Low Back Pain and Hip Pain During Pregnancy
Condition Overview
Low back and hip pain are among the most common musculoskeletal complaints during pregnancy. As your pregnancy progresses, your center of gravity shifts forward, increasing the mechanical stress on the lumbar spine and sacroiliac (SI) joints.
Simultaneously, hormonal shifts result in ligamentous laxity. While this flexibility is necessary for childbirth, it can lead to decreased joint stability. To compensate, the muscles of the back, hips, and glutes often become overworked as they strive to stabilize the pelvis, leading to muscle tension, radiating pain, and persistent discomfort.
Signs and Symptoms
Pregnancy-related back and hip pain can manifest in several ways, and symptoms may be constant or fluctuate based on your activity level. Common experiences include:
Dull, aching pain in the lower back or "dimple" area of the deep glutes.
Sharp, radiating sensations that travel into the hip or down the leg (often referred to as sciatica).
Increased discomfort during transitional movements, such as rolling over in bed, rising from a chair, or stepping out of a car.
Pain with prolonged positioning, such as standing in a long line or sitting at a desk.
A feeling of "heaviness" or instability in the pelvis during walking or stair climbing.
The pelvic floor muscles act as the "foundation" of your core; they attach directly to the pelvis and coordinate with the deep rotators of the hip and the stabilizing muscles of the spine. During pregnancy, the increasing load on the pelvic floor can impact its ability to support these structures, leading to compensatory tension in the hips and low back.
How Can Physical Therapy Help?
At Nola Pelvic Health, we view back and hip pain not just as a "normal part of pregnancy," but as a functional challenge that can be managed. If you are experiencing mild discomfort, starting with our 4-session Birth Prep package is an excellent way to gain the tools you need to reduce and manage your symptoms. If your pain is more significant or limiting your daily life, we will customize a treatment plan to address your specific needs.
During the initial assessment, we will perform a comprehensive assessment of the back, hip, and abdominal muscles. We will assess your joint range of motion, muscle strength, functional mobility and body mechanics. If you are in your second or third trimester, we may perform an internal pelvic floor muscle assessment when appropriate and only with your consent. (Internal assessments are not performed during the first trimester.) This helps us understand pelvic floor muscle strength, coordination, tenderness/tension that may contribute to your symptoms.
From our findings, we will set up a treatment plan depending on the individual characteristics of your pain and external factors such as work related duties, home life, exercise regimen, and goals.
We will generally provide an exercise routine that considers core stability, hip strength, body mechanic modifications, postural control, and full body mobility. The goal is to improve your function and reduce your pain so you can do the things you love!
We may also perform manual treatment to reduce pain, improve tissue mobility, and get you moving better. These treatments may include dry needling, myofascial release, and cupping. With each session we will progress as able and learn new activities to include in your daily routine to manage and prevent worsening symptoms!
Our goal is to reduce pain and improve your functional mobility, ensuring you feel strong and capable as you approach labor and delivery. Because these symptoms can sometimes persist after birth, we also focus on strategies that set the stage for a successful postpartum recovery including our hybrid program.
Don't let back or hip pain overshadow your pregnancy journey. If you are having pain in any of these areas, don’t wait for it to get worse - call and make an appointment today!