Backaches and back pain

Pregnant women are prone to backaches and back pain for a number of reasons. During pregnancy, the joints and ligaments in your pelvic region begin to soften and loosen in preparation for the baby to pass through your pelvis. As your uterus grows, your abdominal organs shift, and your body weight is redistributed, changing your center of gravity. Gradually you begin to adjust your posture and the ways you move. These compensations can lead to backaches and back pain. (See also Abdominal tenderness due to muscle separation; Sciatica.)

■ Prevention and self-care for backaches and back pain

Try these suggestions to help your back feel more comfortable:

• Practice good posture. Tuck your buttocks under, pull your shoulders back and downward, and stand straight and tall. Be aware of how you stand, sit and move.

• Change position often, and avoid standing for long periods of time.

• Avoid lifting heavy objects or children.

• Lift correctly. Don't bend over at the waist. Instead, squat down, bend your knees, and lift with your legs rather than your back.

• Place one foot on a low stool when you have to stand for a long time.

• Wear supportive, low-heeled shoes.

• Exercise (swim, walk or stretch) at least three times a week. Consider joining a prenatal exercise or yoga class.

• Try to avoid sudden reaching movements or stretching your arms high over your head.

• Sit with your feet slightly elevated.

• Sleep on your side with one knee or both knees bent. Place a pillow between your knees and another one under your abdomen. You may also find relief by placing a specially shaped total body pillow under your abdomen.

• Apply heat to your back. Try warm bath soaks, warm wet towels, a hot water bottle or a heating pad. Some people find relief by alternating ice packs with heat.

• Have a back massage or practice relaxation techniques.

• Wear maternity pants with a low, supportive waistband. Or consider using a maternity support belt.

• Do pelvic tilt exercises. Rest comfortably on your hands and knees with your head in line with your back. Pull in your abdomen, arching your back upward. Hold the position for several seconds, then relax your abdomen and back. Repeat three to five times, working gradually up to 10.

■ When to seek medical help for backaches and back pain

Pain relief medications other than acetaminophen (Tylenol, others) — including aspirin, ibuprofen (Advil, Motrin, others) and "superaspirins" (COX-2 inhibitors such as Celebrex) — cause some concern for your unborn baby. If your back pain is severe, ask your health care provider about appropriate treatment. He or she may suggest a variety of approaches, such as special stretching exercises, to alleviate pain without causing concern about your baby.

Back pain may be a sign of a more serious problem if it's severe and unrelenting or if it's accompanied by other signs and symptoms. A low, dull backache may be a sign of labor or preterm labor.

Contact your health care provider if your back pain lasts four to six hours or longer or if you're also experiencing any of the following:

• Vaginal bleeding, which may come and go

• Cramping or abdominal pain

• Passing of tissue from the vagina

• Regular uterine contractions (every 10 minutes or more often), which may feel like a tightening in your abdomen

• A feeling of heaviness or pressure in the pelvis or lower abdomen

• Watery discharge (clear, pink or brownish fluid) leaking from your vagina

• Menstrual-like cramps, which may come and go and may be accompanied by diarrhea

• Ruptured membranes, that is, the breaking of the amniotic sac, a normal part of going into labor (your water breaks )

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