It is believed that about half of all pregnant women will experience back pain, usually in the final trimester, which can last several months post partum. Any woman who has experienced pregnancy can talk at length about pains she’s experienced during a pregnancy. These pains can affect daily activities and one’s ability to work. Pains due to a change in muscle use and posture can be experienced in the lower back, pelvis, or pubic region, but a lot of these pains can be alleviated with a special brace designed for the pregnant woman. Stretches and mobilizations can be used by your physical therapist to help alleviate pain, exercises and the use of heat or ice may also help the pains associated with the changes in posture due to pregnancy.
Back pain during pregnancy usually develops because of a the physiologic and biomechanical changes that occur during pregnancy. As abdominal muscles are stretched they become ineffective in maintaining a neutral posture. Because of the change in posture, the ligaments and supporting muscles become weak, and the spine loses stability. Just as pain would develop if you were to hold your finger back as far as it would go for a prolonged period of time, so would straining the ligaments in your spine for a prolonged period. This instability is aggravated by a loosening of the ligaments by the hormone relaxin during the last trimester. Relaxin is the hormone secreted to create joint laxity in the sacroiliac joints and symphysis pubis to accommodate the fetus.
Some modalities that would normally be available to a non pregnant person are not advisable on a pregnant individual such as electrotherapeutics. Joint manipulations (or adjustments) and whirlpool are contraindicated. While no evidence exists to show that the fetus would be harmed, it is simply not worth risking. Safer ways of treating back pain during pregnancy are as follows:
- Heating pad or hot water bottle
- Massage by a registered massage therapist
- A supportive belt or brace has been shown to reduce pain while walking
- Pain medication as recommended by your physician
- Specific postural exercises as prescribed by your physical therapist
You can avoid back pain and help prevent back pain from worsening by taking the following precautions:
- Wear low heeled supportive shoes. High heels can accentuate the curvature in your lower back and therefore worsen shearing forces on the lower back and sacrum.
- If lifting, keep your chest up, tighten your abdominal muscles and lift with your legs
- Sleep with a pillow between your knees in side lying or, if you can sleep on your back, put a pillow under your knees
- Sit with a supportive chair, or use a small cushion or rolled towel for extra lumbar support. Elevating one foot while sitting will relieve pain by relaxing the iliopsoas muscles and reducing the curvature in your lower back.
- If carrying anything, keep it close to your pelvis (your center of gravity) and keep your chest up
For more information on guidelines for exercise during pregnancy, use of the birth ball, and post partum exercises go to the following website: http://www.exercise-ball-exercises.com and follow the links on the left.
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