BACK PAIN DURING PREGNANCY

Condition

More than half of all expectant mothers experience back pain, usually between the fifth and seventh month of pregnancy. It may hurt from the waist down to the buttocks and sometimes into the buttocks. It may also extend around to the front in the groin and pubic area. The pain may interfere with normal everyday activities, work, school and sexual relations.

Causes

Back pain during pregnancy, while not entirely understood, is believed related to a number of factors. There are several theories that may help explain why it occurs:

There is a hormone, relaxin, produced during pregnancy that loosens the ligaments and muscles around the spine and pubic area to prepare for delivery. This may affect back support, resulting in pain and increased susceptibility to injury.
The growing baby and enlarging uterus puts pressure on the major blood vessels and nerves in the pelvis and back, causing the back pain.
As the baby grows and gets heavier, it changes your center of gravity and pushes stomach muscles forward, creating poor posture and forcing your back muscles to work harder to hold the baby in place.

Tests to diagnose the cause of back pain are limited when you are pregnant. X-rays should not be taken in the first trimester and only if absolutely necessary during the remainder of the pregnancy. Magnetic resonance imaging (MRI) does not give off radiation and is therefore considered safe during pregnancy, but also is ordered only if absolutely necessary because there are no long-term studies regarding possible effects on the unborn baby.

Risk Factors

You may be more prone to back pain during pregnancy if:

You are having more than one baby.
You have had back problems in the past.
You are stressed, you become tense and muscles stiffen.
You smoke and get back pain from chronic cough or from muscle spasms caused by the nicotine.
You have a job that involves heavy or prolonged physical demands.
You have a new back injury or a recurrence from an old one.
You have a family history of conditions that can cause back pain such as osteoporosis or herniated discs.
You are subject to psychological factors such as depression, anxiety or distress that have been shown to contribute to back pain.

WHEN TO CALL YOUR DOCTOR FOR BACK PAIN DURING PREGNANCY

Call 911 Now (you may need an ambulance) If

The pain goes down your leg and you cannot walk.
The pain is severe and you pass out.
You lose control of bladder or bowel function.

Call Your Doctor Right Away (night or day) If

The pain is in your lower back and traveling down your leg into your foot. You may have a slipped disc putting pressure on the nerves in your back.
You have back pain with a fever and a rash with blisters. You may have shingles on your back.
The pain is on one side of your back with or without blood in your urine or a burning sensation when you urinate. You may have a kidney stone or a kidney infection.
You are having back pains that come and go and last for one to two minutes. You may be in labor.

Call Your Doctor During Regular Office Hours If

The pain started with a fall.
You have numbness and tingling in your legs along with the back pain.
Along with the back pain, your leg feels weak.
You need prescription medication for the pain.
You want a referral to a chiropractor.
You think you may need a referral to see a specialist such as a neurologist.

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HOME CARE ADVICE FOR BACK PAIN DURING PREGNANCY

Take a nonprescription medication such as acetaminophen (Tylenol) that has been approved by your doctor for the back pain. Ibuprofen (Advil, Motrin) or naproxen (Aleve) may be taken up to 28 weeks of pregnancy but is not recommended after that time because they may harm the baby. Pregnant women should avoid taking aspirin because it can contribute to bleeding and also because it can cause stomach upset.
Apply heat or cold, whichever makes the pain feel better, for 15 to 20 minutes three or four times a day.
Practice good posture. Stand with your shoulders back, your head straight up and your buttocks tucked under.
Wear shoes with low heels.
Try to avoid lifting anything over five pounds. If you have to lift another child, lift by bending your knees, not by bending at the waist.
If you have to pick something up off the floor, squat rather than bending over at the waist.
Sit in chairs with good back support. Sit up straight with your back against the back of the chair or put a pillow behind your lower back.
Sleep on your left side with one or two pillows between your legs for support. Avoid sleeping on your right side or back because it puts pressure on major blood vessels that could compromise circulation to your heart and to the baby.
If your mattress is too soft, place a board between the box spring and mattress.
Do not stand for long periods of time. If you have to stand, put one foot up on a stool or box.
If necessary, get a maternity back support belt or girdle.
Exercise during your pregnancy to stretch and strengthen your back muscles. Get a physical therapist to advise you about what kind of exercises will help.
A massage therapist might be able to help your back pain.
Acupuncture may be helpful.

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For More Information Click on the Links Below

American Pregnancy Association Back Pain
North American Spine Society Back Pain During Pregnancy
American College of Obstetricians and Gynecologists Easing Back Pain During Pregnancy (Exercises For A Healthy Back)
Familydoctor.org Lower Back Pain

References

The Spine, 5th Edition Volumes 1 & 2, 2006; H. N. Herkowitz, MD, S.R. Garfin, MD F. J. Eismont, MD, G. R. Bell, MD, R. A. Balderston, MD
The Spine, 4th Edition, Volume 1, 1999; Rothman, Simeone.
MacNab's Backache, 3rd Edition, 1997; John A. McCulloch, MD, Ensor E. Transfeldt, MD

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Disclaimer: This content is reviewed periodically and is subject to change as new healthcare information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional