Back to Basics for Moms-to-Be

Aug. 20, 2001 -- When I was pregnant with my daughter almost two years ago, I was told about the overwhelming rush of love I would feel toward her -- but nobody warned me about the overwhelming upper back pain that would come along with caring for a newborn 24-7.

Like most infants, Josie wanted to be held all the time, but complying with her not-so-subtle preverbal demands strained my shoulders, my arms, even my wrists. The near constant hunching and leaning over during her feedings, baths, and floor playtime didn't help the situation, either.

What was going to happen to my back and arms, I wondered with alarm, as she grew from 7 to 20 pounds?

To top it all off, I was still experiencing some of the lower backaches that began during my pregnancy. I had been hoping those aches would finally clear up after childbirth -- instead, they lingered for months.

Statistically, I am in good company: Studies estimate that between 40% and 50% of expectant mothers will experience lower backaches at some point during pregnancy, and many new mothers will develop back pain after the baby's born.

An informal poll of my friends revealed we all share the same dirty little secret: Pregnancy and backaches seem to go hand in hand -- but few of us mention it to our doctors, and fewer still do anything about it.

"In terms of people who complain of back pain, some studies out there quote the number at 40%; that's almost every other person," says Julie Colliton, MD, a rehabilitation medicine specialist at the Steadman-Hawkins Sports Medicine Clinic in Vail, Col. "What we see is a tendency for people who have had back pain prior to their pregnancy to be more likely to have back pain during their pregnancy. So that's one risk factor. And back pain during a prior pregnancy is also a risk factor."

"It's not that every single person will have back pain throughout her entire pregnancy: Some might have pain in the first trimester and then it gets better, and some might not develop it until their second or third trimester," she adds.

The potential causes are varied, Colliton says, but three mechanisms are behind most pregnancy backaches, and they can strike independently or in combination.

The Three Scourges

The first is lumbar pain -- that is, lower back pain.

Lumbar pain is often attributed to the increased pressure on a woman's vertebral discs caused by the increase in her overall mass -- "the increased weight your back has to support -- as well as the change in your center of gravity," says Colliton.

The second is sacroiliac pain, or pain in the pelvis.

"Your body releases a chemical hormone throughout pregnancy called relaxin which helps prepare ... your pelvis to allow ... the birth of your child," she says. "As that continues to progress throughout the pregnancy you can have some pain emanating from those joints and those structures, and some secondary minor instability in those areas."

And the third is nighttime pain.

"This is thought to be due to vascular engorgement: You increase your blood volume during your pregnancy and a lot of that gets pooled in your legs, which is why you get swollen legs by the end of the day," explains Colliton. "And then you go to bed and all that blood pools in your pelvis and stretches those structures, causing that type of pain."