Back pain during pregnancy
At some point, in women during pregnancy, in addition to morning sickness and pain from labor pains, pregnant women may experience another unpleasant sensation of back pain. Between 50% and 70% of expectant mothers experience back pain during pregnancy. Often, back pain (lower back) in pregnant women begins in the second half of pregnancy, as a result of changes in total body weight and displacement of the center of gravity, which puts additional stress on the spine.
Back pain - often perceived as chronic persistent pain in the lower back. Back pain during pregnancy usually occurs in young women or those who have multiple pregnancies or weak back muscles before pregnancy. In most pregnant women or immediately after childbirth, pain occurs in the sacroiliac joint, where the pelvic bones attach to the spine. It can feel like stiffness in the morning hours and can develop into soreness during the day.
Causes of back pain in pregnant women
Many factors cause back or spine pain in pregnant women. Some of the most likely causes are:
- weight gain
- changes in posture
- hormonal changes
- separation of muscles (stratification)
During a physiologically normal pregnancy, a woman usually gains weight from 11 to 16 kilograms. This extra weight must be supported by the spine, which can lead to discomfort in the lower back (lower back and sacrum). Also, the weight of the growing baby and the increasing size of the uterus puts pressure on the blood vessels and nerves in the pelvis and back.
When the uterus becomes heavier due to the growth of the fetus, the center of gravity of the pregnant woman changes. This happens gradually: a pregnant woman, unnoticed by herself, begins to correct her posture and the way she moves. This can lead to back pain or excessive strain on the psoas in pregnant women.
During pregnancy, a woman's body produces a hormone called relaxin, which allows the ligaments in the pelvic area to relax and the joints to become more mobile in preparation for the birth process. This same hormone, relaxin, can weaken the ligaments that support the bones of the spine, leading to a weakening of its critical support function, causing spinal instability and pain.
Muscle separation (stratification)
As the uterus enlarges, the two parallel muscles of the anterior abdominal wall (rectus abdominis muscles, which attach from above to the ribs and down to the pubic bone) may be separated along the central tendon suture (white line). This separation of the abdominal muscles during pregnancy can worsen back pain.
Emotional stress can cause muscle tension in the lower back, which will feel like back pain or spasm. As a result of stress, a pregnant woman may experience pain in the lower back (lower back and sacrum) as a result of this muscle spasm.
Treatment for back pain during pregnancy
Back pain in pregnant women stops after a certain time. But if there were these pains in the lower back and sacrum and were chronic even before the onset of pregnancy, then they can significantly increase in the postpartum period. In any case, there are many ways to eliminate or partially alleviate this discomfort during pregnancy in the lower back.
Regular exercise strengthens the back muscles and improves mobility by relieving muscle tension in the lumbar spine that builds up during pregnancy. In those women who exercise three times a week in the second half of pregnancy, the severity of back pain is significantly eliminated. Safe exercises for all pregnant women include:
- exercise bike
Obstetrician-gynecologists, neurologists, and physical therapists who monitor the pregnancy may recommend certain exercises that will strengthen your abdominal and back muscles during pregnancy.
Cold and warm
After consulting a doctor for back pain during pregnancy, cool and warm compresses may be recommended to relieve tension from painful areas of tense muscles and increase local blood flow in them. Start with cold compresses (a bag of ice or frozen vegetables wrapped in a towel), applying them to painful areas for 20 minutes several times a day. After 2-3 days, they switch to warm compresses - apply heating pads or bottles of hot water to the lower back.
Attention! Warm compresses should not be applied to the abdomen during pregnancy.
During pregnancy, correcting a woman's posture while working, sitting or sleeping can help relieve back pain. For example, while sleeping in a supine position, a pillow is placed between the knees, which relieves muscle tension in the lower back. Sitting at the table, place a rolled-up towel between the seat back and lower back. They put a pile of books or a small chair under the feet and sit with their backs straight and their shoulders turned. Wearing a support brace can also help a pregnant woman relieve back pain.
During pregnancy, women should also avoid:
- wearing high heels
- lifting objects off the floor by bending forward (lower back flexion) instead of squatting (knee flexion)
- sleeping on your back with straight legs
If back pain is associated with muscle tension against a background of emotional problems, stress, and anxiety, counseling a psychotherapist can reduce or completely get rid of these unpleasant sensations in the lower back and sacrum.
Reflexology by acupuncture was born in China. By introducing sterile disposable needles into certain areas on the skin, the desired therapeutic effect is achieved. The use of acupuncture for back pain during pregnancy already within several sessions (in combination with other therapeutic methods) gives a good clinical result. The therapeutic effect of acupuncture is associated with the reflex response of the body (relaxation of tense muscles and improvement of local blood flow in them) in response to irritation caused by acupuncture.
Manual therapy (soft muscle technique, osteopathy) is based on certain manipulations of the back muscles. Manual therapy on the muscles of the lower back and joints of the sacrum during the treatment of back pain during pregnancy is performed by a doctor. Correctly conducted manual therapy (muscle technique, osteopathy) to relieve back pain is not contraindicated in women with uncomplicated pregnancies. The possibility of using manual therapy should be checked with the obstetrician-gynecologist observing the pregnant woman.
If back pain during pregnancy is not relieved by the non-drug methods listed above, then it may be necessary to prescribe medications by an obstetrician-gynecologist or neurologist by an observing doctor. Acetaminophen (Tylenol) is safe for most pregnant women. Aspirin and other nonsteroidal anti-inflammatory drugs or drugs (NSAIDs) such as ibuprofen and naproxen are not recommended for back pain in pregnant women. In some cases, your healthcare provider may recommend other pain relievers or back muscles that are safe to use during pregnancy.