Unfortunately, low back pain or sciatica is a fairly common complaint during pregnancy, with between 50% and 80% of women suffering from this complaint. However, although this problem can be difficult to treat, it should never be accepted as being ‘a part of pregnancy’. There are definitely measures which can be taken to try and resolve this problem.
In order to treat those suffering with low back pain or sciatica during pregnancy, we need to address the change in curvature of the spine and also any muscle imbalance present. This article will look at how to treat the pain you may be currently suffering with.
The aim of the following exercises are two fold:
1) “Reverse the Curve” When pregnant, the tendency is for your back to arch forward and increase the forward curve of your lower back. This places increased stresses across the surfaces of the facet joints. The exercise below will encourage your lower back & pelvis to move in the opposite direction. This will take the pressure away from the sensitive structures and encourage the pain to settle.
2) Strengthening. In order to ‘Reverse the Curve’, you will need to work your abdominal muscles. This will therefore help strengthen them. Increasing the stability of your abdominal muscles will help to prevent your back from over arching, therefore helping to take pressure from the facet joints as mentioned above.
3) Stretching. Once again, by moving your lower back & pelvis in order to ‘Reverse the Curve’ the structures in the lower back which will be tightening due to the increased arch, will now be stretched out. This will further decrease the stresses being placed across the sensitive structures in you lower back.
Exercise One: Posterior Pelvic Tilt
A good exercise for this is to lie on your back on the floor with your knees bent. The aim is then to flatten your back into the floor with a ‘back & downwards’ rotation of your pelvis.
If you find this difficult, you can try using your heels and bottom muscles to help out. As you attempt to flatten your lower back into the floor gently tighten your buttock/gluteal muscles while very gently pushing through your heels.
Exercise Two: Four Point Kneeling Stretch
Placing yourself on all fours, with your knees approximately under your hips and hands below your shoulders, gently arch your back up towards the ceiling. Having done this, gently lean backwards as if to sit on your heels. While doing this, you may feel a stretch in your lower back area, further up your back towards your shoulders or down towards your buttocks and even upper leg. As long as it is only a stretch you are feeling and not pain, this is no problem.
NB None of the exercises given above should aggravate your pain. If they do, either ease off a little or temporarily stop doing them altogether until your pain settles a little more.
As I alluded to above, the main problem with Low Back Pain and Sciatica during pregnancy is typically the increased arch in the lower back. Therefore, other advice which may help is as follows.
Abdominals: Little and often while walking gently tighten your stomach muscles for a few seconds (5-10) and then relax. The abdominal muscles are a vitally important muscle group when it comes to providing stability for the lower back. Therefore if you can tighten them little and often, it can help to prevent the forward tilting of your pelvis.
Footwear: Not that I can imagine many pregnant ladies walking around in high heels, but nevertheless, as a rule of thumb the smaller the heel the better. This is because a high heel will tend to lean you forward, which in turn is compensated for by leaning backwards from the lower back. This movement places increased pressure upon the facet joints which are a potential sauce of your pain.
Sleeping Position: You may well find that sleeping becomes difficult when pregnant, especially towards the last trimester when you are becoming significantly larger. It is likely that the best position for you to sleep in is side lying, with either a pillow between your knees, or the position I feel is better, your bottom leg straight and top leg supported by pillows.
NB As always be guided by what you body tells you. Although this may sound a little flippant, the best position for you to sleep in is the one which gives you the best nights sleep and where you wake feeling most comfortable in the morning.
Support Belt: My personal experience given by feedback from patients is that these are a bit ‘hit & miss’. The aim is to support both the back and your ‘baby bump’ therefore taking pressure from your lower back. They have worked well for some and yet others have gained no benefit.
For further information and diagrams on the two exercises given above and the recommended sleeping position, use the link http://www.spinal-health-care.com/index.php?page=pregnancy
Paul Boxcer – Bsc (Hons) Physiotherapist, has over 14 years experience of treating people with low back pain & sciatica. With careful analysis of this experience, Paul has developed his unique Personalised Treatment Approach to treating both of these painful conditions. Visit his website at http://spinal-health-care.com to find out more about Paul’s unique approach to treating both sciatica and low back pain.
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