Back pain in pregnancy

introduction

Back pain during pregnancy is very common. The main cause is primarily the weight that pulls the mother's stomach down due to the weight of the growing child. In order to ensure an upright gait, the mother's back muscles must counteract this accordingly.
Since the muscles of the back are often not prepared and trained for this increasing weight, it can happen that the spine cannot be held upright and goes into poor posture.

causes

Back pain during pregnancy occurs in 50 to 75% of women. Here it is important to differentiate between the different triggers of back pain in order to be able to treat them appropriately.
On the one hand, there is real back pain that is actually caused by pregnancy. During this time, a pregnant woman carries significantly more weight with her, which is an additional burden on the body. This weight is mainly concentrated on the front part of the body, i.e. mainly on the stomach, and later on the chest.
As a result, these women tend to go into the hollow back, which is a bad posture of the back, which then leads to tension and ultimately back pain.
To make matters worse, the pregnancy hormones released have a negative effect on the back. They actually have the task of preparing the female body for childbirth, which is why they ensure that the birth canal and the pelvis can widen considerably during the birth.
However, ligaments and tissue loosen not only in this area, but also on the spine and thus the strength of the joints decreases. Ligaments become loose and tend to overstretch: So the hold by the spine decreases. Nerves can also be constricted by the space that the child now occupies in the stomach. For this reason it is especially (but not only) in pregnant women often to what is known as sciatica pain, which can be noticeable as numbness and / or weakness. The pain often radiates to the legs.

Please also read: Exercises for sciatic pain during pregnancy

Pain from degenerative changes and a herniated disc

In extreme cases, the incorrect posture in the spine caused by the growing abdomen can lead to increasing degenerative changes in the spine.
It is true that the pregnancy is rather too short to bring about long-lasting, degenerative changes, but apart from bone wear, herniated discs can also occur, which then lead to corresponding pain in the back. In this case, the expectant mother should increasingly take care of herself in order to take the load off her spine.
A herniated disc during pregnancy is almost always localized in the lumbar spine. As the pregnancy progresses, pregnant women develop a hollow back, which increases the risk of a herniated disc and thus back pain.

Read more on this topic at: Disc herniation during pregnancy, exercises for a herniated disc during pregnancy

Pain from myogelosis

Back pain is much more common during pregnancy caused by so-called myogelosis. This is understood to mean muscle tension that can be so tight and strong that it presses on a nerve and can lead to pain in the back. Most of the time, this muscle tension is triggered by the incorrect posture of the spine. The muscles that run along the sides of the spine try to keep the spine in an upright position. If the muscles are not trained appropriately, the result is tension and the perceived back pain.

Back pain in pregnant women at night

Many women experience back pain during pregnancy, especially at night. Pregnant women who sleep on their backs are most commonly affected. The growing child presses on the spine while lying down and this can trigger the pain.
If necessary, you can remedy this by lying on your side and, for example, tucking a nursing pillow in your back so that you don't turn back while sleeping. Women who do not sleep on their back anyway and still suffer from back pain at night during pregnancy can try to place a nursing pillow between their legs and under the stomach. This can relieve the pressure on the back.
If these measures do not lead to sufficient alleviation of the nighttime discomfort, it should also be considered whether the purchase of a new mattress could lead to an improvement. In the case of very severe, recurring or steadily increasing back pain at night, the pregnant woman should also consult the general practitioner or gynecologist as soon as possible in order to rule out another cause of the symptoms.

therapy

There are various ways to prevent back pain during pregnancy or at least to reduce the pain once it has occurred. Above all, this includes relaxation exercises, back exercises and strengthening the relevant muscle groups. Particularly recommended here is water aerobics (see also: Water aerobics during pregnancy), as the back is relieved on the one hand, but the spine has to be active on the other. In addition, the back should be spared as much as possible, unnecessary strain should be avoided and you should try to maintain correct posture despite the increased weight. Special maternity bras can also help to relieve the back of the weight of the front of the body and prevent back pain.
Of course, you should never forget that there can be causes of back pain in pregnant women that have nothing to do with pregnancy, such as herniated discs, inflammation or bone changes. As a result, if left untreated, this pain (unlike the others) will persist after pregnancy.

In the vast majority of cases, the harmless back pain that often occurs during pregnancy disappears very quickly, at the latest when the child is born. Since the downward pulling weight is missing after the birth, the spine can straighten up again at any time and the spinal muscles relax. In this case, no treatment needs to be initiated.
However, if the pain is very severe during pregnancy, physiotherapy treatment can be useful. Above all, the back muscles are specifically trained and strengthened so that they can counter the weight that is pulling forward. The treatment is rather long-term, but a corresponding success should be achieved after a few weeks.
If the pain is so severe and you need immediate help, you can use a pain reliever approved for pregnancy (pain reliever in pregnancy) In the vast majority of cases, paracetamol is used in a dosage of 500 mg 3 times a day and is sufficient. Anti-inflammatory preparations such as ibuprofen or diclofenac should be avoided during pregnancy.
The application of heat can also be helpful. It makes sense to apply a cherry stone pillow or hot water bottle to the affected area of ​​the back. The heat leads to improved blood flow to the muscles, which then relax and reduce pain.

In some cases the downward pulling weight causes such bad posture in the spine that an acute herniated disc results. The patient usually complains of sensory disturbances in the skin and numbness in the upper or lower extremities. Imaging is required despite the pregnancy. As a rule, however, X-rays of the spine are avoided because, on the one hand, it is not suitable for diagnosing herniated discs and, on the other, because X-rays are harmful to the unborn child. At most, one would perform magnetic resonance imaging.
If a herniated disc can be secured, it remains to be considered whether an operation is necessary and when it will be performed. As a rule, one tries to wait until after the birth with an operation. However, if the herniated disc is so severe that permanent neurological damage to the mother is to be feared, immediate surgery should be considered.

