Low Backache in Pregnancy

Back pain is a prevalent issue among pregnant women, affecting 50–70% during pregnancy and continuing in over 30% postpartum. Historically recognized and described by prominent figures such as Hippocrates and Vesalius, this condition was first categorized into pelvic girdle pain (PGP) and lumbar pain (LP) by Walde in 1962. PGP, occurring four times more frequently than LP, is characterized by deep, sharp pain that develops between the gluteal fold and the posterior iliac crest, which may be felt in the calf, knee, and thigh. Both types of pain stem from mechanical, hormonal, and anatomical changes which are seen due to pregnancy-induced hormonal changes, weight gain, shifting body gravity, muscle separation, and high maternal BMI. PGP significantly impacts physical functioning and quality of life, leading to reduced activity and social withdrawal. Accurate diagnosis, which differentiates between PGP and LP, is essential for effective treatment, as the management approaches differ. While there is no universal guideline for treating pregnancy-related back pain, conservative measures such as physiotherapy, stabilization belts, and specific exercises are recommended. Studies suggest that prenatal exercise may not prevent back pain but can reduce its severity. General recommendations for managing PGP include ergonomic adjustments, pelvic support garments, and cautious use of medications. More research is required to better understand and address the multifaceted causes and to find more effective solutions and treatments for back pain during pregnancy.