PRPP can be experienced at almost any time during pregnancy but onset around the middle of the second trimester is most common. Highly problematic pain usually develops in the later stages of pregnancy when both mum and bub are heavier.
Who is at risk of developing persistent pain in pregnancy?
Women who are most at risk of developing back pain are those who are in poorer physical condition or health going in to pregnancy and those who have experienced back pain prior to pregnancy. Especially if they have had recurrent or particularly debilitating back pain prior.
What causes PRPP?
As your body is changing, so does your centre of gravity. It will gradually move forward as your uterus and baby grows, which causes your posture to change and this can produce back pain. Particularly if you lack the flexibility or mobility to accommodate the shift in postural positioning.
Carrying a baby to term also means your back, trunk and core must support additional weight, this can be anywhere from 10-20kg. If you’re not normally active and don’t typically lift, carry and move around these types of loads then there is some chance you could sustain an injury. But, there’s probably a much better chance this will just set off a few alarm bells for your very sensitive nervous system which is super charged, trying to protect you and ensure survival of the future of the species. Injury or not, the struggle of pain is real.
The hormones released during pregnancy often get a bad wrap because they cause so many changes to your body. Most of these changes are actually really helpful and they prepare your body to undertake the most spectacular feat you’ll ever witness. One of the most obvious changes is that the ligaments and connective tissues of your pelvis and low back will soften to permit greater expansion and allow for delivery of the baby.
Overall your joints become looser and this may transiently affect the ability of your muscles to provide back support, but the nervous system usually works this out pretty quickly and adapts support to match your newfound flexibility.
The most common cause of back pain during pregnancy is probably strain on these back muscles as they work to manage the increased loads and your increased range of motion. If these muscles just aren’t up to the job then we start to see increased injury risk to other connective tissue and joint structures like cartilages, discs and ligaments – though this is probably much less common.
Another common cause of pain in pregnancy is nerve irritability, this can manifest as back pain, sciatic pain and even carpal tunnel syndrome. This probably results from fluid retention and compression from local muscles tightening and clenching to cope with increased demands.