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Pain During Pregnancy?

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Are you suffering from pain throughout your pregnancy?

Understand your body and find out what physiotherapy can do to help!

Pregnancy should be a memorable and joyous time; however the reality is that 71% of women experience lumbopelvic pain (LPP) that may have very little impact or be completely debilitating. The disheartening thing is that most women (70%) believe that LPP is to be expected with pregnancy, with only 25% seeking treatment. Whilst low back pain and pelvic girdle pain is common amongst pregnant women, physiotherapy treatment can help manage your pain and support you so that you can enjoy the remainder of your pregnancy.

 

But, why is LPP so prevalent during pregnancy?

Pregnancy stimulates a number of changes within the body including biomechanical, hormonal, vascular and psychological changes.

  • The increased weight positioned at the front of the body when carrying a child shifts the body’s centre of gravity (COG) forwards. Postural changes are adopted to compensate for this altered COG, causing your back to extend (lumbar lordosis) in order to maintain an upright position. This postural adaptation places a larger stress on the lumbar spine which may contribute to low back pain.
  • The abdominal muscles stretch to accommodate an enlarging uterus. As a result, their function in maintaining body posture is reduced, placing more stress and reliance on the lower back for support.
  • A hormone called ‘relaxin’ is believed to increase production ten-fold during pregnancy, causing ligaments to become lax and pliable, reducing the stability of the pelvis and lower back.
  • Vascular supply is altered throughout pregnancy. The growing uterus, in conjunction with increased fluid retention that occurs during pregnancy, may compromise the blood supply and lead to hypoxia (absence of sufficient oxygen) in the pelvis and low back.

All these changes within the body can cause a variety of symptoms including pain, stiffness, instability, poor bladder control, tight muscles, sciatica and more.

 

Suffering from LPP during pregnancy is NOT inevitable and it does NOT have to stop you from enjoying your pregnancy.

 

So, how can physiotherapy treatment help you?

There are a range of different treatment options that can help reduce your pain, increase your support and provide you with some comfort throughout your pregnancy. Treatment varies on the individual and their presentation but can include:

  • Joint mobilisations
  • Dry needling
  • Massage
  • Physical Activity/Exercise e.g. walking, strengthening, stationary cycling
  • Pelvic floor exercises – to increase the support of the womb and speed up post-birth recovery
  • Hydrotherapy/swimming
  • Activity modification/postural advice
  • Belts and compression shorts

 

A combination of the above is most effective in providing support for both you and your child throughout the duration of your pregnancy.

 

Want to know more about some of these treatment options? Read below:

 

Joint mobilisations – Due to the postural changes mentioned above, increased load is directed through the joints in the lower back, which may cause them to become compacted and stiff. Providing gentle mobilisations to your low back joints whilst either side lying or lying face down on our comfortable pregnancy belly pillow, may help relieve compression, improve movement and provide some pain relief.

 

Dry needling – Although needling may sound daunting at first, it is completely safe to perform in the back, buttocks and legs. Dry needling works at reducing muscle tightness by increasing the blood flow to the area, flushing away all the ‘nasties’ and restoring muscle length. It can be a great tool to help provide pain relief and reduce muscle tightness.

 

Massage – Similarly to needling, massage helps to reduce muscle tightness. It can also help to reduce swelling of the feet, legs and arms which commonly occurs as a result of increased fluid retention during pregnancy. Massage can help reduce stress and relieve muscle and joint pain. Here at PhysioWest we are fortunate enough to have our very own in-house massage therapists who we work in collaboration with to ensure the best results for both you and your baby.

 

Exercise – Whilst massage can help provide temporary relief, it is important to compliment it with exercise and/or strengthening. As the ligaments soften causing the pelvis and low back to become less stable, there lies an increased need to strengthen surrounding core, hip and back structures to compensate for this reduction in pelvic stability. Strengthening the abdominal, glute and back muscles reduces the risk of further pregnancy-related back pain and also makes for a speedy post-natal recovery. Through assessment, we can identify any areas that require strengthening and create an individualised and safe program for you to perform throughout your pregnancy. Low impact physical activity such as walking, swimming or pregnancy specific exercise classes can help prevent excessive weight gain, reduce risk of gestational diabetes and enhance fitness/strength to cope with labour.

