How common is back pain during pregnancy?
You are not alone if you are experiencing back pain during your pregnancy. The prevalence varies with reports, showing between 50 to 70 percent of all pregnant women having back pain.
What causes back pain during pregnancy?
Back pain during pregnancy is related to a number of factors. Some women begin to experience lower back pain with the onset of pregnancy. Women who are most at risk for back pain are those who are overweight or had back pain prior to pregnancy.
The sciatic nerve is the largest nerve in the body, providing sensory and motor function to the lower extremities. This nerve provides sensation to the back of the thigh, lower part of the leg and the sole of the foot. Sciatic nerve pain is a periodic severe pain that occurs throughout your legs.
What causes sciatic nerve pain during pregnancy?
The sciatic nerve runs under your uterus to your legs. The cause of sciatic nerve pain is thought to be associated with pressure on the nerve caused by the developing baby.
What can I do to treat sciatic nerve pain during pregnancy?
The simplest remedy is to lie on your side, opposite of the pain. This may help relieve the pressure on the nerve. Avoid heavy lifting and minimize standing for long periods of time. If you experience pressure while standing, try elevating one foot and resting it on something. Swimming may also ease discomfort. You may experience relief by applying heat or cold to the troubled area. Your health care provider may recommend acetaminophen to relieve the pain. It is important to contact your health care provider if the pain becomes constant, or increases in severity or frequency.
But is your pain even more intense?
But has this pain been so painful that walking is difficult? What about turning in bed? Is climbing stairs close to impossible? Then you may be suffering fromSymphysis Pubic Dysfunction.(a more severe form of this is calledDiastasisSymphysis Pubis)What exactly is Symphysis Pubis Dysfunction?
During pregnancy or birth, about one in 35 women will experience intense pelvic pain and may find it difficult to walk, climb stairs, and other movements that involve the pelvic bones. This pain is a result of separation of the symphysis pubis which is a joint in the very front part of the pelvic bone structure. There is cartilage that fills the gap in the bones. During pregnancy, hormones such as relaxin soften this cartilage allowing the pelvic bones to be more flexible for delivery. Some women, however, have too much play in the pelvis causing a large gap between the bones. This makes the symphysis pubis area extremely sensitive to touch.
During pregnancy or birth, about one in 35 women will experience intense pelvic pain and may find it difficult to walk, climb stairs, and other movements that involve the pelvic bones. This pain is a result of separation of the symphysis pubis which is a joint in the very front part of the pelvic bone structure. There is cartilage that fills the gap in the bones. During pregnancy, hormones such as relaxin soften this cartilage allowing the pelvic bones to be more flexible for delivery. Some women, however, have too much play in the pelvis causing a large gap between the bones. This makes the symphysis pubis area extremely sensitive to touch.
Unfortunately not many OBs or practitioners in the US (it seems OBs in the UK are more familiar with this) are well versed about this painful condition. They may suggest that what you are feeling are the normal discomforts of pregnancy and will get better on its own,DO NOT TAKE THAT FOR FACE VALUE! Don't let them pass of your pain as nothing.What you are experiencingIS REAL. Do not let that discourage you. You are not doomed to be in pain the rest of your pregnancy. Help educate your doctor or OB (in a kind way of course) to help spread the word of this so that they may be able to better assist their future patients. You may want to take printed information to them like from this site:http://www.e-radiography.net/radpath/d/diastasis_symphysis.htmto help educate them.
When does separation of the symphysis pubis occur?
Some women will notice pain beginning as early as the first trimester of pregnancy while others experience this separation during the birth or even a few days postpartum. Women who have experienced SPD with previous pregnancies will not necessarily have the problem with subsequent pregnancies however, some will.
When does separation of the symphysis pubis occur?
Some women will notice pain beginning as early as the first trimester of pregnancy while others experience this separation during the birth or even a few days postpartum. Women who have experienced SPD with previous pregnancies will not necessarily have the problem with subsequent pregnancies however, some will.
How will I know if I have SPD?
If you have SPD, you may notice pain in the front of the pelvis that hurts when touched. You may also feel pain in the lower abdomen, hips, inner thigh and groin areas. Marked increased pain with activities such as walking, climbing stairs, lifting your legs, or any other large movements involving the pelvis are key symptoms. You may even experience a clicking type noise with movement as well. If you experience any of these symptoms, you should contact your caregiver for further testing.
What type of testing can I expect if my doctor/midwife and I suspect SPD?
The type of testing depends on when you experience the symptoms. If you are still pregnant, the likely test would be an ultrasound. Other diagnostic tools that can be used after delivery are pelvic x-rays or an MRI.
Is there any treatment for SPD?
The doctor may prescribe painkillers and refer you to a physiotherapist for additional help. The physiotherapist may suggest the use of TENS, Transutaneous Electronic Nerve Stimulation, to help with the pain. Other items such as support belts or crutches can be used as well. Additional specialists also offer potential benefits: acupuncturists, reflexologists, chiropractors, aromatherapists, osteopaths, hypnotherapists, and herbalists. Each in their own way may provide treatment options to minimize the pain of SPD. There is no way to prevent SPD from occurring; however, once the hormones cease production after pregnancy, the condition will gradually subside.
If you are pregnant with SPD you should minimize large pelvic movements throughout your pregnancy. This includes swimming breaststroke, even though normally this is a great means of exercise. Choose other strokes if you are a swimmer. Try to continue to get exercise, just be sure to do exercises that will not aggravate the SPD.
Here is a fantastic link that will show you some ways you can cope with this painful condition:
http://www.plus-size-pregnancy.org/pubicpain.htm#Tips%20for%20Coping%20with%20Pubic%20Symphysis%20Pain
Should I be worried about the delivery?
Birthing vaginally is certainly attainable and preferable even with SPD. Spreading of the legs, however, should not be extreme. Perhaps the best positions for pushing when you have SPD is either "all-fours" (hands and knees) or side-lying. Squatting may be painful as well as the most common birthing position, the sitting position with legs wide apart. Be sure that you explain to the nurses and other caregivers that you have symphysis pubis separation and need to minimize spreading your legs widely. One of the drawbacks of receiving an epidural during the birth is the pain of separation may be masked and therefore you may be put into positions that are only making the problem worse. Unfortunately, you wouldn't find this out until the anesthesia wears off and you have the extreme pelvic pain. Therefore, it is imperative that the caregivers know of your condition and do not suggest positions that could exacerbate the situation.
The final word...
Remember, symphysis pubis dysfunction is a condition that affects pregnant and/or postpartum women. It is a temporary situation and one that will resolve itself once the cartilage softening hormones decrease. Although there is no "cure" and it cannot be prevented in subsequent pregnancies, it does not mean that you will automatically experience SPD each pregnancy or birth. If you do, however, seek help to minimize the pain and worsening of the situation.
