Physical Therapy Can Help with THAT? Part 1: Pain in Pregnancy

“But isn’t it just NORMAL to be uncomfortable in pregnancy??” Ok, yes, you may be running extra warm or feel nauseous, or have difficulty catching your breath sometimes, or have heartburn...but I refuse to believe that women should suffer through all that discomfort in addition to musculoskeletal pain as well. That’s where physical therapy comes in - YES, there’s a solution!


Low Back Pain During Pregnancy:

The bigger the belly gets, the more it pulls on the lumbar spine, causing it to arch more. This is completely normal in pregnancy, but can cause some pain or discomfort if not treated appropriately.

The bigger the belly gets, the more it pulls on the lumbar spine, causing it to arch more. This is completely normal in pregnancy, but can cause some pain or discomfort if not treated appropriately.

66% of pregnant women experience low back pain during their pregnancy, usually increasing in prevalence and severity as the pregnancy progresses. This can be caused by an increased arch in the low back (increased lumbar lordosis), weakness in the core and glute muscles, and/or tightness in the low back muscles. Physical Therapy treatment (including manual therapy, exercise, and activity modification) has been shown to improve symptoms of low back pain during pregnancy.

Sample PT treatment would include: manual work on muscles of low back and hips that are tight, strengthening exercises for core, hips, glutes, and pelvic floor muscles, and instruction on how to perform daily activities in better ways for your body to avoid more injury.

Pelvic Pain During Pregnancy:

This photo shows nicely that as the baby grows, it puts a lot of pressure on all the bones of the pelvis, especially the front (pubic symphysis).

This photo shows nicely that as the baby grows, it puts a lot of pressure on all the bones of the pelvis, especially the front (pubic symphysis).

20% of pregnancy women experience pelvic pain during their pregnancy. Pelvic pain can be felt both in the back of the pelvis (the SI joints) or the front of the pelvis (the pubic symphysis). This can be caused by the extra weight of a growing baby on top of the pelvis as well as weak and/or tight hip and glute muscles. Physical Therapy (including manual therapy, exercise, activity modification, and support belts) and Acupuncture have been shown to improve symptoms of pelvic pain during pregnancy.
Sample PT treatment would include: manual treatment of adductors (inner thigh muscles) because they attach to the pubic symphysis and can pull on it, manual treatment of other hip and/or low back muscles that are tight, gentle strengthening of core and glute muscles, instruction on how to avoid aggravating the pubic symphysis and/or SI joints during daily activities.


Midback Pain During Pregnancy:

You can see the increased curve in the upper mid back (thoracic spine) to compensate for the increased curve in the low back.

You can see the increased curve in the upper mid back (thoracic spine) to compensate for the increased curve in the low back.

Every force has an equal and opposite reaction, right? This applies to the body as well. We already talked about how the lumbar spine (low back) arches more than normal as the pregnancy progresses, in order to balance the rest of the body out, the upper back (thoracic spine) has to curve more as well. So, you end up with a more flexed upper back which can also cause some pain in that region. This pain can be exasperated if you work at a desk or sit for most of the day. Guess what? Physical Therapy treatment can help with this too.

Sample PT treatment includes: gentle mobilization of the thoracic spine so it doesn’t get stiff in that flexed position, manual treatment of tight shoulders/upper back/neck muscles, stretching of pec muscles, strengthening of upper back and shoulder muscles.

Carpal Tunnel Syndrome During Pregnancy:

An example of a common exercise to help with carpal tunnel syndrome: the median nerve glide.

An example of a common exercise to help with carpal tunnel syndrome: the median nerve glide.

Carpal Tunnel Syndrome during pregnancy is usually caused by swelling in the hands/arms that puts pressure in the nerves in the Carpal Tunnel. It usually resolves after delivery, however, exercises have been shown to improve symptoms prior to delivery! Physical Therapists can also suggest the proper wrist splints and/or kinesiotape to help support the wrist.

A sample PT treatment includes: manual tx to tight wrist and forearm muscles, trials of wrist splits and kinesiotape, exercises and stretches to relieve as much nerve irritation as possible, ice to decrease swelling.

Urinary Incontinence During Pregnancy:

About 38% of pregnant women suffer from urinary incontinence during pregnancy. A lot of times, it lingers after delivery as well. Why not nip it in the bud during pregnancy? Pelvic floor strengthening exercises have been shown to help decrease the severity of urinary incontinence during pregnancy and afterwards!

A sample PT treatment includes: instruction on how to perform a proper kegel (pelvic floor muscle contraction and relaxation), pelvic floor/core/glute/hip strengthening exercises, education on the bladder and pelvic floor.

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Whatever problem you’re having during pregnancy, chances are, physical therapy can help! So you don’t have to go through 40 weeks of pain and discomfort! Contact me today for your free phone consultation to see what I can do for you!



Resources:


  1. Liddle  SD, Pennick  V. Interventions for preventing and treating low‐back and pelvic pain during pregnancy. Cochrane Database of Systematic Reviews 2015, Issue 9. Art. No.: CD001139. DOI: 10.1002/14651858.CD001139.pub4.

  2. Low Back Pain and Pelvic Girdle Pain in Pregnancy Casagrande, Danielle MD; Gugala, Zbigniew MD, PhD; Clark, Shannon M. MD; Lindsey, Ronald W. MD JAAOS - Journal of the American Academy of Orthopaedic Surgeons: September 2015 - Volume 23 - Issue 9 - p 539–549 doi: 10.5435/JAAOS-D-14-00248

  3. Effectiveness of home exercise in pregnant women with carpal tunnel syndromeKiliç, Gökhan; Keskin, Yasar; Taspinar, Özgür; Posul, Sevde Özer; Halaç, Gülistan; et al.Journal of The Turkish German Gynecological Association, suppl. Supplement 1; Istanbul Vol. 17,  (May 2016): S320.

  4. Daly, D., Clarke, M. & Begley, C. Int Urogynecol J (2018) 29: 353. https://doi.org/10.1007/s00192-018-3554-1