Lower Back Pain
If you feel pain in your upper or lower back, you're not alone. According to the American College of Obstetricians and Gynecologists (ACOG), back pain is one of the most common discomforts when you're a mother-in-the-making. "Around five or six months into my second pregnancy, I had the worst lower back pain," says Mary Mait, a mother of two from Livingston, New Jersey. "It was so awful that I could barely sleep or drive. Luckily, it went away as soon as my son was born."
What Causes Back Pain?
Your uterus can expand up to 1,000 times its prepregnancy size -- this, plus carrying those extra pounds, can throw your body off balance. Your posture changes, causing strain in your back. "Also, your ab muscles are what support your back, and they're being challenged by the extra weight and the baby," Dr. Trupin says. "Plus, some pregnancy hormones make the ligaments in the body more lax during pregnancy and may cause a little bit of a swayback."
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Preventing Back Pain: What to Do
Apply heat in the form of a heating pad or a hot water bottle, or soak in a warm tub to soothe muscles.
Try to keep weight gain within the recommended range (25 to 35 pounds).
Put any high heels and very flat shoes in storage for the next nine months, and instead look for comfy shoes with good arch support. "And get rid of the flip-flops," Dr. Trupin says. "They have terrible support and are even worse for feet than high heels."
More Tips for Preventing Back Pain
To help alleviate pain, have someone else do the heavy lifting, but if you must lift packages and toddlers, use correct form: squat as you bend at the knees, keep your back straight, and lift with your arms.
You can also make a point to sit in chairs with good back support such as a firm cushion, or place a small pillow or rolled-up towel behind your lower back. Also, when you can, elevate your feet on a stool or bench.
Another tip: Sleep on your side with a pillow between your legs.
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"My feet looked like bread baskets, and my hands were so swollen that I couldn't wear my wedding ring for six months," recalls Carolyn Hepburn-Bozga, a mother of one from New Hyde Park, New York. This swelling (also called edema) in your hands, ankles, and feet typically crops up around the third trimester. It can happen at any time of day, but it often occurs in the afternoon or evening. Be forewarned that it can take up to two weeks postpartum to deflate to your old self.
What Causes Swelling?
In pregnancy, "there's lots of extra fluid accumulating in the body," Dr. Trupin says. Mild puffiness is common -- by some estimates, about 75 percent of women develop it. However, if your hands and face become swollen or if you have a sudden increase in swelling, see your doctor ASAP to rule out a serious medical condition such as preeclampsia (pregnancy-induced hypertension), which can have dangerous complications.
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Preventing Swelling: What to Do
Elevate your legs. Gravity tends to make fluid pool in your feet.
In warm months (when you're more apt to puff up), opt for air-conditioned rooms over the outdoors.
Wear supportive, comfortable shoes and support pantyhose or socks.
More Tips to Prevent Swelling
Try to avoid salty foods and drink at least eight 8-ounce glasses of water. "Yes, it sounds contradictory, but this actually helps you flush out your system," Dr. Trupin says. And eat foods that are natural diuretics like grapefruit and asparagus.
Coolness has also been shown to promote circulation, so hopping in a pool or a cool bath may feel fabulous. "I put my feet in cool, minty water at night when they were very tired, hot, and swollen," says Amber Wylie, a mother of one from Croton-on-Hudson, New York.
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Carpal Tunnel Syndrome (CTS)
This is pain, numbness, tingling, or burning in your fingers, palm, or wrist, or radiating up your arm. "For two of my pregnancies, carpal tunnel syndrome started in my second trimester," says Lisa Stone, a mother of three in Rockland County, New York. "I had that same tingling feeling you get when your hands are asleep, but I had it all the time!"
What Causes Carpal Tunnel Syndrome?
Though the American Academy of Orthopaedic Surgeons (AAOS) says that genetics is the most important factor, it's not the only one. "We have a ligament that is like a bracelet around our wrists called the carpal tunnel, and through it runs the median nerve, which goes from the forearm into the hand," Dr. Trupin says. "Swelling caused by weight gain and water retention puts pressure on this nerve." Repetitive motions -- for example, constantly lifting a toddler or typing -- can also cause CTS, which can happen in one hand or both.
