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Back Pain Due To Pregnancy

Pregnancy related back pain will vary in severity.  For this reason, please take the time to read about the following information about this condition before you decide what approach to take for helping with treatment and prevention of back pain due to pregnacy:

*Health Disclaimer
Any information given about back related conditions, treatments, and products are not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the #1 Back Pain Site!  See *Site disclaimer for more information.

Table Of Contents:

 All About Pregnancy Back Pain and Approach Treatment
 Therapies, Products, and Activities to Help Your Condition
     1.  Choosing the Correct Mattress for Better Back Support
     2.  Finding the Right Chair or Seat Insert Cushion         
     3   Soft Back Braces
     4.  Traction Devices 
     5.  Electric Stimulation Devices 
     6.  Ultrasound
     7.  Ice packs
     8.  Hot Packs
     9.  Whirlpool and Jacuzzi Water Therapy
    10. Mechanical Massage Devices
    11. Topical Analgesics for Pain Relief
    12. Vitamin, Mineral and Herb Supplementation   
    13. Nutritional Aid in the Healing Process                   
    14. Medications
    15. Exercises and Stretches for Your Back Condition
    16. Yoga and Meditation to Relax the Back
    17. Correct Shoes for Avoiding Back Pain
    18. When to Use a Heel Lift or Orthotic Shoe Insert       
  Deciding on the Best Health Care for you
    1.  Chiropractic
    2.  Massage Therapy
    3.  Acupuncture
    4.  Physical Therapy
    5.  Medical Practitioners

All About Pregnancy Back Pain & How to Approach Treatment:

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If your doctor has told you that your back pain may just be the normal aches and pain associated with pregnancy, here might be why.  During pregnancy your body will form Relaxin, a hormone that will allow the joints to become more mobile and loose.  This hormone is helpful in the delivery process, as it will enable the pelvic bones to shift to make room for the baby to be delivered.  Unfortunately this hormone will also allow your normal joints to more easily shift and displace.  This can lead to muscle guarding to prevent any ligament injury.  Also, as your weight increases, so does your lumbar lordosis.  Add to this the fact that you have a ligament which supports the uterine sack by attaching to the sacral bone of the pelvis and you further displace the low back and put cause more pressure to the spinal joints.  The listed Therapies, Products and Activities section will give more information on how to help your condition, however, as each pregnancy related back condition is different, always consult your doctor to determine what treatment is right for your particular situation.               

     

Therapies, Products, and Activities to Help Your Condition:

   
Choosing the Correct Mattress

A good mattress will protect the back for the many hours that you are in bed.  A mattress that properly supports the body will also be a very important element in helping relieve stress on the muscles and joints of the back.  The most important information needed for finding a correct mattress to support the back involves knowing what position you sleep in.  The menu below will help you to search for a mattress that is right for you.

Choose a sleeping position:

        

 

  Finding the Right Chair or Seat Insert Cushion

Whether you sit for minutes or hours, you can't underestimate the value of proper posture while sitting.  It has been demonstrated that at times there can be as much as six times the amount of stress on your back when you sit than while lying down.  Fortunately you can lower the amount of stress placed on the spine with proper back support.  To accomplish this, first you must decide whether the chair you use presently is adequate for your needs.  A good chair will be able to provide your lower back with proper lumbar pressure.  This pressure will keep the curve of the spine in this area supported in the normal position.  When a proper lumbar support is not provided with your chair, an insert lumbar cushion can accomplish this.  The size of the cushion is very important, as too much lumbar support can compress and irritate the spine.  A good working ergonomic type of chair can be adjusted to allow tilting and height control of the seat and chair back.  Here are some tips for adjusting your chair properly:  Adjust the height of the chair to allow your feet to rest comfortably on the floor.  Adjusting the tilt angle of the seat will change the position of your pelvis, thereby shifting the back towards or away from the seat back.  Tilting the front of the seat downward will bring your lower back into extension and thus increase the lower lumbar curve.  Tilting the front of the seat upward will bring your lower back into flexion and thus decrease your lumbar curve.  Combine the seat angle tilt with the seat back tilt for optimal support of the back.  If the seat back height can be adjusted, make sure the small of your back fits with the part of the seat back which curves outward to support the lower back.  If these adjustments still do not support the spine properly, you will definitely need a lumbar insert cushion or more ergonomically correct chair.  Insert cushions will need to have height adjustability to fit correctly.  This is usually achieved with a strap that allows you to set the height of the cushion to the thickest part against the small of your back.  Each person's spine curves differently, so another important feature that some back support cushions provide is the ability to adjust the size of the lumbar thickness to customize the fit.  We found two different types of backrest cushions that meet the strict criteria of what we look for when helping patients to properly support their posture while sitting (see link below).

