Pregnancy Pain and Physiotherapy Treatment
It is well researched that most women at some stage during their pregnancy or after giving birth will experience some element of musculoskeletal type pain. These symptoms are often accepted as normal and not referred for any further intervention. More emphasis is now being placed on pre and post-natal care and women’s health and the options available to women. This blog hopes to highlight the importance of early intervention and common types of pain and symptoms experienced by women. It also hopes to highlight that physiotherapists can help to ease these symptoms and give good advice and treatment. Pregnancy pain and physiotherapy treatment are linked in that the former can be eased by the latter.
Common injuries associated with pregnancy:
1. Lower back pain
2. Sciatic nerve pain
3. Pelvic girdle pain (PGP) and pubic symphysis dysfunction (PSD)
4. Incontinence (involuntary leakage of urine due to weak pelvic floor muscles)
5. Postural dysfunction
6. Pelvic organ prolapse
7. Diastasis rectus abdominis (a separation of the abdominal wall after birth)
Risks for developing injuries:
1. Prior history of lower back pain
2. Prior trauma to the pelvis
3. Poor posture
4. Mixed evidence for obesity
5. Mixed evidence for job type, especially if physically demanding or sedentary
6. Hypermobile joints and multiple births
Signs and Symptoms of pain and when to seek treatment:
1. It is reported that 33% of women begin to get pain at the front or the back of the pelvis in weeks 14-24, early labour or postpartum.
2. Pain radiating down the leg.
3. Pain in the lower back is very common in the first pregnancy and 85% chance in subsequent pregnancies. Discomfort usually begins in months 5-7, but can be earlier.
4. Difficulty with sit- stand, turning in bed, going up or down stairs, getting in and out of a car or walking.
5. Pain can prolong after birth, and is reported to continue 18 months post-partum.
Physiotherapy treatment options:
1. Pelvic floor education, and teach the activation of the pelvic floor
2. Pilates based exercises targeted to your needs. It has been demonstrated that 12 weeks of an exercise program has prevented lower back pain at 36 weeks. We recommend that patients no more that 20 weeks pregnant can complete our Pilates classes (click here for more information)
3. Water based exercises
4. Manual therapy and massage
5. Able to measure and assess the diastasis post-partum and give advice and/or exercises as required
6. Postural assessment and education
7. Advice with positioning
8. Educate if a belt or garment needs to be worn or in some cases if crutches or a wheelchair is needed in severe cases of pain
9. Relaxation and breathing techniques shown
10. General advice and education
In summary, as documented above women can experience all types of issues during or after pregnancy. It has been documented that those who seek early intervention report having less time off work with aches and pains during pregnancy. Treatment can also improve physical and psychological quality of life and improve the outcome for further pregnancies and post partum function. Pilates classes are starting in January 2017 at Beginners, Maintenance and General level in our