Your complete guide to pelvic and lower back discomfort during pregnancy

During pregnancy, many women experience pelvic discomfort, which can begin from the moment they find out they are pregnant. These early symptoms of instability and pain in the lower back and pelvis may seem surprising, but they are caused by an increase in the hormone relaxin. Relaxin has a critical function during pregnancy; it softens the joints and muscles to allow the pelvis to expand, which is necessary for both the growth of the baby and the birth process. This hormone peaks early in pregnancy and, although levels decline, remains significantly higher than normal throughout pregnancy.

Lower back pain is most common in the first trimester, and often intensifies at the end of the second and beginning of the third trimester. This is due not only to hormonal changes, but also to the physical strain of the baby's weight, which increases pressure on the pelvic and lumbar regions, which can worsen the pain and make it more difficult to maintain proper posture.

The primary causes of pelvic discomfort during pregnancy include hormonal changes that soften the body's joints and muscles, a shift in the body's center of gravity due to the increased volume of the abdomen, and split abs, where the connective tissue between the abdominal muscles is stretched. These factors make the body more vulnerable during pregnancy. Lack of core strength and stability can also play a big role, as the body may be forced to compensate through inappropriate movements, increasing the risk of overuse and inflammation.

Additionally, the increased load from the baby's weight can directly affect the pelvis and cause pain. Concerns about exercise and loss of muscle mass during pregnancy can also contribute to worsening symptoms, as many pregnant women do not maintain the physical fitness they had before pregnancy or do not strengthen their bodies sufficiently to support the changed loads, often because they are unsure about how they can and should exercise during pregnancy, or do not receive sufficient guidance.

At Baby Akademiet, we have developed a course on our member page called “Yes, I am pregnant”. In the course we provide guidance on exercise and health during pregnancy, and you can find it for 0 DKK. By signing up on our member page here .

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Other potential causes of pelvic pain may include pre-existing conditions such as previous back injuries, a hunched back, or previous accidents that may become more prominent under the pressure of pregnancy. Pelvic pain can be a complex condition with multiple contributing factors, emphasizing the importance of a comprehensive approach to diagnosis and treatment, but also of making sure that you, as a pregnant woman, feel seen and understood. Being pregnant is not a disease, but it can certainly lead to states of limitation and pain.

What does pelvic pain feel like and how do I know if that's what I have?

Many pregnant women face the challenge of identifying and understanding pelvic pain, which can often be confused with general body discomfort. Understanding what pelvic pain actually feels like is crucial to distinguishing between common pregnancy-related discomforts and more serious conditions like pelvic prolapse.

Although many people believe that pelvic pain during pregnancy always indicates pelvic prolapse, this is actually rarely the case. Pelvic discomfort and pelvic prolapse are two different conditions, but both have a significant impact on the well-being and well-being of the pregnant woman, both mentally and physically. It has been recorded that up to 82% of all pregnant women experience pelvic pain at some point during their pregnancy, which underlines how common this problem is.

Pelvic pain often manifests in the lumbar region around the sacrum and can extend over the hips and down the legs, both on the front and back of the thighs. Sciatica pain is also commonly associated with pelvic discomfort, as it typically occurs when the muscles around the sciatic nerve, the largest and thickest nerve in the body, are overstretched.

This discomfort can feel like a constant, throbbing pain in the back, lower back, or buttocks. It can also occur in more specific situations, such as when walking up stairs, standing with your weight on one leg, turning your upper body while your legs are pointing straight out, or when the spine is subjected to a sudden twist. Sometimes the pain can be stabbing and seem to occur in response to certain movements, provoking an acute pain experience.

Additionally, pelvic pain can also be experienced as a burning sensation on the skin, although this is more rare. Towards the end of pregnancy, as the pressure from the baby intensifies and the baby's position begins to affect the area around the pubic bone, the pain may be felt more prominently in the lower abdomen and lower abdominal area.

Another common complaint is a heavy, pressing sensation in the pelvis, which can be clearly identified as pain. This may be felt more centrally around the vaginal area, and is often described as a downward heaviness that causes a burning sensation.

Interestingly, pelvic pain can also lead to secondary symptoms in other parts of the body as a result of the way the body compensates for the discomfort. When the pelvic area, which is connected to the body’s core and supporting muscles, is affected, it can result in tension in the back and neck, as well as pain in the knees and ankles. While these symptoms may not seem directly related to pelvic pain, they are often a direct consequence of imbalances and overloads originating in the pelvic area.

The impact of pelvic pain sometimes extends far beyond the immediate area in which it occurs. Pregnant women will often unconsciously try to compensate for this pain, which can lead to symptoms spreading to seemingly unrelated areas of the body. This compensation can create further discomfort and reinforce the need for effective treatment and support throughout pregnancy. This emphasizes the importance of early intervention and a comprehensive approach to managing pelvic pain, in order to optimize the health and well-being of both mother and child.

Understanding and managing pelvic pain during pregnancy can be a complex and frustrating process for both pregnant women and healthcare professionals. While there are no strict diagnostic guidelines specifically for pelvic pain, called pelvic girdle pain, the condition can be identified through specific symptoms and tests, most often performed by a physical therapist or other specialized healthcare professional.

