Low Back Pain
Low back pain during pregnancy is caused by increased stress on the lumbar spine by an anterior shift in center of gravity. Compensatory muscle tightness and altered gait patterns also contribute, and this pain ranges from mild to severe depending on the patient’s activity level, daily activities and work duties.2,6 Low back pain is also very common during the postpartum period.7
Sciatic Nerve Pain
Hypertonicity in the gluteal muscles and deep external rotators can irritate or compress the sciatic nerve during pregnancy. Some studies suggest the baby’s growth contributes to uterine pressure on supporting vasculature or direct compression of the sciatic nerve, which results in low back pain with radiation into the legs.8
Sacroiliac Pain
Ligament laxity caused by hormonal changes during pregnancy allows these traditionally stable and primarily weight-bearing sacroiliac joints to move and shift. This increased mobility puts stress on the surrounding ligaments and muscles, which may cause pain.4 Patients sometimes incorrectly describe their discomfort as “hip pain,” however they indicate the sacroiliac joint as the area of complaint.
Pubic Symphysis Pain
During pregnancy, the hormone Relaxin allows the ligaments stabilizing the pubic symphysis joint to relax, and therefore allows the joint to move and separate. Also called Symphysis Pubis Dysfunction, or SPD, this condition produces pain and limitation of mobility. It also may contribute to instability of the bony pelvis.9
Round Ligament Pain
The round ligaments of the uterus contain contractile fibers, and suspend and connect it to the anterolateral abdominal wall on either side. As the uterus grows, the round ligaments also stretch and can cause a sharp pain on either side of the abdomen or at the attachment sites of the ligaments near the pubic bones or labia.10