Pelvic floor exercises are also important to consider here. Strong pelvic floor muscles help support the growing weight of the baby, reduce stress incontinence (urine leakage during a cough/sneeze) and speed up post-natal recovery.

 

Hydrotherapy/swimming – Can help relieve pain as the buoyancy of the water reduces the pressure on the joints and muscles of the lower back and pelvic floor. Higher impact land-based exercises that are advised against during pregnancy such as jogging and jumping, can be performed safely in the water. Strengthening exercises can be performed in the water to increase the support of surrounding structures whilst relieving pressure on the joints. Another benefit of exercising in the water is a reduction in fluid retention and swelling associated with pregnancy.

 

Advice – We can provide our professional opinion and recommend advice regarding pain relief, activity modification and postures to help relieve your pain, symptoms and provide you the most support throughout your pregnancy. Using heat packs on the low back and buttock muscles can help reduce muscle tightness and provide pain relief for those during pregnancy. Avoiding prolonged sitting and getting up and moving regularly can reduce pain, discomfort and excessive weight gain which may lead to pregnancy complications.

 

Belly bands, belt and compression garments – These pieces of clothing can be effective in providing support and relief during pregnancy.

SRC are the leading brand in Australia for pregnancy compression garments and are highly recommended by obstetricians and specialists around the nation. They provide a range of different garments including mini shorts, over the bump shorts and leggings.

They may provide comfort, support, improve sleep, reduce vulval varicose veins and swelling, improve walking, improve sciatic nerve pain and reduce low back and pelvic girdle pain. The compression activates your muscles which promotes better core and pelvic stability.

Research shows that 82% of women who wore SRC pregnancy shorts or leggings reported a reduction in their discomfort and increase in support.

You may even be eligible to claim for health fund rebates as SRC products are classified as medical compression garments, designed to aid with the recovery and health of expectant and new mothers.

 

Book in with one of our female physiotherapists, Zoe, Lauren or Sophie to help create a management plan for you.

 

This is an amazing time that should be celebrated and cherished, so let us help you have an enjoyable pregnancy!

 

Sophie Alderslade

Physiotherapist – PhysioWest

References
George, J.W, Skaggs, C.D, Thompson, P.A, Nelson, D.M, Garvard, J.A & Gross, G.A 2013, ‘A randomized controlled trial comparing a multimodal intervention and standard obstetric care for low back and pelvic pain in pregnancy’, American Journal of Obstetrics and Gynecology, vol. 208, no. 4, p. 295, doi: 10.1016/j.ajog.2012.10.869.
Health Direct 2019, Pregnancy massage, Health Direct Australia, <https://www.healthdirect.gov.au/pregnancy-massage>
Jean Hailes 2017, Pregnancy and Weight, Jean Hailes for Women’s Health, <https://jeanhailes.org.au/health-a-z/fertility-pregnancy/pregnancy-weight>
Jessica Pratley 2020, Hydrotherapy and pregnancy, LifeCare, <https://www.lifecare.com.au/clinic/lifecare-southcare/news/hydrotherapy-and-pregnancy/>
Pierce, H, Homer, C.S.E, Dahlen, H.G & King, J 2012, ‘Pregnancy-Related Lumbopelvic Pain: Listening to Australian Women’, Nursing Research and Practice, vol. 2012, no. 387428, <https://www.hindawi.com/journals/nrp/2012/387428/>
Pregnancy Birth and Baby 2018, Pelvic Floor Exercises, Health direct, <https://www.pregnancybirthbaby.org.au/pelvic-floor-exercises>
Queensland Health 2019, What you should know about your pelvic floor: pre-pregnancy, during pregnancy and after giving birth, Queensland Government, <https://www.health.qld.gov.au/news-events/news/pelvic-floor-pre-during-pregnancy-birth-exercises-physiotherapist>

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