Understanding pelvic pain

Pelvic pain during pregnancy can be difficult to diagnose accurately, as it is not clearly evident from standard medical examinations such as doctor’s visits or scans. Typically, the condition is defined by pain localized around the pelvic area. Healthcare professionals can perform physical tests that help identify specific movements or positions that provoke the pain, providing better insight into the degree and nature of pelvic discomfort.

Challenges and everyday influences

For many pregnant women, pelvic pain becomes a significant obstacle in their daily lives, affecting their ability to work, their physical activity level and even their ability to perform simple tasks such as lifting children or doing housework. The pain can limit the ability to exercise, which is crucial not only for physical health but also for mental well-being. Exercise has a proven positive effect on both physical and mental health, but pelvic pain can seriously limit this activity and thus affect the pregnant woman's general well-being and perceptions of pregnancy. It is really important that you can find a balance between pain and exercise during pregnancy if you suffer from pelvic and lower back problems. It is exercise combined with active rest that has been shown to be most beneficial for the long-term treatment and prevention of lower back and pelvic problems.

Psychological effects

In addition to the physical limitations, pelvic pain can also have a profound effect on the psychological state. Many pregnant women can feel isolated and limited, which can lead to feelings of sadness or frustration at not being able to live up to their own expectations for the pregnancy. This can be exacerbated by the need for possible sick leave, which can further isolate the pregnant woman from social networks and work-related activities.

Treatment and strengthening of the core

When a pregnant woman identifies symptoms of pelvic discomfort, it is crucial to seek professional help for a proper assessment and treatment plan. An important part of treatment is to focus on strengthening the core muscles. A strong core supports the pelvic area and can help stabilize the body, which is essential for minimizing pain and improving mobility during pregnancy.

Physiotherapy can be a valuable treatment modality, with specific exercises designed to strengthen the core muscles and improve overall physical function. This is particularly important as a strong core not only helps during pregnancy, but also prepares the body for birth and the period after, when physical demands can potentially be high, especially if the newborn requires a lot of carrying and care.

It is also important that the pregnant woman does not become bedridden or inactive, although it may be tempting to avoid all activities that provoke pain. Inactivity can worsen pain and lead to further physical problems. Instead, the focus should be on gradually increasing activity within individual tolerance limits with advice and guidance from health professionals.

Final considerations

Managing pelvic pain during pregnancy requires a comprehensive approach that involves both physical treatments and psychological support. It is important to recognize and address both the physical and emotional challenges that come with pelvic pain. By working closely with healthcare professionals, the pregnant woman can find the best strategies to reduce pain and improve quality of life during pregnancy.

Managing pelvic pain during pregnancy

Practical solutions and supporting measures

When you experience pelvic pain during pregnancy, it can be difficult to know exactly how to deal with it. Whether the pain is diagnosed as pelvic pain or not, there are effective steps you can take to relieve the discomfort and improve your daily functioning.

Strengthening the core muscles

The core muscles and pelvic floor play a critical role in maintaining your body’s stability and balance. These muscles support many of the movements you make every day, and their strength is essential for minimizing pelvic pain. Strengthening these muscle groups through targeted exercises can be one of the most effective ways to manage pelvic pain – both during and after pregnancy.

It is recommended to consult a physiotherapist, preferably one who specializes in pregnancy-related conditions, who can guide you in specific exercises that strengthen and stabilize the core muscles and pelvic floor without provoking further pain.

Online training courses and exercise programs

There are online exercise programs designed for pregnant women that offer exercises and techniques for both pain relief and muscle strengthening. These programs teach proper posture and movements that are safe during pregnancy, and help you avoid exercises and movements that may aggravate your symptoms. By participating in such a program, you will not only get the necessary tools to activate and strengthen your muscles, but also the knowledge of how to best relieve the pressure on your pelvis and back in your daily life.

Using support belts

A pelvic belt can be a useful tool for many pregnant women who experience pelvic pain. These belts are designed to support and relieve the pelvic area by helping to redistribute weight and correct posture, which can significantly reduce pain. Carriwell's support belt is highly recommended due to its ability to precisely adjust and support – especially in the pelvic and lumbar area. The belt is adjustable, making it usable throughout the entire pregnancy.

Manual therapies and pain relief measures

Manual therapies such as physiotherapy and massage can be effective in loosening up tight muscles and reducing pain. Heating pads and relaxing baths can also be very helpful in alleviating pain and relaxing the body. These methods can be used in combination with manual therapies to enhance the effect and provide immediate relief.

Daily handling and unloading

To minimize strain on your pelvis and back, it's important to avoid positions or activities that increase pain. This can include heavy lifting or long periods of standing or sitting. It's also a good idea to incorporate regular rest breaks into your day to give your body time to recover.

A pregnancy pillow between your legs while you sleep can also be a great help. These pillows support your legs and pelvis, which can reduce strain and improve your sleep quality.

Long-term considerations

While these measures may temporarily relieve your symptoms, it is crucial to address the underlying cause of your pain. This may mean a long-term commitment to regular physical exercise and maintaining a strong core. By improving your body's overall strength and stability, you can better handle the stresses of pregnancy and be better prepared for life as a new mother.

By combining these strategies, you can achieve significant relief from pelvic pain and improve your overall well-being during pregnancy. It is important to work with a healthcare professional to create a customized plan that fits your specific needs and situation.

This article was written by Maria Dior Duegaard Amdahl, Midwife from Baby Akademiet