The 101 on Lumbopelvic Pain in Pregnancy
What’s Lumbopelvic pain in pregnancy, how might it impact you and what can you do about it if you experience it? Certified fitness trainer Amy Snelling specialises in pre and postnatal fitness and shares some evidence-based advice here.
It is quite common for pregnant women and birthing people to experience low back pain and pelvic girdle pain, with up to 86% experiencing these conditions by the 3rd trimester. When both types of pain occur together, it is referred to as lumbopelvic pain (LBPP). Unfortunately, women and birthing people who experience LBPP during pregnancy have a lower health-related quality of life compared to those without this condition.
Various risk factors for pregnancy-related lumbopelvic pain have been identified, including age, number of pregnancies, a history of low back pain, previous trauma to the back or pelvis, and previous pregnancy-related pelvic girdle pain. Although pregnancy involves hormonal and biomechanical changes as well as neuromuscular adaptations, it is still unclear why these changes can lead to lumbopelvic pain.
While most women and birthing people will report improvements soon after delivery, some who suffer from LBPP during pregnancy may continue to experience pain up to a year after giving birth.
The role of exercise in managing pain
Managing pain through exercise is a complex issue, as pain is caused by a variety of factors that differ from person to person. Finding universal exercises that prevent or treat pain is therefore difficult. However, recent studies provide insight into the role of exercise in pain management….
When it comes to lumbopelvic pain, there are no "best exercises."
Current physiotherapy approaches involve core stabilisation exercises with a focus on the transverse abdominis to restore normal function and reduce pain. The idea is that impaired motor control of the pelvis needs training to restore normal function and reduce pain. However, recent research suggests that this approach may oversimplify the issue, as women with pain exhibit different motor patterns (using different muscles, at different times, in different patterns). Therefore, a one-size-fits-all approach to exercises or muscle focus is not suitable for everyone.
Pain is not the result of not exercising enough or doing the wrong exercises.
Exercising on its own does not always prevent pain. For instance, women and birthing people who exercise during pregnancy may still experience lower back pain or pelvic girdle pain.
Exercise can make pain feel better.
Women and birthing people who exercise during pregnancy reported less or decreased severity of pain than those who did not.
The type of movement doesn’t really matter.
Various research trials have focused on different types of exercises and tend to yield similar results. Therefore, it is best to find a form of movement that is safe and comfortable to stick to during pregnancy.
Always seek help
It is essential to recognise that pain can sometimes hinder movement and reduce quality of life. There should be no shame if pain stops you from exercising as much as you want to. Seek advice from your GP if pain is getting in the way of your day to day.
Want more pregnancy support? Check out our Ultimate Birth Pack - your digital companion throughout pregnancy. The Pregnancy Pack includes a full workshop about pelvic health led by physiotherapist Lucy Allen.
References:
DOI: 10.1136/bjsports-2018-099400
DOI: 10.1002/14651858.CD001139.pub4
DOI: 10.1016/j.clinbiomech.2022.105716
DOI: 10.1016/j.physio.2022.09.004