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Approximately 50-80% of women had developed low back pain during pregnancy. 

This discomfort usually begins between the fifth and seventh month of pregnancy. However up to 20% of women claimed that pain had started as early as 16 weeks with some claiming pain begins in eight weeks. Such pain can range from mild pain related to specific activities to acute back pain that can turn to be chronic back pain.

Types of back pain in pregnancy

There are two common types of back pain in pregnancy: Lumbar pain (LP) and Pelvic Girdle Pain (PGP). PGP and Lumbar pain are two different types of lower back pain (LBP) during pregnancy, however, a small number of women suffer from combined pain.

How to differentiate PGP & LP?

PGP is described as sharp, stabbing, unilateral or bilateral, recurrent or persistent pain between the posterior iliac crestand the gluteal fold, potentially radiating to the posterolateral thigh, the knee and the calf, but never to the foot. During pregnancy, PGP is found to become more intense than during the postpartum period and can transform the natural discomfort of pregnancy into a pathophysiological condition that significantly reduces physical activity withdrawal from social interactions.

Lumbar pain during pregnancy is very similar to lumbar pain experienced by women who are not pregnant as it appears as pain over and around the lumbar spine, above the sacrum. Lumbar pain may or might not radiate to the foot, in contrast with PGP. Tenderness over paravertebral muscles is a common finding in lumbar pain. Lumbar pain worsens during the postpartum period and is typically intensified by certain movements and postures, such as prolonged sitting, but remains less debilitating than PGP.

Who is at risk of developing back pain in pregnancy?

It has been reported that women with previous lumbar problems or chronic back pain are more likely to develop back pain during pregnancy, with pain occurring twice as often as those without previous complaints. Along those same lines, women who experience back pain during first pregnancy have 85% chance of experiencing back pain during a subsequent pregnancy.

What causes back pain in pregnancy?

• Pregnancy hormones
• Poor posture (Hyper lordosis)
• Abdominal muscles insufficiency

Release of pregnancy hormones such as relaxin, estrogen & progesterone will relax the muscles, loosen ligaments and joints, especially around pelvic area to expand in preparation for childbirth. Increased joint laxity and hypermobility will cause instability of pelvic joints. Ligamentous laxity may lead to exaggerated range of movement in pelvic joints, which in turn may result in stretching of ligaments around the pelvic joints and sacroiliac joints leading to back pain.

A misaligned pelvis can also lead to restrictions during the last trimester for the baby in difficulty getting into the optimum, head down position. This can affect the desire of a mother to have a normal vaginal delivery. Both breech and posterior positions can be a reason for a mother to go for a C-section delivery.

As your pregnant uterus enlarges, your centre of gravity shift anteriorly which leads to a tendency to fall forward. To restore the centre of gravity, woman unconsciously arches her upper body back over the pelvis causing progressive lordosis leading to imbalance and finally at risk of falling down. The growing pregnant uterus stretches the abdominal muscles which may weaken these muscles. The weight of your baby and weakening of abdomen muscles pulls your lower spine forward, adding strain to back muscles.

How does maternity belt alleviate back pain in pregnancy?

• Provide optimal support by lifting your growing belly which helps to relieve pressure off of the spine and pelvis caused by the growing baby.
• Provide gentle compression to stabilise your hip and pelvic joints.
• Helps to distribute the weight evenly to abdomen and back muscles to relieve stress, pain and pressure.
• Posture corrector.
• It is anatomically designed to prevent direct strain on the foetus or blood vessels while relieving the lumbar spine at the same time.

These designed, contoured maternity belt fit around the lowest part of your stomach and provide support and compression to relieve many of the pregnancy's common discomforts. A maternity belt can be worn under or over clothes and, when properly fitted, is totally safe for you and your little one.                                                                                      

Why maternity belt is a must have item in pregnancy?

During pregnancy, women are at greater risk of falling due to hormonal, structural and physiological changes occurring during pregnancy. Weight gain, increased joint laxity, increased spinal lordosis, reduced neuromuscular control and coordination, and changes in biomechanics and body mass centre have been reported as significant changes affecting the balance of women during pregnancy. Twenty seven percent of pregnant women experience two or more falls during pregnancy resulting in injuries such as bone fractures, joint sprains, muscle strains, head injury, internal organ rupture, internal haemorrhage, abrupt placenta, uterine and membrane rupture, and occasionally maternal or intrauterine foetal death.

Study shows that maternity belt is safe, comfortable and has promising effect on pregnancy related low back pain.Three studies have shown that the use of maternity belt to perform everyday tasks has decreased discomfort and enhanced the ability to perform daily activities, such as standing, sitting, rolling in bed, and walking. Two studies have shown that maternity support belts have increased the postural stability of women significantly, improvement of functionality and mobility, and reduction of risk of fall during pregnancy

Other benefits of wearing maternity belt are to minimise the risk of recti, minimise the formation of stretch marks by helping to increase blood flow and circulation and also assist abdominal healing in postpartum recovery.

How to choose the right maternity belt?

• Non-rigid belt was regarded as the most effective and comfortable while the rigid belt tended to “ride up” and move out of position when sitting down and was uncomfortable and “digging in” while sitting.
  
  
• Elastic belts are effective to reduce risk of falling because of their wearability and adjustability to accommodate the abdominal girth growth.
  
  
• An adjustable, narrow, and non-rigid belt that can be used in high position at the anterior superior iliac spine or low position at the pubis.

• Flexible pelvic support belt may be more effective in reducing pain and is potentially better tolerated than a rigid belt.

References:

Cakmak, B., Inanir, A., Nacar, M.C. and Filiz, B. (2014), The Effect of Maternity Support Belts on Postural Balance in Pregnancy. PM&R, 6: 624-628.

Quintero Rodriguez, C. and Troynikov, O., 2021. The Effect Of Maternity Support Garments On Alleviation Of Pains And Discomforts During Pregnancy: A Systematic Review.

Carr, C.A. (2003), Use of a Maternity Support Binder for Relief of Pregnancy‐Related Back Pain. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 32: 495-502.

Ho, S. (2021). Maternity garment treatment for the relief of low back pain. Retrieved 16 January 2021, from https://theses.lib.polyu.edu.hk/handle/200/5177

Phillips, James D. MD; Lew, Daniel B. DO Are pregnancy support belts effective in treating pregnancy-associated lumbopelvic pain?, Evidence-Based Practice: April 2017 - Volume 20 - Issue 4 - p E3-E4

Szkwara, J. M., Milne, N., Hing, W., & Pope, R. (2019). Effectiveness, Feasibility, and Acceptability of Dynamic Elastomeric Fabric Orthoses (DEFO) for Managing Pain, Functional Capacity, and Quality of Life during Prenatal and Postnatal Care: A Systematic Review. International journal of environmental research and public health, 16(13).

Flack, N.A., Hay-Smith, E.J.C., Stringer, M.D. et al. Adherence, tolerance and effectiveness of two different pelvic support belts as a treatment for pregnancy-related symphyseal pain - a pilot randomized trial. BMC Pregnancy Childbirth 15, 36 (2015).

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