Back pain or uneasy back is common during pregnancy and should be expected to some degree by most women. Almost  50 to 70 percent of pregnant women experience back pain at some point in their pregnancy according to American Pregnancy Association.

Read more: Prenatal/Postnatal Care

Causes of back pain

Back pain during pregnancy is related to a number of factors. Some women begin to have lower back pain with the onset of pregnancy.  Women who are most at risk for back pain are those who are overweight or had back pain prior to pregnancy.

 Potential causes of back pain or uneasy back during pregnancy:

• Increase of hormones– Hormones released during pregnancy allow ligaments in the pelvic area to soften and the joints to become looser in preparation for the birthing process; this shift in joints and loosening of ligaments may affect the support your back normally experiences.
• Additional weight – Developing a baby creates an additional weight that your back must support.
• Posture or position– Poor posture, excessive standing, and bending can trigger or escalate the pain you experience in your back.
• Stress– Stress usually accumulates in weak areas in the body, and because of the changes in your pelvic area, you may experience an increase in back pain during stressful periods of your pregnancy

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Types of back pain

General muscle strain: due to increased intra-abdominal pressure.

 Lumbar Pain: Lumbar pain during pregnancy is generally located at and above the waist in the center of the back. This lower back pain in pregnancy may or may not be concurrent with pain that radiates into your leg or foot. Pain that radiates into the leg or foot is known as sciatica. In general, lumbar pain during pregnancy is similar to lower back pain experienced by non-pregnant women. This type of pain typically increases with prolonged postures (such as sitting, standing, or repetitive lifting), and tenderness may also be present in the muscles along the spine during pregnancy.

Pregnancy Pelvic Pain: Posterior pelvic pain (in the back of the pelvis) is four times more prevalent than lumbar pain in pregnancy. It is a deep pain felt below and to the side at the waistline, and/or below the waistline on either side across the tailbone. Such pregnancy pelvic pain may be experienced on one or both sides.

 Back pain as a sign of miscarriage: Severe back pain, especially when there are other problems such as bleeding and cramping is a very common warning sign of a miscarriage, especially if the pain begins in the lower abdomen and pelvic area and moves to the lower back.

Labor Pain During Pregnancy:  It is important to note that labor pain is a different type of pain. It is similar to an intense menstrual cramp and has the following characteristics:

• The pain is persistent
• It increases in intensity and frequency over a short period of time
• It is not affected by your level of activity (while back pain associated with pregnancy is often activity-induced).
• There may be bloody discharge per vagina or passing of watery fluid

Ayurvedic management of back pain in pregnancy

 Preventive:

• Watch your posture when you’re sitting. Sitting in a chair all day actually puts more strain on your spine than anything else. At home and at work, make sure the chairs you use provide good support, preferably with a straight back, arms, and a firm cushion. Use a footrest to elevate your feet slightly, and don’t cross your legs. That can cause your pelvis to tilt forward, exacerbating those strained back muscles.
• Take breaks. Walk or stand and stretch at least once an hour. Sitting too long can make your back hurt even more. Try not to stand too long, either. If you work on your feet, try to place one foot on a low stool to take some pressure off your lower back.
• Avoid lifting heavyweights.
• Include physical activity in your daily routine with mild exposure to the sun: Regular physical activity can keep your back strong and might relieve back pain during pregnancy. Try gentle activities — such as walking or water exercise
• Maintain your weight. Manage weight gain with a healthy diet and healthy exercises like plain ground walking.
• Wear the right shoes. Experts recommend a 2-inch heel to keep your body in proper alignment.
• Get a firm mattress and have stress-minimizing sleeping positions.
• Have happy thoughts. A calm mind leads to a looser back. You can also try some prenatal yoga, which will relax both your mind and your back.

Curative:

Ayurveda very strongly recommends a number of practices to prevent back pain in pregnant women both during and after pregnancy.  They are,

1. Regular exercises,

2. Applying warm medicated oil (DhanwantaramTailam) on the body and waiting for some time before having the daily warm bath.

3. Preventing flatulence and gas in the abdomen by taking a herbal formulation called Mahadhanwantaram gulika (this is also called GarbharakshaGulika- meaning tablet to protect the pregnancy)along with avoiding constipation is also an important component in preventing back pain (according to the advice of a doctor)

4. Certain herbal medications like Dhanwantaram(101) and Dhanwantaramkashayam or its tablet form are also recommended after delivery to prevent back pain and to strengthen the back after delivery.

N.B. These should be done according  to the advice of an ayurvedic doctor

Abhyanga (Massage in pregnancy):
Ayurvedic herbal oil Massages in pregnancy are very helpful under the supervision of a physician.

There are several Ayurvedic oils to choose from for massage in pregnancy. But it is better to consult an Ayurvedic doctor in this regard, as a few massage oils are not safe during pregnancy, and is good to use less allergenic oils.

It is neither possible nor advisable for the pregnant mother to do massage herself.