Caring for Back and Hip Pain during Pregnancy

Most people like to talk about the ‘glow’ of a pregnant woman. What isn’t mentioned is something that affects over half of all pregnant women: lower back and hip pain. It happens frequently but doesn’t have to be a part of your pregnancy. If you’re thinking about getting pregnant or are pregnant and already feeling lumbar pain or pelvic pain, seeing a physical therapist specializing in pelvic health is very beneficial.

Back and hip pain can appear early, even during the first trimester. These pregnancy aches, as some like to call them, may occur due to several factors. The pain can worsen as the baby gains weight and the body prepares for labour, especially during the second and third trimesters of pregnancy. There are various ways that you can do to alleviate the discomfort. This article will cover the causes of pregnancy-related back and hip pain and provide tips and suggestions to help you manage it.

What causes your low back and hip pain during pregnancy?

There are several reasons for pregnancy-related lower back and hip. 

The release of the hormone relaxin

Although it is possible to have hip pain during pregnancy during the first trimester, the second and third trimesters of pregnancy are the most likely times for a woman to experience hip pain and similar pregnancy aches, even though hip discomfort can occur at any point during pregnancy. 

The hormone relaxin is responsible for changes in the cartilage and tendons, making them more pliable. It assists in the spreading and widening of the hips, which is necessary for preparation for delivery. Because of this stretching of the muscles and ligaments, the following symptoms may appear: 

● Dull ache along the pelvic joint, most often due to dysfunction at the sacroiliac joint.

● A sharp pain in the thick fibres that run from the pubic region down either side of the abdomen, namely the round ligaments. 

● A shooting pain down the pubic bone and into the groin, usually called symphysis pubis dysfunction, which results in fear and movement avoidance

Pregnancy weight gain

Gaining weight is physiologically normal and expected during pregnancy. A woman who enters pregnancy at a healthy weight can anticipate gaining anywhere from 25 to 35 pounds throughout her pregnancy. When a woman is pregnant and gains weight, the extra weight can put a strain on her lower back and hips. 

As most of the weight gain associated with pregnancy tends to occur in the abdominal region, the body’s center of gravity may begin to shift. This can lead to poor postural alignment, putting additional strain on the hips. Consequently, this change can result in pelvic pain. 

Poor posture

As the pregnancy progresses, your posture changes to adjust to the extra weight and having a more significant proportion of your body’s mass concentrated in the abdominal region. In addition, the fact that your baby sometimes settles more on one side than the other may contribute to more aches and pains in different areas of the body. 

Wearing shoes that offer adequate support will help you maintain a healthy posture throughout pregnancy. If possible, reduce the number of heavy objects you have to lift or carry whenever possible. When walking, take frequent rests so you don’t fall into the habit of slouching or overarching at your lower back due to exhaustion. 

Staying seated for extended periods should be avoided unless otherwise directed by your physician. Get up and move around to prevent extra strain on your muscles and joints, which can get triggered by sitting still for long periods. 

Sleeping position may be linked to hip pain. Sleeping on your side can put stress on your hips, which may lead to hip pain. However, since there aren’t as many positions safe for sleeping while pregnant, lying on your side may be the best option. It is essential to use pillows to support you while sleeping. For example, placing a pillow between your knees helps bring your legs into a more natural position. A regular cushion can be used, but some also find that a pregnancy-specific pillow can offer more support for the entire body.

Transient Osteoporosis

There is a slight possibility that the pain you are experiencing in your hip is due to transient osteoporosis, also known as demineralization of your hip bones. This is a very rare condition. It usually starts in the middle of the second or third trimester and may have something to do with the levels of calcium and potassium in the body. 

This transient osteoporosis can result in pain in your hips, groins or back. You will need to have an MRI to receive an accurate diagnosis. 

The symptoms of transient osteoporosis typically improve within a short amount of time after delivery. In some unusual instances, transient osteoporosis may progress to hip fractures that require more time to heal. Using over-the-counter analgesics like ibuprofen can help with pain and inflammation. Remember, consult your doctor before taking any pills during pregnancy.

How does my pelvic floor affect my back or hip pain?

Your body is made of many different parts that work together so you can lead your life and create new life. When one body part cannot do its job as a team, the other players help.

Your pelvic floor works with your deep abdominal muscles (the transversus abdominis) to help with low back stabilization. As the baby grows and your abdominal stretches, your core strength decreases, and there is less support at your low back. With the ab muscles not working as well as they usually do, your pelvic floor takes on the extra workload, which may result in pelvic pain.

However, your pelvic floor is already under a lot of stress during pregnancy! So, when it needs more support, your pelvic floor reaches out to your inner thigh and hip muscles for help. This can lead to pain around the groin and outer hip.

While it’s great that your body parts can come together to support your core, imagine what happens when a key team member at work goes on sick leave. The workload, and stress, will increase for the other team members.

How can pelvic floor physiotherapy treat my back pain and hip pain?

A typical treatment will include a combination of manual therapy and acupuncture to relieve muscle tension and mobilize the back and hip joints, as well as Pilates and Yoga-based exercises to reactivate and strengthen core muscles.

The exercise program also works on opening and lengthening your pelvic floor to help you prepare for birth. As mentioned above, the pelvic floor is under a lot of stress during pregnancy. A balance of strength and flexibility at the pelvic floor will further support the whole mid-section and help relieve the back and hip pain.

The treatment length for lower back and hip pain varies from person to person, but it typically takes between 6 to 8 sessions to see an improvement.

