Are you pregnant or planning pregnancy?
Follow the tips to prepare yourself to prevent back pain during and after.!
Pregnancy related low back pain is a common problem encountered during second and third trimesters of pregnancy and after the months following delivery. More than half of pregnant ladies experience some back pain during pregnancy or after the delivery. Some of them may start having back pain in the first few months or even few years following the delivery.
There are various reasons for the development of back pain during pregnancy.
- There is additional load on the spine due to the weight of the growing foetus. A forward shift in the centre of gravity puts additional strain on the lumbar spine.
- The pelvic and spinal ligaments stretch and joints loosen due to hormonal changes, making space to accommodate the bigger uterus.
- The abdominal muscles are stretched out, making them weaker and unable to afford adequate support to the spine.
- The stretched out pelvic ligaments and muscles take some time to return to normal tone.
- Lack of adequate exercises in the initial few months, usually due to lack of time, as the mother has to spend a lot of time taking care of the newborn baby.
- Wrong sitting posture, especially while nursing the baby puts additional strain on the lower and upper back muscles.
- Carrying the baby around, sometimes on one side of the waist, bending and lifting in wrong way.
Mental stress associated with pregnancy and labour and the stressful post-delivery period can make the symptoms worse.
All the above factors in various combinations contribute to the back pain related to pregnancy. Although most of them are able to tolerate the pain, it can be severe in some and may need a consultation with your doctor for further investigation to rule out other causes.
Ladies with a history of back pain prior to pregnancy are at a higher risk of significant worsening of back pain during pregnancy. Pain radiating down the legs is an indicator of a possible disc prolapse with nerve root compression, although it is rare in pregnancy. Sometimes the back pain can be a sign of preterm labour, especially if the pain is rhythmic and cramp like.
Here are some essential tips that will help you prevent troublesome back pain due to pregnancy:
- Core strengthening exercises prior to pregnancy and in first trimester strengthen your pelvic floor muscles, abdominal muscles and spinal muscles and help in minimizing the chances of back pain related to pregnancy. Some of the exercises can be continued during second trimester as well. Learn the exercises with the help of a physiotherapist and be regular in continuing them at home, at least once or better twice a day.
- Posture training. Maintaining good posture during the daily routine activities helps in minimizing the strain on the spine and spinal muscles. Learn about the right posture of sitting or standing, the right way to bend and pick up things from a low height or from the floor, the right way of getting into or out of bed. A physiotherapist or your doctor can be of help in training these simple posture precautions.
- Nutritious diet and additional supplementation of calcium and vitamin D are essential during pregnancy and as long as the mother is breast feeding the baby. Most of the calcium comes from the diet, but as the body needs more calcium due to the high demands from the growing foetus as well as for lactation, additional supplements in form of tablets are recommended to meet the daily recommended allowances. Vitamin D is essential to ensure adequate absorption and utilization of the calcium that is taken.
- Rest, ice packs, heat pads local pain gels can be used to alleviate the usual back pain. Pain medications are to be used only if necessary and in consultation with the concerned physician only. Severe pain; sudden onset pain; pain radiating down the legs, associated with tingling or numbness on the legs; pain not getting better with rest and local measures are the situations where a consultation with a spine physician might be necessary.
- After delivery, emphasis should be on improving the abdominal and pelvic muscle strength by specific exercises, which must be continued for at least six months to a year. Posture related advise is essential to the new mothers in order to avoid back strain while nursing and taking care of the newborn baby. Nutritious diet and additional supplementation of calcium and vitamin D are essential as long as the mother is breast feeding the baby.
It is common to blame the spinal or epidural injection given for anaesthesia during labour or Caesarean section for the back pain that develops soon after the delivery or even years later. While it may sometimes be the cause for some back pain or head ache in the initial few days after the injection, it is not the reason for back pain that persists more than few days or starts long after the delivery. The real reason is what we just discussed above. So do not blame the needle that helped you go through the painful process and work on improving your posture and core strength instead!.
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