How Pregnancy Can Cause Knee And Back Pain

Are you pregnant now or planning to start a family soon?

If that’s you, your girlfriends have probably already told you in no uncertain terms to expect a variety of different aches and pains during your pregnancy. It’s par for the course, right?

These pregnancy-related pains tend to pop up all over the body. Sometimes, even without an apparent reason. Like pain in your fingers or toes or the back of your head.

But the pain in the knee joints and the lower back are among the most common kinds of pain for most Mums-to-be. That’s why we often see pregnant women stereotypically depicted shuffling along slowly and grimacing with one hand holding their back. But it doesn’t have to be like that. 

Pregnancy-related joint pain can begin at any stage of your pregnancy from as early as 6-8 weeks and in virtually any joint in the body. However, pain in particular parts of the body – like the lower back and pelvis – are the most common as the pregnancy progresses past the 12-week mark and into the second and third trimester.

In our experience, most of the aches and pains during pregnancy are mild. Still, for some women, the pain can be debilitating. For these women, it’s tough. The pain can stop you from sleeping through the night and affect your quality of life and enjoyment of your pregnancy. Sadly, pregnancy and the postnatal period can be the opposite of “blossoming” for many women.  

Does that sound like you? 

The areas we see that are most affected by joint pain during pregnancy are: 

  • Pelvic region: You may feel pain around the pelvic area. Including the hips, tailbone and pubic symphysis region – the centre of the pubic bone, and the lower back. If left untreated, these pains can lead to the development of pelvic girdle pain and or a condition that causes pain at the front of your pelvis, called “Symphysis Pubis Dysfunction or (SPD)”.
  • Lumbar or lower back: Lumbar or lower back pain in pregnancy is triggered by the softening of the pelvic-area ligaments and the change in your spinal posture/curves as the baby grows
  • Sacroiliac joint: The joints known as SI (sacroiliac) joints are the part of your body where the ilium and sacrum connect, the area between the pelvis and the tail bone. The SI joints are crucial in bearing the additional weight of your baby (although tiny in most cases but large in relation to what your body is used to carrying) and its distribution on the pelvis.  
  • Knee joint: Many women experience knee joint pain during pregnancy due to carrying around the additional weight of the baby, which puts continuous strain on the knees. Knee pain is more likely to occur during pregnancy if you have a pre-existing knee condition or old injury. However, it can also happen spontaneously during pregnancy due to hormone-related ligament changes and postural changes that occur during pregnancy.

The cause of joint pain in pregnancy can be due to many different factors such as: 

  • The shift in posture that happens naturally during pregnancy 
  • An increase in weight in the lower parts of the body 
  • The relaxation of ligaments occurs due to the hormone “relaxin.” 

But the most common reasons for pregnancy-related joint pain that we see in the clinic are:

  • Expanding uterus: As your pregnancy progresses, your womb (uterus) begins to grow and develop, too, which causes your centre of gravity to shift, weakening and stretching your abdominal muscles. Because of this centre of gravity change, it puts additional stress on your lower back, which can lead to pain.  
  • Hormones: In pregnant women, the leading cause of softening joint ligaments and associated pain is the release of the pregnancy-related hormones progesterone and relaxin. Our bodies release the latter of the two, relaxin, to allow the pelvic ligaments to become loose and the pelvic girdle to move. This repositioning enables the baby can move more easily through the birth canal. However, this reduces the regular stability of the joints in the hips and pelvis and can make them feel “loose”. As a result, you may also feel lower back pain because of the release of this hormone. It helps the pelvis stretch and the SI joint to become more flexible to accommodate your baby. 
  • Postural issues: Changes in your posture occur naturally in pregnancy because of the extra weight you carry towards the front of the body. This change, along with the baby’s continual growth, causes a redistribute of weight in the belly region, which can trigger pain in the lower back and hips. In addition, even after pregnancy, continually carrying your new baby/toddler on your hip can affect your posture and cause lower back and hip pain. 
  • Increase in weight: Due to the hormonal changes, increased blood volume, growing baby, placenta, reduced activity levels and sometimes the unavoidable “cravings” and eating to beat morning sickness, we don’t just gain weight in the belly area during pregnancy. We also gain it in other areas of the body. Second, to the belly, most of us see weight gain around the hips, which increases stress on the joints and bones around the hips, knees and pelvis and can lead to joint pain.

The less common cause of joint pain during pregnancy:

One of the more severe but uncommon causes of joint pain during pregnancy is “Symphysis Pubis Dysfunction”. It can be intensely painful and cause issues with walking. 