backrest.gif (20756 bytes)
Click Here
to purchase the
 recommended backrest for your spine with
 the adjustable air cushion found at Relief-Mart .
 

  

Soft Back Braces

There are special soft back braces for pregnancy which will support the back but not place pressure on the abdominal region.  Back braces can be necessary when an injury creates instability to the spinal column, as it will protect the back from further injury.  While soft back braces can be useful for support of fatigued muscles and allow temporary relief to the irritated tissue in the initial stage of injury, wearing a back brace for prolonged periods can also weaken the back musculature, as the muscles will rely on the brace to keep good posture.  While too much movement of the back may cause exacerbation of the Pregnancy related back pain, preventing movement of the area has been shown to hinder the healing process.  It can be noted that the use of a brace while sleeping should not cause any of these problems, but many patients find that overusing the brace can become irritating to the area.  

  
  Traction Devices

Lumbar traction generally not performed with pregnant woman as you need to be cautious tractioning the low back.  See your doctor for more information as to what if any types of traction can work for you.


    Electric Stimulation Devices

Lumbar electric stimulation is generally not performed with pregnant woman as you need to be cautious tractioning the low back.  See your doctor for more information as to what if any types of traction can work for you.


    Ultrasound

Ultrasound for therapeutic purposes should not be performed over the low back of pregnant woman as you need to be cautious not to direct higher powered sound waves to the fetus.  See your doctor for more information as to what if any types of ultrasound can be performed in your particular situation.


    Ice Packs

Ice can be used in the initial 72 hours of an injury to reduce inflammation and numb the pain associated with Pregnancy spinal instability.  One potential problem with ice is that temporarily it will tighten the musculature even more.  Also it should be noted that ice should not be used for longer than 20 minutes to an area, as it will cause a reversal reaction which will allow the tissue to become more inflamed.  For low back inflammation we recommend using a combined brace and ice gel pad to put a more firm pressure over the irritated area.  This will also provide support over the injured area while providing ice therapy.  Patients we surveyed feel that the brace and ice gel pad combination below works extremely well (see Soft Back Brace section for more information on bracing).

Back_Gel.jpg (5012 bytes)
 Click here to purchase the
 recommended Ice gel pads which attach to
 the adjustable air back brace found at Relief-Mart
  


    Hot Packs

Hot packs are useful for increasing circulation and thereby loosening up the muscle tissue.  Waiting to use heat therapy until three days after the onset of when the initial irritation of the pregnancy related back pain occurred will give the swelling a chance to go down, as heat increases the inflammation to the area.  It is believed that moist heat is better than dry, as there is less possibility for dehydration to the musculature.  We found a simple to use moist heat pack (depicted below) which contains beads that activate upon being heated up in a microwave to give off moist steam without adding water.  This occurs from a natural process by which the beads retain moisture from the air.  The ease of use, combined with the comfort of this product, make it a very popular therapy with the patients we surveyed.

 therabeads_back.jpg (5737 bytes)
Click here
to purchase the
 recommended Therabeads moist
 heat packs found at Relief-Mart
  


    Whirlpool and Jacuzzi Water Therapy

As previously mentioned, moist heat therapy is useful for increasing circulation and thereby loosening up the muscle tissue.   In the case of a heated whirlpool, the heat will completely surround the area.  Unfortunately, this type of therapy is often contraindicated in pregnancy.  It is advised that you consult your doctor before using this type of therapy during pregnancy.

