Will my lower back hurt during pregnancy? Prevention methods are crucial

People will have back pain in many cases, such as when they are tired, lying in bed for a long time, lumbar injury, and lumbar disease. However, for pregnant women who experience lumbar pain after pregnancy, it cannot be ruled out that it is related to pathological factors. In addition, it also includes physiological factors. Because the uterus is slowly getting bigger and tilting backwards, this is to maintain the balance of the body, but while tilting backwards it will compress the lumbar spine and cause back pain. In addition to compressing the lumbar spine, the uterus will also compress the pelvic cavity. Many pregnant women cannot sit for too long and often experience back pain. Back pain will lead to lumbar pain and leg pain. Therefore, pregnant women's back pain needs to be checked, the condition must be found in time, and appropriate methods must be selected to prevent it.

Hormonal changes during pregnancy can cause relaxation of ligaments and joints. Weight gain and forward shift of the center of gravity lead to increased lumbar lordosis and forward rotation of the pelvis. Combined with the influence of other external factors, it is easy to suffer from low back pain and pelvic girdle pain during pregnancy.

According to clinical data, symptoms of low back pain during pregnancy generally begin at the 22nd week of pregnancy, nearly half of women still have low back pain symptoms one year after delivery, and 20% of women experience pain during pregnancy for more than 3 years. Pelvic girdle pain during pregnancy usually begins at 24-36 weeks of pregnancy and disappears several months after delivery. In 8%-10%, it may last for 1-2 years after delivery. Because of the need to consider the impact on pregnancy and fetus, the choice of diagnosis and treatment methods requires particular caution.

Timely inspection is crucial

If the pain is particularly severe or symptoms such as leg pain and numbness have appeared, you should see a professional spinal surgeon (rule out other diseases: such as lumbar disc herniation, osteoporosis compression fracture, spinal tumors, etc.).

MRI (magnetic resonance imaging) is currently the safest imaging examination of the lumbar spine during pregnancy. Although there are reports that MRI may be related to the onset of teratoma and hearing impairment, there is currently insufficient data to prove that MRI examinations with magnetic fields below 1.5T have adverse effects on pregnant women and fetuses. Whether MRI with a magnetic field of 3.0T has any adverse effects still requires further study.

The International Commission on Non-Ionizing Radiation Protection recommends that pregnant women undergo MRI examinations after the first trimester (0-14 weeks of gestation). The American College of Radiology believes that MRI examinations can be performed at any stage of pregnancy.

X-ray and CT examinations are generally not recommended during pregnancy due to the high amount of ionizing radiation.

Prevention methods are crucial

Conservative treatment is often preferred for low back pain during pregnancy, including back muscle training, wearing a belt, massage, acupuncture, psychotherapy, etc.

Clinical studies have shown that exercising for 8-20 weeks during pregnancy can significantly reduce the risk of low back pain during pregnancy. When low back pain occurs, back muscle exercises can significantly reduce symptoms, while wearing a belt, other exercises, neuroemotional techniques and massage have no significant effect. Special pillows can reduce nighttime pain. Acupuncture also has certain therapeutic effects, and ear acupuncture is more effective.

Be cautious when taking medication during pregnancy

If medication is needed for low back pain during pregnancy, you can choose according to the pregnancy medication safety classification of the U.S. Food and Drug Administration (FDA). The FDA classifies drugs into five levels: A, B, C, D, and X based on their effects on fetal teratogenicity in animal experiments and clinical experience.

Acetaminophen-grade drugs used orally or by rectal insertion are Class B drugs and are the first choice for mild to moderate low back pain. This class of drugs has no known teratogenicity.

Nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen, or intravenous acetaminophen are class C in the first (0-14 weeks of gestation) and second (14-28 weeks of gestation) trimesters and class D in the third trimester. Their use may result in patent ductus arteriosus in the infant. Therefore, if nonsteroidal drugs must be used, they can only be used for short periods of time during the first and second trimesters.

Aspirin is a Class D drug. Its use may lead to increased fetal mortality, neonatal hemorrhage, neonatal weight loss, prolonged labor, etc.

Drugs used to relieve muscle spasms such as cyclobenzaprine are class B, while methocarbamol is class C.

Opioid-class drugs such as codeine can be used for severe low back pain, but are class C and have been associated with respiratory malformations. Hydrocodone, pethidine, methadone, morphine, oxycodone, fentanyl, and hydromorphone are all Class B drugs. All of these opioid analgesics are Class D if used long-term or in large doses. Despite the low risk to the fetus, the use of epidural steroid injections during pregnancy remains controversial. This treatment method is most suitable for pregnant women with symptoms of nerve compression due to lumbar disc herniation. Recent studies have found that a single epidural hormone injection is also effective for pelvic girdle pain during pregnancy.