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Backing Up Physical Therapy Treatments for Pregnant Women

More than half of all pregnant women report having low back pain. For most women, this goes away after pregnancy. But for about 10 percent, back pain becomes a chronic problem. How can a woman tell if she is at risk for back pain during pregnancy? Several predictors have been identified.

The most common risk factor is low back pain before pregnancy or during an earlier pregnancy. A job with physical labor is another common predictor. Other risk factors include age (younger women), smoking, and lower income level.

The exact cause of back pain among pregnant women is unknown. There are several changes during pregnancy that add to the risk of this problem. These include changes in hormones, rapid weight gain, and abdominal muscle weakness. Treatment with a physical therapist is often advised.
 
Physical therapy treatment for pregnant women with back pain should be different from patients who aren't pregnant. This is because of the physical, biological, and mechanical changes that occur during pregnancy. A physical therapist can check each spinal level for changes in motion. This could be increased motion or a loss of motion. Muscle strength and flexibility will also be tested.

A treatment program to restore movement, improve posture, and stretch muscles can be provided. Each of these must be modified for the changes in a woman's body during pregnancy. Physical therapists are actively studying how to do this safely and effectively. For example, stomach muscles get stretched out during pregnancy. Along with expected weight gain, this can weaken the abdominal muscles. Regular sit-ups can actually cause separation of the abdominal muscles and are therefore not advised. Therapists teach how to brace the abdominal muscles during exercise to avoid this problem.

Only a few studies are available to show which physical therapy methods are best for pregnant patients with low back pain. More studies are needed to show what works best for this group of patients.

References: Susan Mais Requejo, DPT, et al. The Use of a Modified Classification System in the Treatment of Low Back Pain During Pregnancy: A Case Report. In Journal of Orthopaedic & Sports Physical Therapy. July 2002. Vol. 32. No. 7. Pp. 318-326.

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