Back and Hip Ache are very common complaints both during and after pregnancy. As your abdominal muscles stretch, they may no longer be able to keep your pelvis in its correct and most comfortable position. As your tummy gets bigger you will notice that you may begin to arch your back to compensate for this, thus titling your pelvis forward. This can lead to lower back pain and is very common especially in late pregnancy.
You need to engage your stomach muscles to protect your lower back. Even though it might seem like an odd concept, try pulling your stomach muscles in, as if you want to appear thinner and taller! This will immediately straighten your body out, and if repeated frequently, like every time you remember, will tone these stomach muscles, and help to protect your back.
When you are lying down, do not attempt to get up by straining on your stomach muscles. Instead, roll to the side and use your arms. Make sure you do this in the bath too. In late pregnancy you will find it very hard to get out of the bath unless you roll onto your side.
When rolling over in bed, keep your knees together and engage your tummy muscles to prevent jarring your hips.
When bending down or lifting, make sure you always bend your knees. It may seem like more work at the time, but will save your back in the future.
Symphisis Pubis Dysfunction SPD (also known as Pelvic Girdle Pain)
If you experience any of the following symptoms, hip pain, a grinding sensation in your pubic area, a knife-like stabbing pain up the vagina, pain down the inside of your thighs that gets worse when moving, inability to turn over in bed, you could have Symphisis Pubis Dysfunction -known most commonly as SPD. This is pain around the pubic joint due to the separation of the pelvis. This is a natural phenomenon which occurs as a result of the secretion of certain hormones in late pregnancy which relax the ligaments between the two sides of pelvis. It is thought to happen because the bony part of the birth canal is starting to open to assist in childbirth. There are no predictive factors in this condition except previous history of SPD. Sadly, there is not a lot you can do to remedy this situation. Treatment is available in the form of physiotherapy. Some hospitals will give you a girdle to help hold your hips in place, but many patients report little or no relief from either of these options. It is best to avoid activities which aggravate your pain. You will quickly learn what these are. You must learn how to turn over in bed and how to get out of bed whilst minimising the pain. If you continue to swim with SPD, this is not a problem, just don’t do breaststroke.
Sciatica is the result of compression or irritation of the sciatic nerve. This nerve runs through your pelvis, through your buttocks and down through your legs to your feet. When something irritates this nerve, you may feel a pain that starts in your lower back and perhaps travels down your leg. This pain range from mild to severe and can even be debilitating. In other cases, you may not even feel any back pain, just an uncomfortable tingling, like pins and needles down your leg. One of the casues of Sciatica is a slipped or protruding disc and despite popular belief, you are not more prone to this whilst pregnant. It may be that you would have developed Sciatic anyway, but perhaps feel more aware of certain aches and pains as you and your baby get bigger. In many cases, suspected Sciatica can turn out to be SPD
If you are suffering from Sciatica during your pregnancy you should speak to your midwife who may be able to refer you to a physiotherapist who will show you some exercises to strengthen your muscles to support your back. You may be given a support belt to wear which works well for some women but not for others.
A hot or cold pack on the aching site can help, and is very safe during pregnancy.
Gentle stretches and swimming can also help relieve to pressure.
Whilst remaining physically active can help Sciatica, sitting down and getting the weight off your feet from time to time can also relieve the pain.
You should not take anti-inflammatory drugs such as ibruprofen whilst you are pregnant.
In most cases, Sciatica is just a temporary annoyance, lasting up to 6 weeks, but it for some people it can be a more chronic problem. If it lasts beyond your pregnancy you should seek help from your GP who may send you for a scan to check you have not slipped or damaged a disc.
If you develop significant weakness, loss of sensation or numbness this may indicate that the nerves may be compressed and is an indication for and urgent medical opinion. Another serious symptom is that of difficulty or inability to pass urine. This again needs urgent expert assessment.