Curr Rev Musculoskelet Med (2008) 1:137–141 DOI 10.1007/s12178-008-9021-8 Pregnancy and low back pain Jennifer Sabino Æ Jonathan N. Grauer Published online: 26 February 2008 Humana Press 2008 Abstract Back pain is ubiquitous in today’s society and is particularly common during pregnancy. There are mul- tiple factors contributing to these symptoms during pregnancy including pelvic changes as well as alterations to loading. Potential imaging modalities are limited during pregnancy due to the desire to limit ionizing radiation exposure to the fetus. Treatments are generally conserva- tive, exercise-based interventions and alternative modalities may also be considered. Low back pain asso- ciated with pregnancy does generally resolve postpartum. Keywords Spine Prengancy Introduction Back pain is a common complaint of pregnant women. This is generally characterized as axial or para-sagittal discomfort in the lower lumbar region and is musculo- skeletal in nature. This can be due to a combination of mechanical, hormonal, circulatory, and psychosocial fac- tors. Treatment options are often poor, as the cause of back pain is not always fully understood. Furthermore, treat- ments that are available usually have a low success rate and consist mainly of life style adjustments and bed rest. Discomfort in this region may also be contributed to changes in the posterior pelvic region, particularly the sacroiliac joints which undergo changes during pregnancy J. Sabino J. N. Grauer (&) Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, P.O. Box 208071, New Haven, CT 06520- 8071, USA e-mail: jonathan.grauer@yale.edu and/or stretch direct stretch of intrapelvic structures. This can manifest itself in the lumbar region and/or radiate to the buttocks and posterior thighs. Unlike radiculopathy, posterior pelvic pain usually does not extend beyond the knees. The classic description of pain felt by most women is usually a result of symptoms of both types of low back pain, lumbar and pelvic. Such discomfort can have a substantial impact on life during pregnancy and may be of variable intensity and duration. Fortunately, in most cases, low back pain resolves itself quickly after partum and does not cause any lasting issues. However, if discomfort is persistent or not of classic presentation, less common causes such as infection and preterm labor must be considered expeditiously to avoid serious consequences. Incidence Back pain can affect women of child bearing age whether pregnant or not. Approximately 70% of women will report low back pain at some point in their lives [1]. However, during pregnancy alone, the incidence of back pain is reported by 50–80% of women [2, 3]. One-third of preg- nant women claim that low back pain is a signiﬁcant problem [4]. In a study by Stapleton et al. 61.8% of women who reported low back pain during pregnancy claimed the pain was at least moderately severe, 9% claimed they were completely disabled by pain [5]. This discomfort most commonly starts between the ﬁfth and seventh month of pregnancy [2]. Morgen et al. repor- ted a mean gestation age at start of pain of 22.1 weeks. However, in this study up to 20% of women claimed that pain started as early as 16 weeks with some claiming pain within the ﬁrst month [3].