 

  Mechanical Massage Devices

Many of the same benefits seen with regular massage can be accomplished with mechanical massage devices that penetrate deeply through a tapping action called percussion, and thereby disperse lactic acid in the soft tissue and increase circulation, giving an overall relaxing effect to the musculature.  This can be very effective for the "knotted up" type of musculature.  More superficial massage devices that just vibrate may serve to increase circulation to the tissue, but lack the other aforementioned benefits.  It should be noted that the stretching of the muscular fibers will not occur like it does in manual massage.  Percussive massagers should be used on slower speeds when the soft tissue is very inflamed, as it is less irritating to the area.  We found an extremely effective, yet affordable variable speed percussive massager that can be used on the neck and back (pictured below) and feel that it meets every criteria we look for in a home massager.


massager.jpg (4369 bytes)
click here to purchase the
 recommended percussive variable
 speed massager found at Relief-Mart

  

  Topical Analgesics for Pain Relief

Over-the-counter sprays, sports creams and ointments that have analgesic properties can be useful for pain control of the irritated soft tissue, without any intestinal side-effects.  Menthol is the active ingredient which works to block pain receptors and help relieve pain in the soft tissue and joints.  The higher the menthol percentage, the stronger the formula.  Some companies use as much as 16 percent menthol, but that much is not necessary to achieve results and can cause burning side effects.  Menthol can be derived naturally from peppermint or be synthetically produced.  Natural menthol penetrates the skin more effectively.  Other ingredients such as capsaicin, peppermint and eucalyptus can also help to block pain.  Keep in mind that capsaicin or capsicum are responsible for the burning/tingling sensation that occurs in the same pepper spray that police use to stop attackers.  Use of these Cayenne pepper derivatives can leave residual numbness and tingling in an area for days after each use.  Some companies are also using other herbs believed to have natural healing, relaxing and mild anti-inflammatory properties such as MSM (methylsulfonylmethane) and Glucosamine, but most only add trivial amounts.  Glucosamine and MSM are usually taken in oral pill form.  Dosages usually range between 1,000-1,500 mg a day.  Glucosamine is currently undergoing many trials to determine effectiveness for helping cartilage repair.  Studies have demonstrated that patients with deterioration of joint cartilage halt and even regenerate the tissue after taking Glucosamine for at least six weeks.   

For a topical pain reliever to work effectively it needs to have a good transport mechanism (ability to let ingredients be able to pass through the first layer of skin down to the deeper tissues below).  In theory, supplements such as Glucosamine Sulfate and MSM have small enough molecules to pass through the skin barrier and not just affect the top of the skin, but rather penetrate deeper down.  Because Glucosamine and MSM absorb so well, they also make great skin conditioners.  Where as taking Glucosamine and MSM will affect your whole body, placing it over an area can add 28 times more than a pill would provide over a specific area.  Topical pain relievers with oils and waxy substances like glycerin, strearic acid and cetyl alcohol would make a poor transport mechanism for ingredients like Glucosamine and MSM, yet some companies continue to use this ingredient.  While methyl and propyl paraben are preservatives that offer an indefinite shelf life, they also lessen the penetration of a topical pain reliever.

Therefore, the best type of topical analgesic is one that combines good powerful natural ingredients, with a good transport mechanism that has no preservatives, but also no oils to block penetration or eventually turn the formula rancid.  Therapain Plus (shown below) meets the above criteria and has proven successful with the patients we surveyed. 


click Here
to purchase the
 recommended natural topical pain
 relieving formula with 14,000 mg of MSM and
 Glucosamine found at Relief-mart

 

   Vitamin, Mineral and Herb Supplementation

Certain vitamins and herbs can be used as supplementation for the body's natural healing and defense system.  The RDA recently increased some of its recommended daily values for certain vitamins, and has listed tolerability ranges (See RDA's website for further information).  It has been a long standing debate as to how much extra supplementation can be utilized by the body, and many contributing factors may play a part in this process.  These factors may include weight, smoking, exercise, stress, pregnancy, and quality/type of the supplementation.   While the FDA does not approve any of the following vitamins and herbs for use of pain or inflammation, many doctors surveyed are currently using some or all of the following in their practice to target muscle and connective tissue:

Vitamin E, Vitamin C, Zinc , Calcium, Copper, Boswellin, Bromelain, Curcumin, Hops, Valerian Root, Kava Kava, MSM and Glucosamine Sulfate.

*Glucosamine and MSM have the most consistent scientific evidence that support its use for many conditions.  For more information on Glucosamine and MSM, click here.

 

   Nutritional Aid in the Healing Process

While nutritional changes will not usually produce immediate results, there can be no better way to make long term changes in the body than eating right.  Some foods have properties which have been shown to change inflammatory levels.  Acidic fruits can mildly block the body's inflammation process, whereas red meat and shellfish increase arachidonic acid, which is known to increase inflammation levels.  As new nutritional studies are constantly being performed, more information will be continually added to this site on this topic and addressed in our free monthly newsletter.

 
    Medications

One of the most frequent questions our health experts encounter is whether medication should be taken, and which one would be right for them.  It is important to remember that medications are aimed at temporarily reducing pain, inflammation, and relaxing the body, but have not been proven to increase healing to the area.  Here are some of the most commonly mentioned medications: 

For over-the-counter medication, Ibuprofen has been indicated for temporary pain relief.  Studies have also shown that in higher amounts, Ibuprofen can act as an anti-inflammatory, but a medical doctor's prescription is needed for this dosage.  Aspirin and acetaminophen are also indicated for muscle pain relief, but do not show anti-inflammatory properties in prescription dosages.  Acetaminophen does not have warnings about adverse reactions for people with aspirin allergies, as it is not an aspirin derivative.  It has also been demonstrated to be better tolerated by people with weak intestinal systems.  While Aspirin is known to be more abrasive on the intestinal system, it may have other side benefits such as blood thinning that prevents the blood clots which can lead to strokes and myocardial infarctions.

As these medications work to block pain and inflammation temporarily, it stands to reason that the need for these medications can occur when a person can no longer function due to the pain or when it hinders sleep  and thereby impedes the body's natural healing process.  A person on pain medication should consider that they may more easily overdo it during the temporary relief period, which could cause further injury to the muscles.   

*As side effects can occur, always consult your medical doctor to determine if and what medication is appropriate for your situation.*

 

    Exercises and Stretches for the Back

Muscular stretching can be a very important part of the healing process for tightened muscles of the back.  It is essential to lengthen any shortened muscular tissue of the back to help prevent further pulling on the already shortened fibers.  Muscular strengthening exercises will be important once the back irritation has subsided.  Back strengthening exercises help to build stability to weak tissue.  It should be noted that irritated muscles can become further damaged with strengthening exercises that are premature to the healing of the area.  The exercises below are general exercises to increase flexibility and can help to stabilize the back.  However, it should be noted that for most of these exercises, you should not feel the stretch in the back itself.  For example, the back of the legs have a group of muscles called the hamstrings.  These muscles originate in the lower pelvis and insert into the leg.  When the hamstrings are tight, the back itself can  be tightened due to the pulling on the pelvis.  Therefore, stretching the hamstrings will not only loosen the leg muscles up but they will take the strain off the back. 

Each picture below depicts the exercise being performed properly.  The arrows are the direction the body will need to move towards to get the correct angles.  The red circles indicate the area of which you should feel the stretch.

Warning:

*The following back exercises should never be performed if they cause irritation to your back or any other condition while they are being performed!   As each pregnancy related back condition is different,  always consult your doctor before performing any of these exercises to determine what exercises, if any, are right for your particular condition.  If you have any discomfort after performing any of these exercises, discontinue and immediately and consult a doctor to properly assess your situation.*

 

  Hamstring Stretch


Click picture to increase
size and quality

Sitting on the ground, with one leg straight and the other one comfortably bent in front of your body, bend at the waist and lean forward, keeping your back as straight as possible.  Reach with your arms towards the foot until a stretch is felt under your thigh.  Hold each stretch for a minimum of 30 seconds, any less than 15 seconds and the muscle will not conform to the new increase in length.  Do 3 reps, 3-6 times a day.  Any pain you feel with this exercise should only be a local stretching sensation to the back of your thigh area, without aggravating your condition. 

