Lumbar pain or Lower Back Pain (LBP) occurs in the area of the lumbar vertebrae in your lower back, and posterior pelvic pain (PPP) is felt in the back of your pelvis. Some women have symptoms of both types of low back pain. Another problem that can occur in pregnancy is Sciatica. Sciatica refers to nerve pain that shoots rapidly down from the buttocks and down one leg, ending in the foot. True Sciatica is extremely rare in pregnancies affects only about 1% of pregnancies. It is either caused by a herniated disc (the cushioning between vertebrae bulging into the spine) or very rarely by uterine pressure on the sciatic nerve.
A history of pelvic trauma, chronic low back pain and low back pain during a previous pregnancy are the most common and widely accepted risk factors for getting back pain during pregnancy. Eighty five percent of women with back pain in a previous pregnancy develop back pain in a subsequent pregnancy. The number of previous pregnancies also seems to increase the risk. It is not possible to estimate the risk, or to predict who will suffer from LBP during pregnancy, however, women with a history of LBP before pregnancy, are most likely to suffer from more severe pain and of a longer duration after childbirth. LBP during menstruation is an additional risk factor for pregnancy related LBP. Excessive body weight may also be a risk factor for LBP during pregnancy.
A history of pelvic trauma, chronic low back pain and low back pain during a previous pregnancy are the most common and widely accepted risk factors for getting back pain during pregnancy. Eighty five percent of women with back pain in a previous pregnancy develop back pain in a subsequent pregnancy. The number of previous pregnancies also seems to increase the risk. It is not possible to estimate the risk, or to predict who will suffer from LBP during pregnancy, however, women with a history of LBP before pregnancy, are most likely to suffer from more severe pain and of a longer duration after childbirth. LBP during menstruation is an additional risk factor for pregnancy related LBP. Excessive body weight may also be a risk factor for LBP during pregnancy.
Pregnancy related low back pain affects women’s lives dramatically. Most women consider LBP as an inevitable, normal discomfort during pregnancy. Only 50% of women suffering from pregnancy related LBP seek advice from a health care professional and only 70% of them receive some kind of treatment. LBP and PPP should be diagnosed and differentiated early, since the treatment is different for each condition. Taking into consideration the individuality of every woman and pregnancy, early identification and treatment will lead to the best possible outcome.
Conservative management is the most preferred mode of treatment including physiotherapy, stabilization belts, oil application, ayurvedic massage, relaxation, and yoga and ayurvedic herbal medication. Most painkillers are not to be used by pregnant women. Weight loss during postpartum and prevention of weight gain may help to prevent the risk and the severity of LBP.
Although it is rather difficult to prevent LBP completely, it is very important that future mothers, follow some precautionary measures so as to reduce the possibility of suffering from pregnancy related Low Back Pain (LBP).
Pregnant women should take care to maintain a proper posture, while doing everyday activities, so that their back is not overloaded and misaligned. That can be easily performed if practiced and can be enhanced by aerobic or physiotherapy exercises, preferably before pregnancy. It is also very important for women to learn how to lift weights without stressing their backs, a habit that can be proven very useful throughout pregnancy. Women should use proper seats with back support, beds which support the back and do not sag (full foam beds are not advisable). They should also adopt the right technique for getting in and out of bed (should roll to the side and raise up with the support of the hand) so that the body maintains a proper position and the spine is supported and not stressed.
Ayurveda very strongly recommends a number of practices to prevent back pain in pregnant women both during and after pregnancy. They are, regular exercises, applying warm medicated oil (DhanwantaramTailam) on the body and waiting for some time before having the dailywarm bath. Preventing flatulence and gas in the abdomen by taking aherbal formulation called Mahadhanwantaramgulika (this is also called GarbharakshaGulika- meaning tablet to protect the pregnancy)along with avoiding constipation is also an important component in preventing back pain. Certain herbal medications like Dhanwantaram(101) and Dhanwantaramkashayam or its tablet form are also recommended after delivery to prevent back pain and to strengthen the back after delivery.