Preventing Carpal Tunnel: What to Do
Talk to your doctor about getting a wrist brace (available at drugstores) that helps relieve pain, says Dr. Trupin.
Try this exercise from the AAOS: Curl fingers into a fist, and bend your wrist toward the palm. Then straighten fingers and stretch your wrist in the other direction. Do 10 reps at least once a day.
If you spend a lot of time on the computer, take frequent stretching breaks. Also, adjust your keyboard or get one with a cushioned support so wrists are in a straight (not bent) position.
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More Tips to Prevent & Manage CTS
Set your hands free. "I used to sleep with my hands under me, and the pain would be horrible when I woke up," Stone says. "When I stopped doing that, the tingling in the morning really improved."
Reduce water retention by decreasing your salt intake and by eating foods that are natural diuretics such as grapefruit and asparagus. "Less swelling may mean less pressure on the nerve," Dr. Trupin explains.
Pain and Cramping During Pregnancy: When to Worry
This pain can go from your lower back to your butt and down your hip and leg. It can also cause a feeling of numbness. "I had bad sciatica that started around the fifth or sixth month of my pregnancy," Wylie says. "It was a sharp, ever-present pain in my hips that radiated down the back of my legs."
What Causes Sciatica?
"Your growing uterus can change your posture and compress the sciatic nerve, which branches from the back through the pelvis to the hips and down your legs," says Jill Maura Rabin, MD, associate professor of clinical obstetrics and gynecology at the Albert Einstein College of Medicine, in the Bronx, New York.
Preventing Sciatica: What to Do
Consider prenatal yoga to prevent sciatica or ease its pain.
You can also try this exercise to relieve pressure on the sciatic nerve: Stand facing a wall; place hands on wall and lift your right leg behind you to the count of five; switch legs and repeat. Do three reps on each side at least once a day.
More Tips to Prevent Sciatica
Get into a girdle. "My doctor recommended a brace -- an elastic band that went around my waist and under my belly. It helped sooo much," Wylie says. (Braces are available at maternity stores.)
Again, heat may provide temporary relief. Try using a heating pad or hot water bottle, or soak in a warm bath.
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Luckily, these painful muscle contractions usually last for only a few minutes. They often happen at night during the second and third trimesters. "Extremely painful cramps in my calves would wake me," says Vikki Goldman, a mother of one from San Francisco. "They hurt so much that I'd have to bite on the pillow to avoid screaming out in pain."
What Causes Leg Cramps?
"There's extra blood and water in the veins during pregnancy," says Dr. Rabin. Also, "the hormone progesterone relaxes the vascular system, which means the veins get filled with fluid that can cause cramps."
Preventing Leg Cramps: What to Do
Stretching your feet and legs before bed may make muscles more flexible and reduce cramps. Try straightening your leg and flexing your ankle and toes slowly up toward your torso several times.
Both walking and leg massage can ease cramps. "When I'd get cramps, or even to prevent them before bed, I'd massage my leg," Goldman says. "It helped a little, and with that kind of pain every bit is worth it!"
Heat, from a heating pad or a hot water bottle, can loosen muscles and improve circulation.
More Tips to Prevent Leg Cramps
Try upping your intake of calcium and potassium, low levels of which are linked to cramps. Dr. Rabin suggests taking a calcium pill at night. "Just check with your doctor to make sure it's okay," she advises. For potassium, eat bananas or baked potatoes.
"Sometimes cramps are caused by a lack of oxygen in the muscles," Dr. Rabin says. "Deep breathing can help bring oxygen to the muscles."
And when all else fails, repeat the mantra "Nothing worthwhile in life is easy." It worked for me!
Copyright © 2008. Used with permission from the May 2008 issue of American Babymagazine.
Updated March 2010.
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