Pregnancy Related Pain

Many women experience mechanical pregnancy pains at some stage during the course of their pregnancy.

Your osteopath has a great deal of experience in the treatment of these types of complaints and offer fast, effective solutions to alleviate common symptoms.

Back pain in pregnancy is one of the most common symptoms that pregnant women complain of. Sciatica treatment (for a trapped nerve in the leg), relief for Sacro-iliac joint pain and help with Symphysis Pubis Dysfunction, or PSD (pelvic joint pain at the front), are also commonly treated. Fluid retention causing hand numbness (carpal tunnel syndrome) is another common “side-effect” of pregnancy which can be eased using osteopathy.

Pelvic Pain in Pregnancy

Some women develop pelvic pain in pregnancy. This is sometimes called pregnancy-related pelvic girdle pain (PPGP) or symphysis pubis dysfunction (SPD).

Symptoms of PPGP

PPGP is a collection of uncomfortable symptoms caused by a misalignment or stiffness of your pelvic joints at either the back or front of your pelvis. PPGP is not harmful to your baby, but it can cause severe pain around your pelvic area and make it difficult for you to get around. Different women have different symptoms, and PPGP is worse for some women than others. 

Symptoms can include:

• pain over the pubic bone at the front in the centre

• pain across one or both sides of your lower back

• pain in the area between your vagina and anus (perineum)

Pain can also radiate to your thighs, and some women feel or hear a clicking or grinding in the pelvic area. The pain can be most noticeable when you are:

• walking

• going upstairs

• standing on one leg (for example, when you’re getting dressed or going upstairs)

• turning over in bed.

It can also be difficult to move your legs apart – for example, when you get out of a car.

Occasionally, the symptoms even clear up completely. Most women with PPGP can have a normal vaginal birth.

SPD affects up to one in five pregnant women to some degree. It’s not known exactly why pelvic pain affects some women, but it’s thought to be linked to a number of issues, including previous damage to the pelvis, pelvic joints moving unevenly, and the weight or position of the baby.

Factors that may make a woman more likely to develop PPGP include:

• a history of lower back or pelvic girdle pain

• previous injury to the pelvis – for example, from a fall or accident

• having PPGP in a previous pregnancy

• a hard physical job

Treatment: If you get the right advice and treatment early on, pelvic pain can usually be managed and the symptoms minimised. Treatment by an Osteopath usually involves moving the affected joint, which helps it work normally again.

If you notice pain around your pelvic area, tell your midwife, GP or obstetrician. Ask a member of your maternity team for a referral to an Osteopath or manual physiotherapist who is experienced in treating pelvic joint problems. These problems tend not to get completely better until the baby is born, but treatment from an experienced practitioner can significantly improve the symptoms during pregnancy.

Treatments

Osteopathy aims to relieve or ease pain, improve muscle function and improve your pelvic joint position and stability. This may include:

• manual therapy to make sure the joints of your pelvis, hip and spine move normally

• exercises to strengthen your pelvic floor, stomach, back and hip muscles

• exercises in water

• advice and suggestions, including positions for labour and birth, looking after your baby and positions for sex

• pain relief, such as TENS

• equipment, if necessary, such as crutches or pelvic support belts.

Management:

• Be as active as possible within your pain limits, and avoid activities that make the pain worse.

• Rest when you can.

• Get help with household chores from your partner, family and friends.

• Wear flat, supportive shoes.

• Sit down to get dressed – for example, don’t stand on one leg when putting on jeans.

• Keep your knees together when getting in and out of the car – a plastic bag on the seat can help you swivel.

• Sleep in a comfortable position – for example, on your side with a pillow between your legs.

• Try different ways of turning over in bed – for example, turning over with your knees together and squeezing your buttocks.

• Take the stairs one at a time, or go upstairs backwards or on your bottom.

• If you’re using crutches, have a small backpack to carry things in.

• If you want to have sex, consider different positions, such as kneeling on all fours.

Avoid:

• standing on one leg

• bending and twisting to lift, or carrying a baby on one hip

• crossing your legs

• sitting on the floor, or sitting twisted

• sitting or standing for long periods

• lifting heavy weights, such as shopping bags, wet washing or a toddler

• vacuuming

• pushing heavy objects, such as a supermarket trolley

• carrying anything in only one hand (try using a small backpack)

Back pain in pregnancy

Hormonal changes during pregnancy cause an increase in the level of the hormone Relaxin which has an effect on softening the ligaments (structures which hold joints together). During pregnancy, the ligaments in your body naturally become softer and stretch to prepare you for labour. This can put a strain on the joints of your lower back and pelvis, which can cause backache.

Avoiding backache in pregnancy

There are several things you can do to help prevent backache from happening, and to help you cope with an aching back if it does occur.

The tips listed here can help you to protect your back – try to remember them every day:

• avoid lifting heavy objects

• bend your knees and keep your back straight when lifting or picking up something from the floor

• move your feet when turning round to avoid twisting your spine

• wear flat shoes as these allow your weight to be evenly distributed

• work at a surface high enough to prevent you stooping

• try to balance the weight between two bags when carrying shopping

• sit with your back straight and well supported

• make sure you get enough rest, particularly later in pregnancy

A firm mattress can also help to prevent and relieve backache. If your mattress is too soft, put a piece of hardboard under it to make it firmer. Massage can also help.

Exercises can ease backache in pregnancy

The gentle exercise below helps to strengthen stomach (abdominal) muscles and this can ease backache in pregnancy:

• start in a box position (on all fours) with knees under hips, hands under shoulders, with fingers facing forwards and abdominals lifted to keep your back straight

• pull in your stomach muscles and raise your back up towards the ceiling, curling your trunk and allowing your head to relax gently forward – don't let your elbows lock

• hold for a few seconds then slowly return to the box position

• take care not to hollow your back – it should always return to a straight, neutral position

• do this slowly and rhythmically 10 times, making your muscles work hard and moving your back carefully

• only move your back as far as you can comfortably

The National Institute for Health and Clinical Excellence (NICE) advises that exercising in water, massage therapy, and group or individual back care classes might help to ease back pain in pregnancy.Some local swimming pools provide aquanatal classes (gentle exercise classes in water, especially for pregnant women) with qualified instructors. Ask at your local leisure centre. Being in water will support your increasing weight.

For a more personalised exercise regime that is individually suited to your symptoms, ask your Osteopath. 

Although it may be difficult to avoid mechanical pain during pregnancy entirely, we will help to minimise your discomfort and are available to give you a helping hand throughout these important 40 weeks. Contact us today to arrange a consultation.