Back Pain & Pregnancy - An Interview with Esther Gokhale

The following is an interview with Esther Gokhale, creator of the Gokhale Method, a set of steps that center around healthy posture and movement to relieve back pain. Esther has spent years studying and researching integrative therapies, and after experienving crippling back pain after her first pregnancy and later back surgery, has dedicated her life's work to finding solutions to eliminate back pain. In this interview, Esther shares advice to address common back pain during pregnancy. To learn more about the Gokhale Method, check out the website at


back pain.jpgHow can back pain affect a woman's pregnancy? How did it affect yours? Back pain threatens one’s physical and emotional well-being at any time, but during pregnancy this effect is manifold worse. A pregnant woman knows she is vulnerable with looser ligaments (thanks to relaxin coursing through her bloodstream) and a heavier load. She may worry about how the pain will progress, have sleepless nights, and be unable to exercise. The pain may be inescapable (mine was). She may not want to take medication for fear of the effect on the baby (I didn’t). It’s hard to enjoy pregnancy, or life in general, with a back that is complaining strongly. 

My back pain began in the ninth month of pregnancy with my first child. I was told that it might be caused by the baby sitting on a nerve and that it would likely dissipate after delivery. That reassured me somewhat (falsely, as it turned out). My main reaction to the pain, besides the physical discomfort, inability to exercise, and compromised sleep, was shock. I had been a yoga model in Mumbai, I had always been athletic and in good health - why did this happen to me? Especially when the pain did not go away, and in fact became much worse following childbirth, the pain undermined my confidence in my body. I had always assumed my body would be there for me on whatever adventures I embarked on; I had not anticipated being stumped by a healthy challenge. I felt broken in body and in spirit. 

What are common roadblocks women face in getting relief from back pain in pregnancy? 

A lot of the conventional prescriptions for back pain don’t really work for pregnant women. Many medications and procedures are contraindicated during pregnancy; the standard “core strengthening” exercises like crunches are not advised during pregnancy; losing weight is not an option. Pregnant women are left with very few tools and techniques to help their back pain. I remember feeling as though I was expected to hold my nose and close my eyes until my pregnancy ended. 

What kinds of advice/products would you advise pregnant women to avoid during pregnancy in order to lower back pain? 
When it comes to products for pregnant women, much of my advice coincides with conventional wisdom. Examples are to avoid high heels, very soft beds, and unsupportive shoes. 

In some cases, my recommendations differ sharply from current practice. Lumbar rolls and lumbar supports are ubiquitous and commonly prescribed for lower back pain sufferers. I believe they are based on an incorrect assumption that the human spine is designed to have a significant lumbar curve. In fact, research shows that a flatter, longer small of the back correlates with less back pain. Pregnant women, with the weight of their babies pulling forward on the lumbar spine, tend to have excessive lumbar curves anyway. Lumbar rolls exaggerate this effect and I recommend against them. 

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