Welcome back to Spine IQ’s Back Blog! Mother’s day just passed and we would like to take this time to wish a very happy mother’s day to all of the mothers that read our blog. This week, our blog will focus on low back pain and motherhood. This blog will contain information that may be useful for you (as a mother) or for your patients. In a recent blog during Women’s History Month, we discussed the prevalence of low back pain during pregnancy and how conservative spine clinicians can help alleviate low back pain during pregnancy. Therefore, we would like to focus this blog on post-partum low back pain.
Prevalence and prognosis for postpartum low back pain
Post-partum low back pain is common with approximately 70% of recently pregnant women experiencing low back pain immediately after delivery.1 Similar to low back pain during pregnancy, low back pain post-partum is more common than low back pain during non-pregnancy or non-postpartum.2 This means that the conservative spine clinician can play a vital role in the care after delivery of the baby for women experiencing low back pain postpartum. The positive news is that low back pain during post-partum has a good prognosis. The majority of women with low back pain immediately after delivery do not report having low back pain within 6 months. Specifically, ~70% of women do not report having low back pain one month after delivery and ~80% of women do not report having low back pain 6 months after delivery.3
Treatment suggestions for postpartum low back pain
Pregnancy and delivery of the baby can be a very stressful time for mothers, especially first-time mothers. Many factors may increase the risk of low back pain, such as increased stress, decreased sleep, and even postpartum depression. The factor that has been most commonly associated with post-partum low back pain is physically demanding work.3 This should not come as too much of a surprise as physically demanding work has also been identified as a risk factor for regular (non-pregnancy related) low back pain.4 During post-partum there is an increase of physical demanding work in trying to build things for the baby and carrying/holding the baby oftentimes for long periods of time. The baby quickly grows during this time, and it may be more physically demanding work and very different postures and demands than the mother is typically accustomed to.
This is the key to conservative treatment of low back pain during post-partum. Similar to regular (non-pregnancy related) low back pain and pregnancy-related low back pain, exercise and physical activity can be a great, conservative treatment for postpartum low back pain.5 In order to better prepare people for postpartum physical demands, clinicians should encourage their patients to gradually increase exercise, especially lifting things from the ground (e.g., squats and deadlifts). This gradual increase, preferably before pregnancy, can help patients reduce their risk of postpartum low back pain by increasing their physical capacity. In previous blogs, we have described how clinicians can create exercise plans for their patients. These plans can be used to create an exercise plan for pregnant and post-partum patients with low back pain.
Conclusion
Post-partum low back pain is very common and is usually transitory and has a favorable prognosis, which is important to discuss with pregnant women early to remove fear. While most people can expect to recover from post-partum low back pain within 6 months, it can help speed up recovery or prevent future low back pain by intervening. Considering the risk factor of physically demanding work, exercise can be a guideline concordant and effective treatment by conservative spine clinicians to help patients with postpartum low back pain. The joy of pregnancy is often marred by the discomfort of back pain, early discussion can greatly remove fear with proper discussion and calming reassurance.
References
- Ostgaard HC, Andersson GBJ. Postpartum Low-Back Pain. Spine. 1992;17(1):53-55.
- Weis CA, Pohlman K, Draper C, daSilva-Oolup S, Stuber K, Hawk C. Chiropractic Care for Adults With Pregnancy-Related Low Back, Pelvic Girdle Pain, or Combination Pain: A Systematic Review. J Manipulative Physiol Ther. 2020;43(7):714-731. doi:10.1016/j.jmpt.2020.05.005
- Tavares P, Barrett J, Hogg-Johnson S, et al. Prevalence of Low Back Pain, Pelvic Girdle Pain, and Combination Pain in a Postpartum Ontario Population. J Obstet Gynaecol Can JOGC J Obstet Gynecol Can JOGC. 2020;42(4):473-480. doi:10.1016/j.jogc.2019.08.030
- Parreira P, Maher CG, Steffens D, Hancock MJ, Ferreira ML. Risk factors for low back pain and sciatica: an umbrella review. Spine J Off J North Am Spine Soc. 2018;18(9):1715-1721. doi:10.1016/j.spinee.2018.05.018
- Hayden JA, Ellis J, Ogilvie R, Malmivaara A, Tulder MW van. Exercise therapy for chronic low back pain. Cochrane Database Syst Rev. 2021;(9). doi:10.1002/14651858.CD009790.pub2