  TFL Stretch


Click picture to
increase size
 and quality

Start with stretching the TFL portion of the left hip and outside thigh. While standing, hold your left hand securely on a solid surface to support your body as you place your left leg past your right until you reach a maximum stretch.  Follow this with tilting your upper back to the right side while simultaneously pushing the left side of the hip.  Do the exact opposite to achieve a stretch of the right TFL portion of the hip and outside thigh.  Hold each stretch for a minimum of 30 seconds, any less than 15 seconds and the muscle will not conform to the new increase in length.  Do 3 reps, 3-6 times a day.  Any pain you feel with this exercise should only be a local stretching sensation to the TFL portion of the hip and outside thigh, without aggravating your condition. 

  Calf Stretch


Click picture to
increase size
 and quality

Start with stretching the right Gastrocnemius portion of the right calf area. While standing, place your right leg in front of you and your left foot directly behind you.  Place the toes of your right forefoot up against a door or other flat wall surface, keeping your heel down to the floor.  Lean your upper body forward to place a stretch on the back of the calf.   Do the exact opposite to achieve a stretch of the left calf area.  Hold each stretch for a minimum of 30 seconds.  Any less than 15 seconds and the muscle will not conform to the new increase in length.  Do 3 reps, 3-6 times a day.  Any pain you feel with this exercise should only be a local stretching sensation to the calf area of the leg, without aggravating your condition.

  Psoas Stretch


Click picture to
increase size
 and quality

Start with stretching the right Psoas muscle.  While standing, place your right leg in front of you and your left foot directly behind you as far as you can comfortably stretch it.  Shift your lower body forward, while simultaneously pushing your upper body backwards with your arms.  Do the exact opposite to achieve a stretch of the right Psoas portion of your front upper thigh area.  Hold each stretch for a minimum of 30 seconds.  Any less than 15 seconds and the muscle will not conform to the new increase in length.  Do 3 reps, 3-6 times a day.  Any pain you feel with this exercise should only be a local stretching sensation to the Psoas area of the upper thigh, without aggravating your condition.

  Quadriceps Stretch


Click picture to
increase size
 and quality

Start with stretching the left Quadriceps muscle.  While standing hold a solid surface for support and bend back your left leg.  Grab your left ankle and pull that foot to your left buttocks while simultaneously pulling your left thigh backwards while keeping your back straight.  Pulling your thigh backwards is a very important part of this stretch, as it will place the stretch in the mid-thigh instead of overloading the pressure on the knee.  Do the exact opposite to achieve a stretch of the right Psoas portion of your front upper thigh area.  Hold each stretch for a minimum of 30 seconds.  Any less than 15 seconds and the muscle will not conform to the new increase in length.  Do 3 reps, 3-6 times a day.  Any pain you feel with this exercise should only be a local stretching sensation to the Quadriceps muscle area of the upper thigh, without aggravating your condition. 

 

    Yoga and Meditation to Relax the Back

Regardless of the current situation your back is in, relaxing could be key to helping it heal.  While meditation can always be useful for achieving this, Yoga can at times be irritating if caution is not taken.  Yoga is a series of slow movements combined with stretches and meditation to allow for an increase in flexibility and relaxation to the muscles and joints, as well as to help optimally integrate the connection between the mind and body.  However, what might seem to be easy maneuvers should still be treated cautiously, as your individual situation may prohibit certain Yoga moves.  One simple meditation practice that is usually met with good success is to close your eyes and visualize yourself in the most happy and relaxing place you know of.  Sometimes just taking the time to do this can be what you need to begin the healing process.

 

    Correct Shoes for Avoiding Back Pain

While walking is one of the overall best exercises for your health, the shoes you choose to stroll in may just be the difference between hurting your back and helping to keep it strong and loose.  High heel shoes put your spine in extension, which can impact the joints further when the vertebrae are already in a compressed state.  Lack of shock absorption will further impact the joints with every step you take.  Shoes that contain proper arch support can help take the pressure off those tired feet and add to increase overall shock absorption.  Shoes with pressurized air or other cushioning chambers are necessary to protect the spine during the much harder impact a person will experience during exercise. 

