II. Pathophysiology
- Musculoskeletal strain occurs with increased lordosis and soft tissue laxity in later pregnancy
III. Findings: Red Flags
- See Low Back Pain Red Flags
- Trauma in Pregnancy
- Vaginal Bleeding
- Severe Abdominal Pain
- Uterine contractions
- Uterine tenderness to palpation
- Decreased fetal movement
- Vaginal fluid loss
- Urinary Tract Infection symptoms
IV. Differential Diagnosis
- See Low Back Pain Causes
- Musculoskeletal causes
- Musculoskeletal Low Back Pain
- Sacroiliac Joint loosening
- Lumbar Disc Herniation
- Cauda Equina Syndrome
- Sacroiliitis
- Sciatic nerve pressure or lumbar plexus pressure
- Medical causes
- Obstetric causes
- Placental Abruption
- Intrauterine Fetal Demise
- Uterine contractions (e.g. Preterm Labor)
V. Management: Musculoskeletal Low Back Pain
- Low back Exercises (adjusted for pregnancy)
- Physical therapy
- Back support devices
- Warm baths
- Medications
- Acetaminophen
- Transdermal Lidocaine Patch (refractory symptoms)
- Procedures
- Acupuncture
- Epidural steroid injection
- Osteopathic back manipulation