Low back pain is one of the most common diagnoses that we see as physical therapists. It is particularly common in the population of pregnant women that I treat. Up to 70% of pregnant women will experience some kind of low back pain during their pregnancy.
One of the most common causes for low back pain during pregnancy is a dysfunction of the sacroiliac joint (SIJ). The SIJ is the joint where the pelvis and the bottom of the spine connect, and where we transfer force from our legs to our torso. This is a relatively immobile joint, but it is highly affected during pregnancy due to normal hormonal and mechanical changes that occur in the body. This joint needs to soften and become more mobile in order for natural childbirth to occur. However, this increased mobility, coupled with the changes in weight distribution and posture, put it at risk for pain.
Sacroiliac joint pain presents itself as a sharp pain on one side of the tailbone. It is most commonly aggravated by activities that involve standing on one leg, such as walking, climbing the stairs, getting into/out of the car, and putting on shoes/pants. Certain sitting and lying positions can also aggravate SIJ pain. Sitting with your legs crossed should be avoided and it may be most comfortable to lie on your side with a pillow between your knees. Finally, it is important to avoid heavy lifting, especially if it involves simultaneously twisting your torso. This can be particularly challenging for pregnant mothers with young children. Lifting your child from straight on, bending both knees and engaging your abdominal muscles can help to protect your SIJ.
If you find that you are experiencing sacroiliac joint pain, there are several treatment options that are safe during the duration of your pregnancy. Two of the most common are physical therapy and SIJ support belts. There are several types of belts on the market, all with limited research to support their efficacy, although I have had anecdotal success with patients using these belts. Physical therapy can be a highly effective way to treat a painful SIJ. We can access what type of dysfunction is causing the pain, use hands on soft tissue and joint mobilizations to correct the dysfunction, and prescribe exercises to help support your low back and pelvis. While SIJ pain can be a debilitating and common pregnancy symptom, there are things you can do to decrease your pain and allow you to stay safe and active during the duration of your pregnancy.