Question
I am 4 months pregnant with my second child and have had really bad back pain for 4-4 1/2 months. I don't think it is related to my pregnancy and had no problems with my first pregnancy. I have been to 2 chyropractors and 2 different therapy groups. Nothing has helped! My OB said I could get an MRI but no one will write a referal for it to be done.  I'm afraid if this doesn't get resolved I will hardly be able to walk by the time I'm large and 9 months pregnant and even worse end up with permanent damage to my back.

Answer
Hi Kari

Congratulations on your pregnancy, but sorry to hear about the back pain. An MRI is certainly not a bad idea, but often they don't show anything. In the absence of being able to have one done, the approach to your pain would be pretty much the same as for someone who is not pregnant.

I would suggest an approach that concentrates on maximizing strength and flexibility in your back.

If you have access to a place that teaches yoga, try a yoga class for pregnant women, or a class that the teacher will modify for you. Daily walking or swimming can also be beneficial.

Some other things that may help include sticking with low heeled shoes, sleeping on your side, alternating heat and cold on the back, and pelvic tilt exercises.

I would encourage you to stay as active as possible, since decreasing activity level can lead to a spiral of deconditioning and increased pain.

One exception to the above has to do with the issue of radiating pain (radiculopathy). If you have pain that radiates down into the legs or feet, or out into the arms, then you are a candidate for an MRI, and you should insist on a referral. Otherwise, try some of the above and see if you can hit on something that provides you with some relief.

Best of luck to you, and don't hesitate to send a follow up question if need be.

Barry