What quick solutions can I try at home?

You can try a few different things at home to assist you in managing any hip pain that you feel while you are pregnant. These can be helpful. 

Move frequently

Exercising while pregnant is encouraged, but you should never push yourself beyond what you can do. Do exercise that is appropriate for your stage of pregnancy and at a frequency that you can sustain. 

Your lower back and hip pain can be alleviated by performing appropriate light stretches and exercises that help lengthen and strengthen your stomach and lower back muscles. If you are not sure what is considered safe for you to do, your pelvic physiotherapist can evaluate and prescribe suitable exercises for you.

Swimming is excellent during pregnancy because your weight is supported by the water, which decreases the pressure that is placed on your joints. If you already experience pain in your back or hips, you should try to avoid swimming the breaststroke because the frog kicks can trigger or aggravate pelvic girdle pain.

Alternately, backstroke would be gentler on the body, either with or without a float. Avoid strong twisting movement as it can strain your lower back. 

Prenatal yoga or Pilates are great choices to maintain strength and flexibility, especially towards the end of the pregnancy. Be sure to inform the instructor of your injury or pain so they can guide you through poses and stretches appropriate for your condition. 

In general, you should avoid activities that are overly taxing on the body, such as contact sports like martial arts and try to rest between workouts.

Use a warm bath or a compress 

When treating hip pain with temperature, it is best to administer heat rather than cold to help relieve symptoms. The presence of warmth stimulates the blood flow to the region. Additionally, it decreases the joints’ stiffness and the muscles’ spasms. 

You can apply a warm compress using either a heating pad or a damp towel soaked in warm water. Each application should last between ten and fifteen minutes. It is not recommended to place the heating pad directly onto your stomach. 

When taking a warm bath to relieve the discomfort associated with pregnancy, the water temperature should not be too high. It should be warm enough to not feel cold, but it should not be so hot that it raises your body temperature. 

Practice good posture

Because changes in posture are one of the potential causes of hip discomfort, there are several things you may do to help rectify it, including the following: 

● use of pillows to keep your body in a neutral position while you sleep 

● keeping your legs together when getting out of bed or a car 

● keeping your back straight and not crossing your legs while sitting; when sitting in front of the computer, try to face the screen and don’t twist your back to one side; avoid sitting for too long and move around every 30 minutes

● standing with your weight evenly distributed over both your hips

● avoid standing for long periods.

Use of a maternity belt

A maternity belt can support and help you feel more comfortable during pregnancy.

Maternity belts are designed to fit around the belly and hips, providing extra support for your growing bump. They also offer comfort in various ways: some have built-in padding, others are padded and shaped to hug your tummy, and still others are made from soft fabrics that conform to your shape.

Maternity belts come in many styles, colours, sizes, and materials. Most are adjustable and stretchy, allowing you to customize them to fit perfectly. You’ll find that maternity belts are available in all price ranges, from inexpensive options to those that will set you back hundreds of dollars.

The most important thing to consider before purchasing a maternity belt is what type of support you need. If you are experiencing lower back pain, a maternity belt with added padding is ideal. However, if you want something that provides additional support without adding bulk or overheating, look for a maternity belt with velcro and less padding.

Get a massage

Your partner can massage various regions around your hips to reduce the pressure and pain you are experiencing. 

How to do a side-lying hip and leg massage safely in the comfort of your home: 

● The best position would be lying on your side with your knees and arms around a pregnancy pillow or using several pillows with one between your knees, one under your belly, and one under your arms. 

● Ask your spouse to locate your sacrum, which can be found in your lower back just above your butt crack. Your sacrum is a triangular bone that connects your spine to your pelvis. Have them apply pressure and massage the area in different directions.

● Alternatively, your partner can concentrate on the gluteal muscles located on the side of the hip bone. Start with rubbing the area with light pressure and working in a circular or rocking motion with their fingers. 

● Repeat the massage on the opposite side of your body. 

● This can be done once or twice a day. The best time would be when you’re in pain or before bed for a good night’s sleep.

Use over-the-counter pain relievers

You might also get some relief from your discomfort by using over-the-counter (OTC) pain medicines and doing exercises and stretches. For example, acetaminophen, sold under the brand name Tylenol, is a medicine that falls under category B and is typically considered safe to take during pregnancy. Consult your healthcare provider regarding the treatment option that might work best for you and the dose you should take. 

With over half of pregnant women experiencing lower back or hip pain, it can seem normal to be in pain. Pregnancy shouldn’t be that way! Another advantage of taking care of your pelvic floor during pregnancy is that it will help you prepare for a smooth birth. Knowing what’s happening in the area will also prevent any issues that might arise as you get further into your pregnancy (such as incontinence). The best time to come in for an overall pelvic floor check-in is during your second trimester. 

Lower back and hip pain often happen during pregnancy due to many factors such as hormonal change, weight gain, poor pregnancy posture etc. However, they are treatable, and seeking treatment as early as possible is essential to prevent the pain from worsening. Many health practitioners can treat this issue effectively and help you have a pain-free pregnancy, such as pelvic physiotherapists, osteopathic manual practitioners, chiropractors, and massage therapists.

If you’re pregnant or thinking about getting pregnant, book yourself a pelvic floor checkup. Don’t let body pain dim your pregnant ‘glow’! If you have any questions, please reach out at trang@invigophysio.com

If you’re ready, we’d love to see you at our Toronto clinic or through a virtual appointment. Book your physiotherapy appointment today!