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Most women experience back pain at some point during their pregnancy. The pain could range from being mild to severe. Though it isn’t uncommon to have back pain while being pregnant, due attention must be given to it and methods to treat and avoid it should be considered.
Causes of back pain during pregnancy
- Weight gain – A woman gains around 25 to 35 pounds in a healthy pregnancy. The spine that supports this extra weight may experience lower back pain during this time. Also, the growing baby and uterus puts pressure on nerves and blood vessels in the back and pelvis.
- Posture change – Pregnancy changes a woman’s centre of gravity, and she adjusts her posture and movement in response to it. This can cause pain or strain in the back.
- Muscle separation – The expanding uterus causes two parallel muscle sheets (rectal abdominis muscles) that run from the rib cage to the pubic bone, to separate along the central seam. This can increase back pain.
- Hormone changes – The pelvic area and joints loosen up in preparation of birth. The hormone relaxin that causes this also loosens the ligaments that support spine, leading to back pain and instability.
- Stress – Stress may also increase muscle tension in the back, causing back spasms.
Treating back pain during pregnancy
There are many ways to treat back pain in pregnancy or make it milder. These include:
- Exercise – Muscles of the back can be strengthened and made flexible with regular exercise and reduce strain on the back. Walking and swimming are good exercises for pregnant women, and a doctor or therapist can also recommend an exercise regimen. Regular physical activity is important to keep back strong.
- Heat or cold – Applying heat or ice can provide relief. Cold compresses for up to 20 minutes a day or hot water bottle or heating pad prove helpful. However, care must be taken to not apply heat to the abdomen during pregnancy.
- Improve posture – Maintaining proper posture while sitting, working or sleeping prevents strain on back. Shoulders should be kept back while standing, a small pillow or rolled-up towel can be placed behind when sitting, and a pillow between the knees when sleeping on the side can take some stress off the back.
- Rest – Adequate rest is necessary, especially in the later months of pregnancy.
Back pain can also be avoided by following some simple steps during pregnancy:
- Avoiding sitting for long periods of time.
- Keeping back straight and using leg muscles instead of back muscles when lifting things.
- Avoiding bending and twisting motions.
- Keeping feet up on a stool while sitting.
- Gentle exercise during the day.
- Wearing supportive, low-heeled shoes.
When to contact a doctor
Though back pain during pregnancy should not cause worry, some situations may require a pregnant woman to seek medical help. These include:
- Severe pain – Severe back pain could be related to vertebral osteoarthritis, septic arthritis, or pregnancy-associated osteoporosis.
- Abrupt onset of back pain or pain that is increasing in severity
- Rhythmic cramping (it could be a sign of premature labour)
Pelvic Inflammatory disease related back pain
Lower back pain may be caused by a variety of factors, which also include menstrual cramps and sexually contracted diseases like pelvic inflammatory disease (PID). It is normal to experience mild lower back pain around the time of menstrual period, but a woman must consult a doctor if the pain persists throughout the length of the cycle, or is abnormally severe during menstruation.
Back pain may also be experienced around the region of kidneys or liver, and should be brought to a doctor’s notice at once. The lower back pain may extend to the legs. These could signal pelvic inflammatory disease.
Here’s how to detect and treat lower back pain that might be a symptom of PID:
PID causes and symptoms
Pelvic inflammatory disease (PID) is an infection of female reproductive organs that occurs when bacteria transmitted during sexual intercourse travel from the vagina or cervix to the uterus, ovaries, fallopian tubes or pelvis.
The most common cause of contracting pelvic inflammatory disease is in form of sexually transmitted infection (STI) by bacteria that cause chlamydia and gonorrhoea. However, bacteria may also enter the body though insertion of intrauterine device (IUD), childbirth, miscarriage or endometrial biopsy.
Many women experience no signs of PID or do not seek treatment, and it is detected only later when chronic pelvic pain develops or they have difficulty getting pregnant. Inflammation in the uterus and fallopian tubes occurs as result of PID, which further forms scar tissue in the reproductive organs and abdominal cavity that can cause infertility, chronic pelvic pain and ectopic pregnancy.
Detecting pelvic inflammatory disease
Women experiencing unexplained back pain along with other symptoms like pelvic pain, fever, painful, irregular or no menstruation, etc. must consult their gynaecologist at the earliest.
Pain and tenderness in the pelvis, lower abdomen or lower back is one of the most common symptoms of PID.
Others include fever, vaginal discharge with abnormal smell and colour, frequent or painful urination, bleeding after intercourse or painful intercourse, nausea, no menstruation, fatigue, chills, nausea, and loss of appetite.
The doctor will conduct a pelvic examination and swab the inside of the cervix with a sterile, cotton swab to be tested in the laboratory for gonorrhoea and chlamydia. The pelvic exam may show if the cervix is releasing any discharge or if it bleeds easily, whether cervix movement causes pain or if there is any tenderness in the uterus or ovaries.
A blood test will check for white blood cell count; a high count indicates severe infection. Other methods to diagnose PID and rule out other diseases like appendicitis or possible pregnancy are ultrasound and laparoscopy (to view the pelvic organs).
Since PID is caused by infection, the primary treatment is through antibiotics. The doctor may prescribe two or more antibiotics since PID is often caused by more than one type of organism. It is important to complete the course of antibiotics and not leave it midway upon improvement in symptoms, as the infection can persist even after the symptoms disappear. Most PID infections clear up after 10 to 14 days of antibiotic treatment.
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