Backache in Pregnancy: A Guide by Dr. Anu Vij

Backache in Pregnancy

Back pain is a common complaint during pregnancy, affecting more than half of all women. It is most commonly seen at the sacro-iliac joint ie where the spine meets the hip joint.

About 10 percent of the time the pain becomes so severe that it can interfere with the ability to work or carry out normal activities during pregnancy.

Studies show that lower back pain usually occurs between the fifth and seventh months of being pregnant, although in some cases it begins as early as eight to 12 weeks.

Women with pre-existing lower back problems are at higher risk for back pain, and their back pain can occur earlier in their pregnancy.

It's usually caused by physical changes, such as:

• • Hormones: During pregnancy, your body makes a hormone called relaxin that allows ligaments in the pelvic area to relax and the joints to become looser in preparation for the birth process. The same hormone can cause ligaments that support the spine to loosen, leading to instability and pain.
• • Changes in posture: Pregnancy shifts your centre of gravity due to the increased lumbar curvature. As a result, you may gradually -- even without noticing -- begin to adjust your posture and the way you move. This may result in back pain or strain.
• • Stress:Emotional stress can cause muscle tension in the back, which may be felt as back pain or back spasms. You may find that you experience an increase in back pain during stressful periods of your pregnancy.
• • Weight gain : During a healthy pregnancy, women typically gain between 9-11 kgs. The spine has to support that weight. That can cause lower back pain. The weight of the growing baby and uterus also puts pressure on the blood vessels and nerves in the pelvis and back.
• • Muscle separation: As the uterus expands, two parallel sheets of muscles (the rectus abdominis muscles), which run from the rib cage to the pubic bone, may separate along the centre seam. This separation may worsen back pain.

Treatment for Back Pain in Pregnancy

If you have a chronic pre-existing backache ie. presentbefore you got pregnant, your pain will likely ease gradually before you give birth.

Some measures to ease backache :

• • Improve your posture: This forms the mainstay of the measures. Slouching strains your spine. So using proper posture when working, sitting, or sleeping is a good move. For example, sleeping on your side with a pillow between the knees will take stress off your back. When sitting at a desk, place a rolled-up towel behind your back for support; rest your feet on a stack of books or stool and sit up straight, with your shoulders back. When standing, pull your hips forward and your shoulders back. You may tend to lean back to compensate for your growing belly. Wearing a support belt may also help.
• • Stretch regularly: The "backward stretch," the "low back stretch," and the "standing pelvic tilt." These will strengthen your back and pelvic muscles.Avoid lifting heavy loads.Wear the right shoes. Extremely high heels are out, as are completely flat ones. Experts recommend a 2-inch heel to keep your body in proper alignment.
• • Exercise: Regular exercise strengthens muscles and boosts flexibility. That can ease the stress on your spine. Safe exercises pregnancy include walking, swimming, and stationary cycling. Start exercise under guidance and supervision first ; once you are confident , then do on your own.Take breaks. Walk or stand and stretch at least once an hour. Sitting too long can make your back hurt even more. Try not to stand too long either. If you work on your feet, try to place one foot on a low stool to take some pressure off your lower back.
• • Heat and cold : Applying heat and cold to your back may help. Put cold compresses (such as a bag of ice) on the painful area for up to 20 minutes several times a day. After two or three days, switch to heat -- put a heating pad or hot water bottle on the painful area.
• • Medication: Local analgesic creams , sprays, massages may help. In severe cases you can take Tab Dolo650

When to be alarmed:

Sometimes back pain is a red flag that something serious is going on. Among the most worrisome causes of pregnancy back pain is preterm labour. Women should watch for pain that is new and cyclical — which could be a sign of uterine contractions — along with vaginal bleeding or any change in vaginal discharge that could indicate a placental issue or an early rupture of your waters.

If you experience numbness, tingling or a sharp, shooting pain in your buttocks, legs or feet, call your doctor to make sure there are no serious conditions. It could signify compression of the sciatic nerve or other nerves that connect your spine to the lower body and pelvic area.