Pregnancy - Aches and Pains
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The commonest of all pregnancy ‘aches and pains’. Most low back in pregnancy is caused by changing biomechanics, especially weakening abdominal muscles. This provides progressively less support for the lumbar spine. |
Causes: |
Some back pain is positional, due to poor postures (standing, as well as sitting).
Other low back pain is directly related to decreasing stability. Proper assessment is essential to correct the dysfunction. |
Presentation: |
Pain in the lower back, may be one sided.
May be worse with particular movements, but usually worse with sustained positions. |
Note: If you have a chronic (pre-existing) back condition (e.g. slipped disc) you should expect it to get worse. With proper management, you should be able to keep it well controlled. If planning a pregnancy, get your back assessed BEFORE you start showing (i.e. before baby starts growing and putting pressure on the abdominals and lumbar spine). |
| Groin Pain (Symphysis Pubis Dysfunction - SPD) |
| The most debilitating of all pregnancy related pains. |
| Causes: |
Poor stability at the pubic symphysis (the pelvic joint at the front, under the pubic hair).
May be due to ‘gapping’ of the symphysis, but may also be caused by a slightly unstable joint without any actual joint widening. |
| Presentation: |
Pain is often felt when moving from a still position.
It is ‘jarring’ or ‘stabbing’ and may be so severe as to prevent movement, leaving you frozen.
It may be central, or one sided. It is known to refer down the inside thigh, across the lower abdominals, and even extend back into the vagina. |
Note: SPD can be extremely debilitating. Seek early appropriate medical assessment and advice by specialist. Once the pain is present it is very difficult to treat. |
| Buttock Pain (Sacroiliac Joint Dysfunction – SIJ Dysfunction) |
A sharp pain in the buttock. Often, women want to push on the buttock to ‘hold’ it. |
| Causes: |
Poor stability at the sacroiliac joints (SIJs). |
| Presentation: |
Pain commonly felt in buttocks, usually with walking (stairs worst), or standing on one leg (getting dressed).
May also be present if sitting asymmetrically. |
Note: SIJ dysfunction is a sign that all is not stable in the pelvis. Beware ignoring it; lest it develops into SPD (see above). |
| Mid Back Pain (Thoracic Pain) |
Mid back pain is usually due to poor sustained sitting postures, but may also be due to rapid breast development. The shoulders tend to round, and we ‘hang’ on our mid backs. |
| Causes: |
Pain due to pulling and stretching of mid back muscles and other tissues. |
| Presentation: |
Progressive mid back ache, may refer up into neck. |
| Rib and Breastbone Stress (Rib and Sternal Dysfunction) |
From 36 weeks, many women will complain of an ache, or shooting pain, around the sternum (breastbone). This is due to the increased pressure across the joints between the sternum and ribs. |
| Causes: |
| The ribs ‘bucket handle’ upwards (as they do with a deep breath in) and cant come back down, due to baby. |
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| Presentation: |
A dull ache, or sharp shooting pain around the ribcage, most commonly felt where the ribs join the sternum at the front (between the breasts). |
Neck Pain |
Most common post-natally, with breastfeeding….
Usually secondary to poor sitting postures.
May be accompanied by headaches. |
Separated abdominal muscles (Diastasis Abdominis Rectalis – DAR) |
The line down the middle of the 6 pack (Rectus Abdominis) unzips, causing doming when doing sit-ups, or in the bath! |
| Causes: |
The softening effect of relaxin, coupled with abdominal work that exceeds the body’s ability to keep ‘zipped up’. |
| Presentation: |
A dome or 'church roof' running up the middle of the tummy. |
Note: if your muscles have unzipped in 1 pregnancy, they will unzip in the next. Treatment occurs post-natally, and needs to be undertaken within the 1 st 6 months of delivery. |
Other |
Pain is your body’s way of telling you that all is not well. LISTEN to your body. Pushing through pain may get you through the day, but it won’t get you through the pregnancy. |
If pain is associated with decreased foetal movements, or fluid loss from the vagina SEEK IMMEDIATE MEDICAL ATTENTION. |
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