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Why is back pain prevalent during pregnancy and can it be treated?

Half of women report having back pain at some point during pregnancy. The pain can be lumbar or sacroiliac. The pain may also be present only at night. Back pain is thought to be due to multiple factors, which include shifting of the center of gravity caused by the enlarging uterus, increased joint laxity due to an increase in relaxin, stretching of the ligaments (which are pain-sensitive structures), and pregnancy-related circulatory changes.

Treatment is heat and ice, acetaminophen, massage, proper posturing, good support shoes, and a good exercise program for strength and conditioning. Pregnant women may also relieve back pain by placing one foot on a stool when standing for long periods of time and placing a pillow between the legs when lying down.

In a randomized, placebo-controlled trial, Lacciardone et al studied the effect of osteopathic manipulative treatment of back pain during pregnancy. No statistically significant differences were achieved between treatment and control groups; however, back pain decreased in the usual obstetric care and osteopathic manipulative treatment group, remained unchanged in the usual obstetric care and sham ultrasound treatment group, and increased in the usual obstetric care only group.

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