Low back pain in pregnancy although common, should not be viewed as a normal part of pregnancy to be ignored.
Low back pain during pregnancy is very common. It affects about 60% – 70% of pregnant women. The pain is generally located at the area below the rib cage and above the sacrum (the large triangular bone that forms the base of the spine). Pregnancy-related low back pain is characterised by a dull pain that is often aggravated by prolonged standing or sitting in one posture. This type of pain may be accompanied by stiffness and limited motion in the back. Tenderness is often present in the muscles along the spine.
Pregnancy-related low back pain can occur as early as the first trimester of pregnancy, but usually begins between the 5th and 7th month of being pregnant, as the influence of postural change and body weight becomes more significant during this time. Women who have a history of low back pain before pregnancy, and those who are involved in physically strenuous jobs are at a higher risk of developing the condition, and the onset of their back pain can occur earlier in the pregnancy.
What causes low back pain in pregnancy?
1. Pregnancy Hormones
During pregnancy, the increased production of the hormones progesterone and relaxin relax the muscles and causes the ligaments that support the spine and the pelvis to become loose. This results in instability of the pelvis and the spine, which in turn puts more stress on the low back area, leading to low back pain.
2. Pregnancy Weight Gain
As pregnancy progresses, weight gain during pregnancy becomes a contributor to low back pain. The additional weight gained increases the load on the spine and the pelvis. The enlarging uterus also causes a shift of the centre of gravity forwards, increasing the strain on the lower back. To compensate for this additional load, pregnant mothers tend to arch their lower backs to maintain stability and balance, placing additional stress on the lower back. In addition, the abdominal muscles stretch to accommodate the growth of the uterus, and in doing so they become weakened and are less able to help support the increased weight and maintain proper alignment of the spine. This increases back strain and pain.
From pregnancy low back pain, to postnatal chronic back pain
Low back pain in pregnancy although common, should not be viewed as a normal part of pregnancy to be ignored. Left untreated, prolonged low back pain in pregnancy may persist after childbirth, turning into chronic low back pain. Early assessment and treatment can help ensure a pleasant pregnancy experience, and a favourable prognosis.
How TCM works?
Low Back Pain during pregnancy can be treated effectively and quickly with TCM (Traditional Chinese Medicine) methods, particularly, acupuncture and therapeutic tuina.
According to the TCM Meridian Theory, low back pain during pregnancy is attributed to a disruption to the flow of Qi and Blood along the Bladder Meridian channel which passes through the lower back. The Bladder Meridian points such as BL-23 to BL-26 are often chosen to help clear localized stagnation. Distal points on the stagnated Meridian, such as BL-62 may be added to promote the Qi and Blood flow along the entire Meridian. Points which work on the Liver and Gallbladder Channel, such as LIV-3 and GB-34 may also be added to strengthen the sinews and tendons. One important point to note is that these points should only be treated with a neutral technique for pregnant women. Strong stimulation of the points should be avoided.
Other points may be chosen to restore balance of the body according to TCM Internal Organ theory, and to eliminate pathogenic factors according to disharmony pattern identified using TCM syndrome differentiation method.
Tuina, which is a Chinese ancient form of massage, is a very useful complement to acupuncture in restoring patency of the meridians. Rolling along the Bladder Meridian at the lower back helps relax the muscles, tendons and ligaments. This is often followed by kneading on the specific pain area to help reduce pain and inflammation, and to promote the circulation of Qi and Blood. Other techniques such as pressing and rubbing are also often used to work on removing blockage along the Meridians.