How To Alleviate Joint Pain In Pregnancy

While joint pain in pregnancy can be intense and painful, there are many ways to relieve the pain:

  • Physical therapy/ exercise: Gentle movement and exercises during pregnancy can help strengthen the muscles and help to reduce pain in the joints. However, you must check with your doctor first and consult a professional oestopath specialising in pre and postnatal care. They can provide pain relief with manual treatment and they can guide you through appropriate exercises, especially if you have joint pain. You can also try swimming, prenatal Pilates, and Yoga with your doctor’s approval. 
  • Consider a massage: In some cases, opting for a prenatal massage with a trained prenatal massage therapist can be beneficial in reducing tension in the muscles and reducing aches and joint pain. 
  • Use hot packs on the affected area: Hot packs, heating pads, or a hot water bottle can help relieve pain if you have joint pain. Some women like to talk a warm bath too to help relax the muscles and reduce pain. However, always take care to avoid direct heat on your bump.
  • Belly band: If you’re in the second or third trimester of your pregnancy, you may want to try using a “belly band” for extra support. These bands can help relieve the ligament pain and pain in the lower back region that is so common in pregnancy. In addition, belly bands can alleviate round ligament pain due to the uterus stretching.
  • Improve posture: If you try to improve your posture while sitting, standing, and walking around, it can pay dividends in reducing joint pain during pregnancy by reducing the strain on your joints. This improvement doesn’t just mean sitting on standing up straight. You can also improve your pregnancy posture by building strength and flexibility in the joints and surrounding ligaments and tendons. To do this, you can work with a professional osteopath who will create a customised exercise regimen for your needs. 
  • Modify sleep position: If you suffer from pain in your lower back during pregnancy. Just making simple modifications to your sleeping position can help significantly by reducing the pressure on your joints. For example, instead of lying on your back all the time, switch to sleeping on your side with a pillow tucked between your knees. But only if it works for you. If it’s not comfortable, don’t do it. Instead, find a position that works for you. The most comfortable sleeping position for you will depend on your baby’s position and how much they move during the night. 

At Focus Osteopathy, we support Mums and soon-to-be Mums through every stage of their pre and postnatal journey. Osteopathy can be helpful for back pain and other musculoskeletal pains.

There are no quick fixes, but we can help you find the root cause of your pain and work with you to recover. We empower you to stay fit, have a healthy pregnancy, and prepare for and recover well after birth.

As well as finding the cause of your pain, we can also help you sit, sleep, and walk more comfortably.

If you have pregnancy-related knee pain, back pain, or any other joint pain, now. You can book a free consultation to talk to one of our Pregnancy and Post Natal practitioners to find out how we may be able to help you. 

When your shoulder is really a pain in the neck…

An aching shoulder may not necessarily indicate a shoulder problem, and equally a sore neck may not always be a neck problem. The body can often report pain in a confusing, unreliable way. It is common that people with shoulder pain really have a neck problem and vice versa.

Why? Because the neck and shoulder are closely connected by nerves. When injury occurs, referred pain can develop as a result of the brain having difficulty determining the source of pain along the commonly shared nerves. Therefore, often what we feel may not be what is actually occurring.

Because the reported site of pain is often not the source, a thorough examination in combination with a detailed history is required to determine the true source of pain. This involves range of motion testing, provocative neck and shoulder tests, and strength tests.

When the shoulder is the source

Shoulder pain is most often caused by an injury to the rotator cuff, a group of tendons and muscles that stabilize the joint. The rotator cuff can be easily injured by falls, repetitive activities of the arm, sporting injuries etc.  When the rotator cuff is injured we compensate by using different muscles to perform simple tasks like reaching or picking things up. This compensation may cause both shoulder and neck pain.

How do you know it’s your shoulder? You may have a shoulder problem if your pain:

  • Develops in the shoulder itself (at the ball and socket joint)
  • Is on the outside of your upper arm
  • Is dull and aching at the above locations
  • Occurs when you do movements involving the arm
    • reaching overhead
    • reaching behind your back
    • when lifting
    • putting your jacket on
  • Radiates into the upper arm, but not past the elbow
  • Aches at night in the shoulder joint
  • Improves when you rest your arm

When the neck is the source

The neck is made up of eight pairs of joints and many nerves and muscles, which means inflammation of any of these structures can cause neck pain. Considering the neck is responsible for all head movements, including even the slightest nod when in a conversation, there is a good chance you will experience inflammation in the neck at some point!! Common ways to injure your neck include; sleeping awkwardly, turning your head suddenly and awkwardly, holding your neck in one position too long (ie at computer or on the phone), car accidents to name a few.

How do you know it’s your neck? You may have neck pain if your pain:

  • Develops in or on the side of your neck, or develops in the shoulder blade
  • Is sharp or stabbing in the neck
  • Radiates down past your elbow or even into your hand
  • Causes difficulty turning your head, or looking up or down
  • Is relieved when you support your neck

It’s important to see a specialist to get a thorough physical examination of your neck and shoulder to help with diagnosis. Whether the problem lies in your neck or your shoulder, it is imperative that conservative measures are first adopted.

