Why does upper back pain occur during pregnancy? 

Pregnancy is a monumental time during a person’s life. There are countless changes, both physical and mental. Some changes are exciting and beautiful, while other changes can lead to discomfort. If you experience back pain during pregnancy, you are not alone. An estimated 50-80% of pregnant women experience some form of back pain.1 This is due to the rapid posture changes that occur during pregnancy while supporting the growing child.2 

Everything within your body is connected. When there is a shift in one area, there is bound to be a ripple effect that causes a shift in a different area of the body. It is an incredible reminder of how resilient your body is, with its main goal to nourish and support you through all phases of life. Knowledge is power, and taking the time to learn about the physiological changes that take place within your body during pregnancy can empower you to move forward in your pregnancy by being your own best advocate.

What musculoskeletal changes occur during pregnancy?

At the beginning of pregnancy, a hormone called relaxin is released. This hormone prepares the pelvis for birth. Relaxin increases laxity in the ligaments around the pelvis to allow more room for delivery.3 The ligaments around the pelvis aren’t the only ones impacted by relaxin. All the ligaments within your body loosen up to make room for a growing child. 4

Due to weight gain and carrying a growing child within your uterus in the front body, your center of gravity is thrown off as well. This causes changes in your postural distribution. This, combined with loosened ligaments, results in several musculoskeletal changes during pregnancy. These postural changes can contribute to upper back pain or discomfort. Let’s dive into some of these specific musculoskeletal changes now. 

The anterior weight a woman holds during pregnancy can contribute to rounded shoulders and forward head posture.5 Rounded shoulders can cause tightness in the muscles of the chest, such as your pectoralis muscles.2 When you’re in a forward flexed position with tight chest muscles, the muscles of your upper back, such as your rhomboids, can become elongated and weak. Both the weakness and tightness of muscles can contribute to aches and pains. 

A similar reaction takes place with forward head posture. The muscles in the front of your neck, such as your deep cervical flexors, become long and weak, and the muscles in the back of your neck, such as your levator scapula and upper traps, become short and tight.2 Often, when you see someone holding the area where their shoulder meets their neck or complaining about pain between their shoulder blades, it’s the result of rounded shoulders and forward head posture. 

Activities to relieve upper back pain during pregnancy 

A therapeutic exercise program can bring great relief to pregnant women experiencing upper back pain. Upper back pain during pregnancy is often caused by tightness in the chest and weakness in the upper back. Below are two great exercises to help open up the chest and strengthen the upper back.

Thoracic opener 

Instructions 

Start: Stand facing a wall with your feet shoulder-width apart.

Step 1: Bring both arms up to shoulder height with your palms together. Place your forearms on the wall with your elbows wider than your shoulders.

Step 2: Take your time here to draw your baby up and in toward your heart to engage your core, lengthen your spine, and tuck your chin. Maintain this length during the stretch.

Step 3: Step away from the wall. Keep your core engaged as you hinge forward at your hips. Hold your arms in place and drop your chest toward the floor.

Step 4: Continue to drop your chest toward the floor until you feel a gentle stretch in your shoulders, chest, and upper back. Relax as you take slow deep breaths.

Step 5: When you are complete, slowly step forward with one leg and come back to an upright position.

Shoulder External Rotation: Bilateral

Instructions

Start: Stand holding your band with hands shoulder distance apart. Bend your elbows to 90°.

Step 1: Bring your feet shoulder-width apart. Stand tall and draw your baby up and in toward your heart to engage your core.

Step 2: Keep your elbows by your side and slowly pull your hands apart, squeezing your shoulder blades down and back.

Step 3: Slowly return to the starting position. Work within your range of motion. Repeat for 3 sets of 8-10 reps.

Additional ways to relieve upper back pain during pregnancy

Sleep position

Deep sleep is crucial for you and your growing baby. While your body changes, your sleep positions should too. Side sleeping with pillows is the best sleep position during pregnancy. You can sleep on whichever side is most comfortable. But, there are greater benefits to sleeping on your left side. Left side sleeping promotes healthy circulation, better elimination, and less edema. 

Using pillows can help you get the most comfortable sleep. You can place a wedge pillow between your growing belly and the bed. This supports your growing belly and avoids excess pressure on your back. Place a pillow next to your back to help prevent you from rolling onto your back. You can also place an oblong pillow in front of your legs and place your top leg only on top of the pillow at 90 degrees. The entirety of your lower leg should be on the pillow.

Lastly, choose a head pillow that keeps your head and neck in a neutral and straight position.

Breathe correctly

While pregnant, your ribs get pushed out and flatten your diaphragm, while the baby and organs get pushed up, inhibiting full diaphragm expansion during inhales and exhales. Due to postural changes, there are also restrictions to back diagram expansion as well.2

To practice proper breathing while pregnant, you can place your hands on the sides of your torso while sending your breath into your diaphragm, expanding your diaphragm and ribs side to side.

Proper clothing 

Clothing can help reduce strain on your upper back. Wearing a properly fitting bra with extra support helps take pressure off your back and can improve your posture. If you are unsure what your sizing is, you can get measured at most department stores or maternity shops.

Regular exercise 

Exercise can support you and your child’s health. It can boost your mood, prevent discomfort, and increase resilience. Some other benefits of exercise during pregnancy include: lower incidence of cesarean birth, lower incidence of preterm birth, decreased postpartum recovery time, lower incidence of excessive weight gain, lower incidence of hypertensive disorders, decreased risk of gestational diabetes mellitus, fewer aches and pains, and improved physical fitness.6  Find ways to include both cardio and resistance training for 30 minutes 3 times a week.

Improve your pregnancy-related back pain today

Before you begin a new exercise regimen, please first consult your doctor. Pain and discomfort can negatively impact your pregnancy journey. Targeting the root cause of your issues can relieve pain, improve your pregnancy, and optimize postpartum outcomes. If you would like more information on how Orbit can help you decrease pain, manage stress, and improve your overall well-being, contact us today.

Resources

  1. Sabino, J., & Grauer, J. N. (2008). Pregnancy and low back pain. Current reviews in musculoskeletal medicine, 1(2), 137–141. https://doi.org/10.1007/s12178-008-9021-8
  2. Duvall, S. (n.d.). PCES 2.0 Pregnancy and Postpartum Corrective Exercise Specialist Course Book. Core Exercise Solutions.
  3. CSPC. (2019, December 10). Effects of pregnancy on musculoskeletal system: CSPC Physiotherapy, Leeds. CSPC Physiotherapy. Retrieved September 14, 2022, from https://www.cspc.co.uk/complex-conditions/your-body-during-pregnancy/effects-of-pregnancy-on-musculoskeletal-system/
  4. Sacks, D. N. (n.d.). Back pain in pregnancy. Back Pain in Pregnancy – Health Encyclopedia – University of Rochester Medical Center. Retrieved September 14, 2022, from https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=134&contentid=52#:~:text=Throughout%20pregnancy%2C%20hormones%20affect%20a,especially%20in%20the%20pelvic%20area.
  5. Morrison, M. M. (2017, January 30). How to improve pregnancy posture and alleviate back pain. How to Improve Pregnancy Posture and Alleviate Back Pain. Retrieved September 14, 2022, from https://www.thebump.com/a/simple-strategies-to-banish-backaches-and-improve-posture 
  6. Nascimento, S. L., Surita, F. G., & Cecatti, J. G. (2012). Physical exercise during pregnancy. Current Opinion in Obstetrics & Gynecology, 24(6), 387–394. https://doi.org/10.1097/gco.0b013e328359f131
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