VIDEO 1: Introduction

Back pain is a significant musculoskeletal issue that adversely affects the quality of life for women during pregnancy. While the prevalence of back pain in pregnant women ranges from 50% to 80%, it has been on the rise worldwide over the years. The emergence of back pain during pregnancy is believed to be associated with various factors. These factors include the mother’s body mass index, strenuous working conditions, parity, pre-existing lumbar issues before pregnancy, a history of back pain in previous pregnancies, and the mechanical, hormonal, circulatory, and psychosocial changes occurring during pregnancy.

Pregnant women experience numerous anatomical and physiological changes to meet the increased metabolic demands and support fetal development. Changes in ligaments, edema in soft tissues, weight gain, and increased lordosis occur due to alterations in estrogen, relaxin, and progesterone hormone levels. In addition to changes in the musculoskeletal system, there are also alterations in the cardiovascular system, with an increase in blood volume and a shift in the body’s center of gravity towards the ventral direction due to the fetus’s development. This change in the center of gravity leads to an increase in lumbar lordosis and anterior pelvic tilt. The increased lumbar lordosis can affect the curvature of the cervical and thoracic spine, while the growing breast tissue can cause protractions in the shoulders. The influence of the relaxin hormone results in laxity in the sacroiliac joint and ligaments connecting the ribs to the sternum. The growing uterus in the abdominal region affects the function of abdominal muscles by causing elongation and separation of the linea alba. Simultaneously, the enlargement of the uterus leads to dysfunction in the diaphragm and pelvic floor muscles due to increased pressure.

As a result of all these factors, back pain during pregnancy typically begins around the 22.1st week of gestation, with an increasing incidence as the trimesters progress. While it is expected to subside in the postpartum period within a few months after childbirth, it may persist due to overuse and the impact of changes occurring during pregnancy. In the upcoming videos, you can observe the methods used for evaluating a patient presenting with back pain during the prenatal and postnatal periods, as well as the exercises employed in its treatment.