5 ways to help relieve pain from a shoulder problem

  1. Resting from activities that aggravate pain
  2. Osteopathic /physical therapy treatment
  3. Icing the shoulder
  4. Anti-inflammatory medications, as directed by your health professional
  5. Rehabilitation/strengthening exercises for the shoulder

If these measures fail to bring relief, you may need imaging (ie X-ray or MRI) of your shoulder to definitively diagnose if there is a more severe injury such as a tear.

6 ways to help relieve pain from a neck complaint

  1. Osteopathic /physical therapy treatment
  2. Ice or heat
  3. Massage
  4. Resting from aggravating activities
  5. Anti-inflammatory medications, as directed by your health professional
  6. Postural exercises

Whether you have persistent pain in your shoulder, your neck or both, don’t wait to seek advice. Having an osteopath or other physical therapist evaluate your complaints will determine where the main problem is and will get you started on the correct course of treatment for you. The earlier the intervention, the quicker the resolution.

Pregnancy back pain from an Osteopath’s view

Pregnancy is such a special experience. There is something to be said about carrying, growing and protecting your little bundle of joy. It is almost impossible to describe the feeling. The pregnancy experience is often described as all joy, love, glowing and happiness, however in reality it can actually turn out to be all nausea, discomfort and pain. Yes it would be wonderful if we all had a pregnancy full of bliss but unfortunately for a large percentage of women this just isn’t how it happens.

For a large portion of pregnant women, we experience varying degrees of back pain. This can range from a low grade ache and discomfort in bed, or on the couch, to discomfort whilst standing, after walking or being on our feet too long. In some instances it is not uncommon to experience severe debilitating pain in which you have to resort to using crouches or a wheel chair or being almost completely house bound.

Whatever the degree of pain you have suffered throughout your pregnancy it certainly puts a “downer” on the whole experience.

So why does it happen?

Firstly, we all know that a women’s body undergoes dramatic changes throughout a pregnancy whilst growing a baby. There are changes that you can see from the outside, changes you can feel on the inside and changes you have no idea that are happening. It is a combination of all these things that can lead to back pain.

Hormonal changes: Some hormonal changes you will feel – you may feel more emotional or have mood swings, your breasts will feel tender, you may feel more hungry, you may feel nauseous, you may need to go to the bathroom more regularly. What you won’t feel is the softening of the ligaments and changes in the soft tissues or muscles which are all attributable to hormones.

Physical changes: You may notice a growing belly, weight gain, larger breasts, swollen hands and feet, your luscious locks of hair. What you may not notice, as it happens so gradually, are the changes in your posture.

As the pregnancy progresses your once good posture starts to fade away to accommodate the growing baby. Your abdominal muscles stretch and are less efficient at contracting, this results in poor alignment and support of the lower back. Your pelvis tilts forward and your back arches. This posture alone means that your once stable lower back and pelvic joints do not function properly and rely more heavily on the surrounding muscles to provide the support and to maintain some sort of posture. For many women their bodies cope with this change and their muscles are able to adapt and provide sufficient support to the joints. However in a number of women their muscles are insufficient and lack the ability to provide the correct support. When this occurs there is significant strain on the joints and this can lead to pain.

Women with existing back or pelvic dysfunction are more likely to develop back pain during pregnancy. Many of the population are unaware they have a back or pelvic problem due to never having symptoms in this region, however the dramatic changes during pregnancy often highlight the problem.

It is common for women that have had a history of prior injury or dysfunction to the lower back or pelvic region will suffer from this type of pain. However injuries to other areas of the body may also contribute to back pain during pregnancy.

The following previous injuries may contribute to pregnancy related back pain;

  • Back strain/injury
  • Hip strain/injury
  • Ankle or knee injury
  • Surgeries to the hip, knee, ankle, back

Unfortunately many women who suffer from back pain during pregnancy become sedentary, thinking that stopping physical activity and resting will help their pain. Although this is the recommended action for some complaints, the vast majority of pregnancy related back pains require the opposite. It is essential to keep those muscles activated and get them working properly to help support the progressing postural changes throughout pregnancy.

The good news is that in most cases, pregnancy related back pain can be treated and managed so that you can enjoy your pregnancy. It is important however to seek the advice of a medical professional and one that is experienced in pregnancy related problems. This may be your obstetrician, osteopath, physiotherapist or chiropractor.

As an Osteopath and a mother, the best advice I can give is DO NOT WAIT to see how it goes. It is unlikely to go away as your body is changing constantly. The earlier you act and address the back pain the quicker you can manage it and prevent it getting worse, so that you can enjoy your pregnancy and remember it being a joyous time!