 

    When to Use a Heel Lift

During standing a proper balance is needed between both hips to keep the back in correct alignment.  When one leg is slightly longer, or the hip becomes fixated in a higher position, it may be necessary to supplement the lower side of the hips with a heel lift worn inside the shoe.  When the spine is tilting to the lower hip side, a lift may allow the spine to realign properly, and thus take pressure off the back.  If one leg actually grew shorter than the other, a lift may be needed on a permanent basis to prevent the spine from moving back to its incorrect position.  A health practitioner should be the one to evaluate the situation and assess the correct size heel lift needed. 
  

Deciding on the best health care for you

 

    Chiropractic Care

Chiropractic care can be safely performed with pregnant females.  However, it is recommended that you seek care from a chiropractor who has had a lot of experience with treating pregnancy.  Chiropractors have the level of education befitting their title as doctors. Their focus is primarily on diagnosing and treating dysfunction of the muscles, nerves, and skeletal system without the use of drugs or surgery.  As a particular back condition may at times warrant more aggressive forms of treatment, many chiropractors have developed good working relationships with medical doctors to enable a system of cooperative care to optimally benefit their patients.  Chiropractic care helps increase the flexibility of the soft tissue of the spine and reduces the pressure that occurs from any restricted and minor misalignments of individual vertebral joint segments.  This in turn helps to eliminate any nerve interference created from the dysfunctional area.  This can be achieved by breaking down scar tissue through techniques which adjust the spine,  re-aligning the attached vertebrae, as well as performing release techniques to the fibrous portion of the soft tissue.  Many doctors of chiropractic also use therapeutic measures such as ultrasound, electric stimulation, and heat therapy.  A doctor of chiropractic should take the time to diagnose your condition and help determine its cause. 

  
  Massage Therapy

Many chiropractors have recognized the benefit of working in conjunction with massage therapists to loosen their patient's muscles as a precursor to treatment.  This relationship works so well because the patient can be treated after becoming more relaxed and euphoric due to the natural release of endorphins, as well as the loosening of the musculature due to all the benefits of massage.  Other benefits of massage depend on the type of massage being given. 

Swedish massage is usually a more superficial, relaxing form, and therefore is less likely to break down scar tissue and trigger a release of spasmodic musculature as a deeper type of massage would accomplish.  It should be noted that due to the increase in circulation and release of lactic acid (a natural chemical irritant that is a byproduct of muscle utilization without oxygenation) with massage, it is possible that the area can feel more inflamed and tender temporarily. 

  
  Acupuncture

Eastern philosophy proposes that acupuncture utilizes needles to stimulate energy points and  are referred to as meridians.  The Western scientific explanation is that the stimulation from the needle puncture triggers natural pain relieving chemicals from the brain, a reduction in inflammation to the area through an increase in circulation, and a relaxation response to the musculature.  As no scar tissue is being broken down from the injured tissue, increase in flexibility will be less likely than with a manual tissue and joint mobilizing type of therapy.

 
    Physical Therapy

Physical Therapy utilizes a variety of modalities such as ultrasound, electric stimulation, massage, and thermal therapy to help relieve muscular spasms.  Manual tissue and joint mobilizing types of therapy can be used to help increase tissue flexibility.  Physical Therapy excels in the use of muscular strengthening exercises to build stability to weaken tissue.  It should be noted that irritated muscles can become further damaged with strengthening exercises that are premature to the healing of the area.  A prescription from a doctor is often needed prior to treatment with a physical therapist for most health insurances to pay for any care rendered. 

 
    Medical Practitioners

A doctor of medicine can take the time to evaluate your condition and confirm your specific diagnosis.  Medical doctors prescribe either over the counter or prescription only medication.  They can prescribe medications that temporarily relieve inflammation, temporarily relax muscles, and temporarily relieve pain.  Many medical doctors work with physical therapists and chiropractors to provide conservative management for the many back pain conditions a patient can experience.  Orthopedic doctors have extended training with sub-specialties in particular joints of the body.  

   

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