During the second half of my pregnancy, I surely said "rub my back" to my husband more often than "I love you." I'm 5'2", and my stomach was nearly as wide as I was tall. My back was paying the price for my rapidly increasing circumference. Fortunately, my husband's healing hands would temporarily ease the pain, but just like my in utero son's daily hiccups, the throbbing would return like clockwork the next day. I complained to friends, and they just nodded their heads with knowing sympathy.
"Somewhere between 50 to 80 percent of all women experience hip and back pain during their pregnancy," says Ronald J. Tyszkowski, chiropractic physician, founder of Pregnancy-Related Low-Back Pain Clinic at the Women & Infants Hospital of Rhode Island, in Providence. While my back pain was a normal pregnancy side effect, which I managed with pillows, exercise, and massage, there are a few more complicated, yet still common, hip and back pregnancy-related conditions. We spoke with the experts to discover the three most frequent ailments as well as advice on how you can cope.
"Whenever I tried to stand up from a seated position, and especially when I tried to get out of bed, I felt a lot of soreness in my left hip -- to the point where I'd limp around for a few minutes or more," says Alexa Young, of Encino, California, mother of Jack, 2 months. "It sort of felt like a pulled or cramped muscle, and it would migrate around to the lower back a bit." Indeed, sacroiliac joint pain (SJP) usually feels like a sharp jolt on either side of your back or hips that might extend down your legs. "A lot of women think they have sciatica," says Tyszkowski, "but it's sacroiliac pain." Unfortunately, because the two ailments might feel similar, you should see a doctor to determine the root of the problem. The difference: Sciatica stems from nerve compression while SJP is joint-related.
SJP is the most common back complaint and typically flares up in the second trimester. "The sacroiliac joint is where the spinal column meets the pelvis," explains Robert Atlas, MD, chairman of obstetrics at Mercy Medical Center, in Baltimore. "During pregnancy, hormones cause the joints to relax, which may make you favor one side over the other," says Susan Warhus, MD, author of Countdown to Baby: Answers to the 100 Most Asked Questions About Pregnancy and Childbirth (Addicus Books). "This may lead to inflammation." And further pain.
Young eased her pain with warm (not hot!) baths and pain relievers such as Tylenol. These therapies are a good starting point, as long as you keep the water under 100 degrees (anything hotter can affect the fetus) and check with your doctor about any medication beforehand, Dr. Warhus says. Another option: See a prenatal chiropractor, who can perform a spinal adjustment to help correct your weight imbalance. If the cause is hormonal fluctuation, you can expect the pain to subside after delivery.
Lumbar spine pain (LSP) is an achiness that spreads throughout your central lower back, and unlike the general lower-back pain that I (like many others) experienced as my stomach expanded, LSP usually begins in the first or second trimester. "Why does this happen then? Honestly, we don't yet know," says Tyszkowski. "But my best guess is that a lot of these patients have preexisting problems that flare up due to the physical changes that occur during pregnancy." Not sure if you have LSP or SJP? There is typically very little hip pain involved in LSP, and you won't feel it on one side or the other: This baby hits you smack in the middle. Because LSP can be hard to diagnose, if you're in pain, see your doctor.
If you're predisposed to lower-back problems, you're at greater risk, says Tyszkowski. "It's not that uncommon to see a spontaneous onset of lumbar spine pain." Because your back already gives you grief, your body is more likely to be thrown out of whack due to changing body mechanics. "The abdominal muscles stretch and the center of gravity is shifted forward due to the growing uterus," says Dr. Warhus. "This causes a big strain on the back musculature."
After getting your doctor's okay, turn to some tried-and-true techniques. Carolyn Brann, of San Francisco, mom to 1-year-old Lily, soothed her pain with prenatal yoga, a remedy Dr. Warhus recommends as well. "The cat-cow stretch was the most effective," says Brann. You can perform 10 to 15 reps of this pose once a day by getting on all fours and alternately arching and rounding your back while inhaling and exhaling. Finally, if possible, modify your routine: The longer you're on your feet, the more severe the pain may be since the stress of carrying that extra weight can cause back strain and poor posture.
Sciatica rears its ugly head by sending sharp, knifelike pains down your butt, legs, and thighs. Luckily, only 1 percent of all moms experience it.
Unfortunately, whether you develop sciatica (or not) is the luck of the draw. As your little one grows inside of you, his head can press against the sciatic nerve and cause bulging or herniated disks, which means a serious "ouch!" for you.
"I tell women to sit on a tennis ball on a hard surface" says Dr. Warhus. "It provides a deep massage and helps ease the pain. Maternity massage also works well." And while you might not be able to prevent sciatica once it occurs, you'll manage your pain more easily by staying in shape and avoiding excess weight gain, says Dr. Atlas.
Of course, we all know that back and hip pain can be tough to manage. But here's the good news: It's all temporary. My discomfort melted away after birth, leaving me with a beautiful bundle as my sweet reward.
A lot of pregnant women assume that backaches are simply part of the nine-month program. Soreness might be. Extreme pain is not. Call your doctor if you experience any of the following:
Not sure if standing in stilettos will have you grimacing in pain? (Tip: It will.) Here's a handy list of what to skip if your back is aching:
Allison Winn Scotch is a writer in New York City.
Originally published in the June 2006 issue of American Baby magazine.
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