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Low Back and Sacroiliac Joint Pain in Pregnancy

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Got a baby bump? There’s a good chance you have some lower back pain too. The American College of Obstetrics and Gynecology says back pain is one of the most common problems to occur during pregnancy, especially in later months.

It’s not exactly surprising that growing a watermelon-sized human in your belly could throw your posture out of whack and make your back ache. But you should also know about another common cause of low back pain during and after pregnancy. It’s called sacroiliac (SI) joint dysfunction.

The sacroiliac joint connects your sacrum (the lowest part of your spine) to the iliac joints in your pelvis. Sacroiliac joint pain occurs when these bones are not in proper alignment.

What Causes Sacroiliac Joint Pain During Pregnancy?

As with other body changes, you can blame your pregnancy hormones — specifically, one called relaxin. Aptly named, relaxin helps prepare your body for labor by relaxing and loosening some of the ligaments that hold your pelvic bones in place. While this is a good thing, it can also cause pain. Other related issues can also worsen this:

  • Improper body mechanics while lifting heavy items

  • Your growing uterus putting pressure on your SI joints and low back

  • Weakening abdominal muscles, which provide less back support

Signs of Sacroiliac Joint Pain

How do you know pain is stemming from your SI joint? Keep an eye out for these signs:

  • Low back pain or pain in the back of the hip that feels dull and achy or sharp and stabbing

  • Stiffness, tightness, or tension in your low back and hip, buttock, groin, or upper thigh

  • Pain that gets worse with bearing weight, such as with standing or walking for long periods, or lying on the affected side at night

  • Hip pain with specific movements, such as getting in and out of bed or a car, or bending to pick something up from the floor

How to Manage Sacroiliac Joint and Low Back Pain

Your Hinge Health physical therapist can provide you with therapeutic exercises to help SI joint pain. Some lifestyle tweaks can also help your symptoms:

Avoid activities that aggravate your pain.

  • If walking up and down stairs is painful, do one stair at a time, or go sideways.

  • To get out of the car, pivot your hips toward the door and keep your legs together before getting up.

  • Don’t stand for long periods without taking frequent breaks to sit.

  • Remember you’re not Superwoman! Activities that may have been okay before your pregnancy (say, unpacking groceries) might trigger pain now. Ask for help.

Stick with comfy shoes. High heels tilt your body forward, further straining your low back muscles. But flats with no support (like flip-flops) can also cause back pain. Look for shoes with low heels or wedges that have built-in arch support.

Maintain a healthy pregnancy weight. Gaining the right amount for you may help minimize extra pressure on your lower back.

Try a belly band. Available online and in maternity stores, these garments help ease the weight of your growing belly on your back muscles. Maternity clothes with wide elastic bands that fit under and support the belly can help too.

Rethink your sleep. Sleeping on your side is often what’s most comfortable, especially later in pregnancy. Add a pillow between your knees or a full-length body pillow for extra support.

Stay active. Exercising during pregnancy is not only safe for most women (unless your provider has told you otherwise), but a great way to prevent pain, boost energy, and more. Prenatal yoga and swimming or water aerobics may be particularly soothing for a sore back.

Bump-Safe Back Pain Exercises

In addition to regular cardio exercise (like swimming and walking) or gentle stretching (like yoga) your Hinge Health physical therapist can also recommended specific exercises for low back and SI joint pain during pregnancy, including those that:

  • Stabilize your pelvis

  • Strengthen your core

  • Improve posture

If your pain persists, speak with your Hinge Health coach or physical therapist for more advice on treatments that can help reduce your symptoms.

When Back Pain Is a Red Flag

Although back pain is very common during pregnancy and is usually related to musculoskeletal (MSK) issues, it can sometimes be a warning sign of certain complications, such as preterm labor or a urinary tract infection. Watch for back pain that occurs with vaginal bleeding or a change in vaginal discharge, fever, contractions, or pain that feels new and cyclical. If you experience any of these symptoms, contact your doctor.

Key Takeaways

  1. Sacroiliac (SI) joint pain is a common source of pain during and after pregnancy and occurs when the sacrum and iliac joints in the pelvis are not in proper alignment.

  2. You can manage SI joint pain with a combination of PT-recommended exercises and a few minor lifestyle changes, such as switching shoes and sleep positions.

  3. Unless your doctor has told you to avoid exercise, staying active during and after pregnancy can help prevent and manage low back and SI joint pain, boost energy, and more. Remember, though: Don’t try new types of exercise during pregnancy without consulting your provider.

References

  1. Back Pain During Pregnancy. (n. d.). American College of Obstetricians and Gynecologists. https://www.acog.org/womens-health/faqs/back-pain-during-pregnancy

  2. Ghodke, P., Shete, D., & Anap, D. (2017). Prevalence of Sacroiliac Joint Dysfunction in Postpartum Women-A Cross Sectional Study. Journal of Physiotherapy & Physical Rehabilitation, 2. doi: 10.4172/2573-0312.1000149

  3. Back Pain During Pregnancy. (n. d.). Cedars-Sinai. https://www.cedars-sinai.org/health-library/diseases-and-conditions/b/back-pain-during-pregnancy.html

  4. Robles, B. (2020, September 27). SI joint pain in pregnancy (what you can do about it). Postpartum Trainer, MD. https://postpartumtrainer.com/si-joint-pain-pregnancy/