Low Back Pain and Pregnancy
Understanding Back Pain during Pregnancy
Every pregnant woman does not experience low back and associated pains, but many do for a variety of reasons. Each phase or stage of pregnancy has its own contributing factors, which predispose women to aches and pains associated with pregnancy. Encouraging news, right?
Common symptoms include: low back pain, hip pain, leg pain, numbness of the groin, hip, and or leg, as well as weakness and instability of the lower extremities. Hopefully understanding the causes of these conditions will help pregnant women and the people who care about them, treat and possibly prevent a variety of these symptoms.
The Nervous System is the master system in the body which processes and regulates all body functions by sending messages from the brain, into the spinal cord, into the peripheral nerves, to all of the different parts of the body, and then back to the brain via the same pathway. This is how the brain controls the entire body and every function it performs. There are a variety of causes which alter this communication loop, and the symptoms listed previously are as a result of this break in the nervous system function.
A predominant factor in low back pain and associated symptoms in the pregnant women is as a result of a misalignment in the low back vertebra, sacrum, and or pelvis, or any combination of those. These problems often are asymptomatic until complicated by a variety of factors associated with pregnancy.
Hormonal fluctuations throughout the pregnancy are blamed for most pregnancy symptoms and low back and related aches and pains are no exception. Early in the pregnancy the increased hormonal levels lead to increased inflammation and sensitivity within the joints, as well as a variety of other locations. Additionally, complicating joint pain occurs because the ribs as well as pelvis begin to expand and shift prior to significant size requirement from the growing baby. These changes begin early in the second trimester.
Posture changes can begin as early as the first trimester. Adding to the changing ribs and pelvis are a quickly growing chest. These alterations in posture will change the body's center of gravity as well as how the joints each move and function. On occasion these changes do not occur fluidly and joints become locked, muscles change how they contract, and a variety of nerves are stretched beyond their pre-pregnancy limits, all leading to potentially significant pain sources.
Obviously a rapidly growing uterus and developing baby inside of it will cause significant strain to the low back and pelvic region. The normal lumbar (low back) curvature is pulled to a more significant degree, and this can irritate the lumbar and sacral (tail bone) nerves. The pelvis which was already widening in the first trimester then is pulled foreword in a flexed position. Complicating an already strained situation is the addition of the hormone Relaxin which increases around the seventh month to assist in further pelvic expansion and flexibility during delivery.
Although all of these processes are a completely normal aspect of pregnancy and need to happen for normal growth and development of the baby, any one of them can lead to low back pain, hip pain, leg pain, numbness of the groin, hip, and or leg, as well as weakness and instability of the lower extremity. Just because the symptomatology is common and explainable by normal effects due to pregnancy, the woman does not "simply have to live with it". As with most symptoms often experienced in pregnancy, it is always recommended that the medical doctor is aware of the symptom and evaluates her to see if there is a medical problem which should first be addressed. When the medical doctor clears any potentially serious conditions, there are several options to provide relief and or treat the problem.
Some of the effects of the hormonal fluctuations and resulting inflammation can be possibly be decreased with increasing the amount of good, clean drinking water the woman consumes on a daily basis. Water is necessary for the body to cleanse itself. Sipping small or moderate amounts of water frequently throughout the day is better for the body, then consuming large amounts at less frequent intervals. An additional therapeutic and non-invasive way to assist in decreasing inflammation and pain associated with it is to apply ice to the area of inflammation. Due to the increased blood flow as a result of pregnancy, ice should be applied to the inflamed joint for only ten minutes, then take the ice away for 20 minutes and then resume with ten minutes of ice application. Any joint can receive ice, with two exceptions. No one should apply ice to the groin or underarm, unless under specific medical observation and care. These areas have superficial blood and lymph circulation and applying ice could cause a sudden drop in body temperature.
As mentioned above, many of the "normal" changes due to pregnancy will aggravate a pre-existing condition in the spine and pelvis. Often these are musculoskeletal problems which can be very safely and effectively treated by a chiropractor. Frequently questions arise relating to the safety of chiropractic for the woman as well as the baby. As a result of this real concern, specific treatment protocols are followed with safety as the paramount issue. Additionally, many chiropractic tables have a piece which drops away as the woman is laying face-down, which accommodates a growing belly in a very comfortable manner, while she is having her treatment. Chiropractors assess and treat patients in a way which looks at the patient as a whole being and does not only evaluate the area of complaint. Pregnancy affects every aspect of a woman's health. Anyone who has been pregnant, or has lived with a pregnant woman will affirm that. Evaluating and treating the health of the entire person is an overriding concept with chiropractic, and this is accomplished by specifically evaluating the Nervous System and seeing how it is functioning and how the body is working as a whole.
