Back pain is one of the most common complaints among pregnant women and has a potentially negative impact on their lives. Around 50 percent of women at some point in their pregnancy, either early or late, or in the postpartum period may encounter pain. Most women feel it is normal discomfort and an inevitable part of pregnancy, but it unknowingly affects them physically and mentally. It is one of the most neglected issues.
Low back pain (LBP) in pregnancy have been reviewed extensively, However, there is still much ambiguity with regard to the definition of LBP in pregnancy, identifying appropriate investigations, considering safe treatment options, and decision-making regarding the use of neuraxial analgesia and anaesthesia during labour and deliver.
Low back pain during pregnancy is one of the most common reasons for women taking leave from their work or their daily routine. Also, this leads to increased chances of Cesarean sections. Pain can be either hormonal, stress-induced, mechanical, or because of associated pathological disorders like underlying disk herniation. Mechanical means can be due to weight gain in pregnancy, and shifting of the central cavity, which is what increases the tendency for ladies to lean backward.
The abdominal muscle in a pregnant lady stretches a lot to accommodate the growing uterus. All this causes muscle fatigue and puts an extra load on the spine, which pressurizes the back. Relaxin, an important hormone that is released 10 times more during pregnancy, causes laxity and discomfort not only in the joints, but the entire back.
Back pain can either be on the pelvic region anteriorly, or the whole pelvic girdle which includes the lumbar region, which is the lower back posterior and also the lateral side. The pain can be unilateral, bilateral and can be radiating down to the thighs or calf. The anterior pelvic pain is more common as compared to posterior. The type of pain and origin of same can be differentiated by performing examinations on the woman.
Sciatica, a common condition is a rare entity in pregnancy and occurs only in 1% of females. So, early identification and treatment give a better outcome to the mother. The risk factors for such backache include the history of lower back pain during the previous pregnancy, history of previous trauma, history of pain during menses, and hyper-mobility of joints.
It needs to be understood that spinal anesthesia or epidural anesthesia doesn’t increase the risk of chronic or acute back pain. Prevention is important to reduce the incidence of back pain cases so few tips to avoid back pain during pregnancy.
* Use a good chair that supports the back.
* Prolonged sitting and lying down is not recommended, and there should be constant movement of limbs after every 25 minutes.
* Women should practice yoga, aerobics, and physiotherapy exercises. Exercises like kegels, pelvic tilt, cat stretches, back stretches and breathing exercises should be learned and done.
* Learn to do lightweight lifting without stressing the back.
* Have a backrest on your bed, know about the proper technique of getting in and out from the bed to maintain the proper position of the spine.
* Morning walk or swimming
* Good back support while sitting
* Resting in the afternoon
For managing pain around the pelvic region, minimize activities like climbing and running that increase the pain, support legs while lying by using a pillow under the feet, and avoid too much bending of the hips and spine. Use belts after consulting a doctor to manage lumbar or pelvic pain. In case of acute back pain, just completely rest and do not exercise at all.
* When talking about the posture, stand straight, so that the lower tummy muscles are tightened.
* The weight has to be equally distributed on both feet. Avoid leaning on one side, avoid using big cushions while sitting that can cause arching of the back, and do not slouch or cross your legs.
* Avoid heels and buy larger shoes with low heels. Do not buy totally flat shoes.
* Avoid sudden movements.
* Avoid lifting heavy weights or moving furniture. Do not bend forward from the hips.
* Try to follow proper sleeping positions during pregnancy. Either sleep on one side with a pillow between the legs and a pillow behind the back.
* Lying down straight is not recommended in pregnancy.
* Massage, stretching, hot water compression, and acupuncture can also be helpful in reducing the pain.
* The right amount of weight gain under the expert’s guidance will prevent lower backache during pregnancy.
* Do take the medication prescribed by the gynaecologist.
* If severe, it should be shown to a physiotherapist and orthopedic.
Given the high incidence of low back pain during pregnancy, larger studies are needed, in order to test prevention and treatment options in broader populations and contribute to improving woman’s health.