Causes of Pregnancy Related Pain
Because of the popularity of an earlier blog post, we have decided to explore in more detail the relationship of pregnancy and back pain.
To avoid being repetitive, here is a link to that earlier pregnancy and back pain article, where we describe the effects of hormonal changes and fluid retention on spinal joints and nerve tissue.
As mentioned in that article, many so-called "pregnancy related" pains are due to exacerbation of pre-existing problems and the best remedy is to look after yourself well all the time and not just whilst pregnant.
There are some causes of pain that can be attributed almost solely to the changes experienced throughout pregnancy and we will try to explain these here, as well as describing the kind of interventions that may help.
We are also fortunate enough to be able to offer specialist pregnancy care, as this is a particular clinical interest of one our chiropractors, Bethan Rawlings.
Fluid retention during pregnancy is a key factor when considering problems that may arise during term. This is a perfectly natural process and may cause some swelling of joints or extremities.
Note – if there is a sudden swelling this could be something called pre-eclampsia and may need treatment. If worried, speak to your midwife.
Fluid retention and minor swelling are important in a musculoskeletal context because it can predispose to trapped nerves and muscle pain.
Carpal tunnel syndrome is probably the most common trapped nerve type symptom, affecting approximately 60% of pregnancies.
Carpal tunnel syndrome results from compression of a nerve in your wrist and leads to pain, tingling or numbness, and sometimes weakness, affecting the palm of your hand. This can be on one or both sides.
There are exercises that may help with carpal tunnel syndrome, most being centred around moving the wrist. Compression gloves are also a useful remedy but, if symptoms are persistent, manual therapy may be helpful for releasing the nerve where it passes between muscles and through your wrist.
Another complication of fluid retention is known as myositis. This technically means "inflammation of muscle tissue", but in this context means generally very achy muscles. This can affect your whole body and may feel slightly flu like.
Stretching and massage can be very helpful at dealing with these symptoms, and general activity, particularly cardiovascular exercises like swimming and walking/running, is tremendously beneficial.
Sometimes fluid retention can lead to a bruised sensation affecting specific joints, usually in the spine. The spinal joints are very closely packed and any swelling can exert a pressure on pain sensitive nerves in-between the joints.
This type of pain generally can be relieved by manipulation, which affects the ability of those nerves to transmit pain. Manipulation involves very small stretches of joints, one at a time. These stretches are done very rapidly, and it is the speed that affects the nerves.
Manipulation is very safe for pregnant patients and is usually entirely painless, although sometimes getting into position can be painful if you are in discomfort already.
At Worcester Chiropractic Clinic we have special aids for pregnant patients that make lying down and moving around more comfortable, and we have a number of tools that mean we can carry out manipulation in a variety of ways to suit each individual.
Other causes of pain for pregnant patients relate to adaptations of the pelvis and its junction with the spine.
The additional load of carrying the foetus often results in "anterior pelvic tilt". This causes compression of the joints at the very bottom of the spine, which can be relieved with manipulation and stretching.
Anterior pelvic tilt can also strain the sacroiliac joints. These joints are responsible for distributing load evenly to and from the lower limbs, and any postural shift can markedly affect their ability to do this. Often, the result is pain and stiffness around the back of the pelvis.
The sacroiliac joints are fairly complex and require a very in depth analysis before deciding on the best treatment modality and implementation. Manipulating this area without proper assessment can result in significantly more pain.
Sometimes both sacroiliac joints may be causing pain, at which point the label Pregnancy-Related Pelvic Girdle Pain (PPGP) is often used. PPGP may, or may not, come with pain around the pubic bone.
If pain around the pubic bone is felt in the absence of any other pelvic pain it is often labelled symphysis pubis dysfunction (SPD).
SPD can be relieved by using exercises, stretching and manual therapy.
Often SPD and PPGP will recur throughout pregnancy and may last a short while after giving birth, but supportive care throughout pregnancy is very helpful at limiting the impact of bouts of PPGP/SPD and preventing lasting problems.
It is important to realise that most causes of pain during pregnancy are entirely normal and do not have any lasting consequences. Having said that, it is a time of immense mechanical strain and chiropractic treatment can be very useful for helping your body cope.
To find out if our chiropractors can help, please contact us