Lower backache is a very common type of pregnancy pain you’ll have to deal with — especially in your second and third trimesters.
In fact, this problem plagues about half of all pregnant women, notes Dr Tan Toh Lick, a consultant ob-gyn at Thomson Wellth Clinic.
And pregnancy hormones are to blame for these aches and pains. Dr Tan explains, “During pregnancy, higher levels of hormones like relaxin, progesterone and [other] hormones result in joint laxity (or loosening of the joints).” In particular, if the loosened spin and weak back muscles don’t get proper support, it can result in pain.
Your growing bump can also weaken your abdominal muscles, which can change the curvature of the spine and exert pressure and weight on the spinal nerves.
“If the [pressure on the nerve becomes] chronic, it may cause permanent damage to the nerve and the function of organs such as the bladder or bowel, or leg.”
If you suffer from a regular back ache, you’ll only feel back pain. However, some women may experience a more severe form of back pain, called sciatica. This happens when the additional weight from carrying your foetus narrows one of your spinal discs, causing it to protrude. This exerts additional pressure on the sciatic nerve — a spinal nerve that extends from the lower back to each leg — resulting in sciatica. Dr Tan lists the symptoms you should look out for:
* Sharp pain.
* Numbness and weakness.
* A tingling sensation.
You can also feel such symptoms on one side of the body ― along the spinal nerves that run from your lower back to the leg. Sciatica can also become a debilitating condition if it isn’t treated.
Dr Tan explains that the pain may even affect various different parts of your body. “If the [pressure on the nerve becomes] chronic, it may cause permanent damage to the nerve and the function of organs such as the bladder or bowel, or leg.”
Noting that expectant women who have lower back pain radiating to the leg with numbness or weakness, as well as fever or incontinence, are displaying warning signs of the condition, he advises that they see a doc.
Dr Tan tackles common questions about sciatica…
What scanning tests do doctors run to diagnose sciatica?
During pregnancy, the most commonly used imaging procedure is magnetic resonance imaging (MRI). CT-scans and X-rays are also employed, although typically only after delivery. If needed, electro-diagnostic studies such as electromyography (EMG) may also be carried out to supplement other scans.
What treatment options do pregnant women with sciatica have?
Pelvic belts, physiotherapy and warm massages are helpful in managing the condition. Supervised exercises that strengthen back muscles such as antenatal yoga, swimming and water gymnastics are also effective in reducing pain. Resting on the side with your back curled also relieves pressure on the spinal nerves and eases pain.
Exercising in water is particularly suitable as water relieves the weight of the expanding womb.
Medication such as paracetamol can lessen any pain and joint inflammation. Pregnant women aren’t given pain relief alternatives such as non-steroidal anti-inflammatory drugs and opioids. Procedures like acupuncture and transcutaneous electrical nerve stimulation — where a low voltage electricity is used to stimulate the nerves — may also help in pain relief.
Surgical procedures include:
* Discectomy Surgical removal of a spinal disc or part of it.
* Micro-discectomy Surgical removal of a disc or part of it using a special microscope.
* Laminectomy Decompression surgery to relieve pressure on the spinal cord or nerves.
Besides the weight of carrying a baby, what else can give rise to sciatica?
Unusual causes may include osteoporosis, tumours, infection such as tuberculosis, trauma, or inflammatory disease of the joints such as spondyloarthritis. While most cases are due to orthopaedic conditions, gynaecological causes have also been reported, too. These include fibroids, endometriosis and malignant tumours that may also involve the spine.
What measures pregnant women take to guard against sciatica?
Women who are fit and healthy before pregnancy are less likely to experience sciatica in pregnancy. Being active during pregnancy may also improve your back muscles, but what you do should accommodate your reduced joint mobility. This lessens irritation on the spinal nerves and lowers the risk of sciatica. Exercising in water is particularly suitable as water relieves the weight of the expanding womb.
Women can also lessen lower back pain by adopting correct postures and practising relaxation techniques. Also, they should avoid lifting heavy objects with a bent waist, wearing high-heeled or poorly fitted shoes.
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