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[HEALTHTRACK]

Expecting Back Pain?

HEALTHTRACK - JUL/AUG 97
A SUPPLEMENT TO THE PHYSICIAN AND SPORTSMEDICINE FOR THE WAITING ROOM


Pregnancy, especially the later stages, is fertile ground for back pain. Your center of gravity shifts because your uterus expands. And hormonal changes temporarily loosen important support structures—ligaments and tendons leaving you with back and pelvis muscles that seem to groan under the stress of increased weight.

Up to 50% of pregnant women will experience back pain, which usually starts during the third trimester and can last up to 6 months after delivery. There are three types of pregnancy-related back pain, which is largely unavoidable. Some women experience a combination of the three:

Lumbar pain
Where? At the low back; pain may radiate to the legs.
When? As pregnancy progresses.
Why? Posture changes associated with expanding uterus; overburdened spinal muscles; hormones loosen joints and ligaments, which can cause pain.

Sacroiliac pain
Where? In the back of your pelvis and deep in your buttocks; pain may radiate to the back of the thighs.
When? As pregnancy progresses, sometimes after pregnancy.
Why? Hormonal changes soften ligaments, allowing joints in the pelvis area to stretch in preparation for labor.

Night pain
Where? In the low back.
When? At night when lying down.
Why? The reason isn't known for sure, but it probably has to do with daylong stress.

Your doctor can advise you about minimizing discomfort. The following tips may help:

  • Focus on posture: Try to keep your spine in a neutral position—neither swaybacked nor flat.
  • Wear flat or low-heeled shoes to reduce stress on your spine.
  • Take breaks if you must stand for long periods.
  • Place one foot on a low stool if you stand or sit for long periods; it reduces back and pelvis stress.
  • At night, lie on your side with pillows supporting your uterus and between your thighs.

If back pain interrupts your sleep or daily activities, you should talk to your doctor. Ice, heat, massage therapy, and physical therapy visits are treatments he or she may consider. But check with your doctor before treating your own symptoms—it's risky to take certain drugs, sit in a whirlpool, or undergo certain joint manipulation when you're pregnant. Many doctors prescribe strengthening and flexibility exercises to reduce back pain. Try the ones in figures 1 through 3 (not shown) for starters. When done correctly, they're easy to perform at home and should not be painful. If exercise and preventive measures aren't effective, your doctor may advise other options such as pool exercises or a supervised exercise program.


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