More information and exercises can be found at: Physiotherapy for back pain during pregnancy, exercises for back pain during pregnancy

Exercises for back pain during pregnancy

The most effective way to prevent or relieve back pain during pregnancy is to exercise regularly and appropriately for the circumstances. In addition to walking, swimming or cycling, specific exercises can also be carried out to strengthen muscles, joints and ligaments. Anyone who had already exercised regularly before their pregnancy should keep up the activities, but avoid overloading them.
Special exercises are best learned as part of pregnancy gymnastics. It can also be useful to train for correct posture under the guidance of a physiotherapist during pregnancy.
Very suitable exercises during pregnancy, with which back pain can be combated, can also be found in yoga. An example of a suitable yoga exercise is the "dancing cat". To do this, the pregnant woman stands on four feet with legs hip-width apart and hands shoulder-width apart. Now let the pelvis gently circle, whereby the rest of the spine and the head move with it. Then the right foot is placed forward to the hands and the pelvis is circled again. Finally, the exercise is repeated with the left leg forward.

Read more on this topic: Back exercises during pregnancy, exercises for sciatic pain during pregnancy

massage

If you have back pain during pregnancy, gentle massages can have a relaxing and relieving effect. It is important that the massage is also perceived as pleasant. The person performing the massage should make sure that the connective tissue becomes looser during pregnancy and should therefore be massaged with less pressure than usual.
In the case of frequent and recurring back pain, passive measures such as massages alone are usually not sufficient to alleviate the symptoms. In addition, active movement exercises, for example in the form of pregnancy exercises or swimming, should be carried out.

Heat application

In the case of muscular tension, which is common in back pain during pregnancy, the application of heat can often provide good relief from the symptoms. For example, a hot water bottle, a spelled or cherry stone pillow and hot potato wraps are suitable.
Irradiating the affected area with a red light lamp, which can be carried out several times a day for about ten minutes, is also very effective.A relaxation bath can also help loosen up the muscles and thus reduce back pain during pregnancy. The effect can even be enhanced with a muscle-loosening bath additive such as pine or St. John's wort.
Care should be taken when using heat. if the character of the pain is rather dull and throbbing, as the cause of the pain can also be inflammation, where heat can have a negative effect. In the event of corresponding symptoms, the gynecologist or family doctor should be consulted promptly.

Application of ointments

In the case of back pain, you can try to get relief by applying a pain relieving ointment to the affected area. Massaging in the ointment also helps loosen up tense muscles. Herbal ingredients such as arnica are particularly suitable.
The use of many other ointments during pregnancy has often not been tested and should therefore not be given if the information in the package leaflet is appropriate.

Taping

The affected muscles can be taped as a supportive measure to alleviate back pain during pregnancy. For this purpose, special elastic bands are stuck to the back along the course of the muscles and left there for a few days. This is intended to encourage relaxation of the muscles so that the pain subsides. The taping should be carried out by a person who is trained in its correct use. If laypeople, who do not have a reliable knowledge of the anatomy of the muscle courses and how the tapes work, stick the tapes on, usually no effect can be expected. If necessary, the symptoms are even aggravated. In addition, taping should never be the sole measure used to treat back pain during pregnancy.
In addition to the application of heat, regular physical activity that is adapted to the circumstances is important in order to address the causes of the symptoms caused by tense muscles. Taping can increase the positive effect of movement. Without physical activity, however, the tapes are unlikely to have any effect.

When to see a doctor

Back pain is common during pregnancy and is usually harmless. Very rarely is it a warning sign of an impending miscarriage or other threat to mother or child.
You should see a doctor if the symptoms are very severe, occurred suddenly or if you feel different from previous back pain. Circulatory weakness, fever or malaise that manifests itself in other ways should also be clarified by a doctor. If the expectant mother is troubled by the pain, this alone justifies a consultation with the doctor during pregnancy. In most cases, this can rule out the presence of a threat, reassure the pregnant woman and, if necessary, give advice on relieving back pain.

Symptoms

Classic are after above or after below pulling pains along the spine. Sometimes this pain also extends into the buttock.
Read about this: Pain in the buttock during pregnancy

Are these myogeloses? small, rough nodules palpable along the spine and under pressure sensitive to pain. To neurological failures it does not usually occur here. Lying patients can usually achieve a reduction in pain. Is it a degenerative change or is it? Herniated discs, neurological failures can certainly occur. These can be found in Numbness in the arms or legs as well tingle manifest in the area of ​​the skin. In this case, a doctor should be consulted immediately, as immediate treatment may be necessary.

Can back pain be a sign of pregnancy?

There are a variety of possible signs of pregnancy, some more common than others. In general, back pain is a very common symptom with many different causes. Pregnancy is also often the trigger for back pain, although this typically does not occur at the beginning but only after a few weeks or months, when the growing uterus presses on the tailbone. The first and most obvious sign of pregnancy is missing your period if your cycle is otherwise regular.
Other common signs include nausea, breast tenderness, and craving for food. However, in women of childbearing potential it is possible that the first consciously perceived signs of pregnancy may be back pain.

Appointment with a back specialist?

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Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

The spine is difficult to treat. On the one hand it is exposed to high mechanical loads, on the other hand it has great mobility.

The treatment of the spine (e.g. herniated disc, facet syndrome, foramen stenosis, etc.) therefore requires a lot of experience.
I focus on a wide variety of diseases of the spine.
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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