #4: Your Neck is Shooting Forward

Now, what I know a lot of you are probably worried about is that little hump on your neck that you can get, especially after pregnancy. And that can end up being exacerbated by breastfeeding. So get on top of it now. Try to think of keeping your head back. So not your head back like you’re swaying backward, but your head back on top of your shoulders, that’ll help prevent that.

Reason #5: Your Activity Level is Decreasing…

A couple of other things you can do to help augment and prevent this back pain when you are pregnant is to stay active. So be aware of your posture, but that’s easier said than done, especially when your muscles are weakening, and you’re gaining weight in places that you haven’t had before. Staying active will help your muscles stay on top of that. And a couple of muscle groups you should be focusing on are your glutes. Addressing your pelvic floor, not just doing Kegels, and your deep core muscles, like your breathing muscles. That is why you should see a pelvic health physical therapist. We’re the ones that are professionals in pregnancy care, including back pain.

Reason #6: Change the Way You’re Sleeping

Now a couple of other quick fixes are your positioning when you’re sleeping, obviously lying on the left side is best for most pregnant women from the second trimester on. And make sure you have a pregnancy pillow. You can place things between your knees. You can place things under your head and your neck, and you can also adjust in different ways that you wouldn’t be able to do without any type of pillow or bolster.

And then another thing to consider on top of getting back to activity or continuing activity to stay strong is some sort of pelvic or abdominal brace that’s best fitted and suggested by a pelvic health physical therapist. That will help assist your muscles to keep better posture and support your growing belly. So if you have back pain and you’re pregnant, yes, your body is technically falling apart. But no, it’s not something that you lose control of and you can’t do anything about. Take the pieces of advice I have provided. And on top of that, go see a pelvic health physical therapist near you. Be well y’all.