Month 5 What a pain!

Which aches and pains are a normal part of pregnancy, and for which ones should you get help?

Women have various aches, pains and niggles throughout pregnancy, especially from four months onwards when the changes in your body become evident.

Pain can be acute (sudden), chronic (long-lasting), severe or dull. Sudden, sharp and persistent pain that gets worse – especially when it comes with fever, nausea, headache, fainting or vomiting – is a red alert, and you need to see your doctor or go to the nearest emergency room. Dull, annoying pain that’s sporadic and relieved by heat, massage or moderate exercise is no cause for alarm, but you should tell your doctor about these at your next visit. Of course, if these pains suddenly become acute, call your doctor. While some women cope effortlessly with the physical changes that stretch and change their body shape, others may flinch with every twinge and feel utterly miserable until their due day. Luckily there is a lot you can do to help yourself.

How you cope with these aches and pains depends on your personality, pain threshold, level of fitness before conception and health.

Activities like swimming and yoga, or even taking a warm bath, having a massage or getting a good night’s sleep can go a long way to relieving common pregnancy related discomforts.

ROUND LIGAMENT PAIN

Ligaments are like elastic bands that hold the body together. Although the womb is a free-moving organ that’s attached to the top of the vagina at the cervix, it is also supported by the round ligaments that stretch from the top of the womb down to the groin. After four months, the womb has outgrown the pelvis and starts to push into the abdomen. This is when the round ligaments start to stretch. Even though this usually happens only a fraction at a time, round ligament stretching can be sudden and painful or it can be ongoing and uncomfortable. Acute round ligament pain can be caused by sudden movement like standing up quickly or when turning over in bed. If you’re pregnant with twins (or more), carrying a big baby or have more amniotic fluid, you need to be careful. Make a point of standing up slowly or moving carefully from side to side when sleeping.

Gentle rubbing, heat and massage usually bring instant and lasting relief.

BACK PAIN

Backache during pregnancy is more common in the second and third trimester, when hormones soften the cartilage of the spine. This may cause a temporary curvature of the spine as the body adapts to the changing centre of gravity.

Acute and severe backache may come from a previous injury, and this may need physiotherapy and specific exercises to prevent or alleviate pain. Lingering backache may be caused by poor posture – especially when you sit for a long time. It can also be caused by sleeping on an old mattress, or by the way you sleep.

Preventing backache means paying attention to your posture and walking tall. Specific prenatal exercises can help to improve blood circulation and strengthen muscles that support the spine.

A session with a physiotherapist to show you which exercises to do and how to maintain these throughout your pregnancy may be helpful.

NECK PAIN

You may not realise that you are slumping your shoulders forward and tensing your neck muscles to cope with the physical and even emotional challenges of pregnancy. Neck pain may also be caused by pressure on the shoulder joints when sleeping or slumping at your desk. This can even manifest with symptoms of carpal tunnel syndrome – painful wrists and a tingling weakness of the thumb. Use more pillows to support your shoulders when you sleep. Also put a cushion into the small of your back when working at your desk or watching television. Do some neck exercises – gently moving your head from side to side or up and down, but not round and round. A relaxing warm (not hot) bath and a regular neck massage may be all that’s needed to bring welcome relief and prevent problems.

PELVIC PAIN

The most common cause of acute and sometimes severe pelvic pain at this stage of the pregnancy is a bladder infection. The symptoms may be confused with contractions, and they may start suddenly with or without the typical symptoms of an infection like burning sensation when urinating, frequency and a temperature. Chat to your doctor if you can’t distinguish between the two. Ask your chemist for a homoeopathic remedy for bladder infections, drink extra water and cranberry juice, and use a warmed heating pad the way you would for period pain. If there is vaginal bleeding, go straight to your doctor. These could be symptoms of a miscarriage threatening to happen.

MUSCULAR PAIN

Muscular pain begins with the expanding womb and spreads to the pelvic floor and abdominal muscles, then dominoes up the back and down to the thigh muscles. This type of pain is associated with muscular stretching, poor posture, a changed centre of gravity after 20 weeks when the womb reaches up into the abdomen, sitting or standing for too long and even sleeping on a nonsupportive mattress.

Muscular pain is best relieved with daily stretching and relaxing exercises: get down onto your hands and knees, spreading your knees apart and rocking backwards and forwards while keeping your back straight. This helps by taking the weight of the womb off the supporting muscles. It also relieves nerve and ligament pain.

Heat (taking a warm, not hot bath) and massage can also help, as stimulating blood flow to tired muscles helps to revive them.

LIGAMENT PAIN

Ligaments are tough, flexible fibrous bands that join bones. They also attach the womb to the pelvis and spine. Ligaments are softened by pregnancy hormones in order to make the pelvis more flexible in preparation for childbirth. But this can also cause painful joints, backache or ligament pain.

An exercise to relieve this type of pain is called the tailor position. Sit on the floor with your back straight and knees bent outwards, and bring the soles of your feet together. Holding your feet together, bring them as close to your body as you can, and lower your knees as close to the floor as possible.

This exercise helps to open the pubic arch and relax inner thigh and groin muscles.

SWELLING

Tired and swollen legs, feet and ankles can be relieved by elevating them above the level of your heart, either with them resting upright against a wall, or lying on the floor with your knees bent and supported by a chair.

NERVE PAIN

Backache and sciatic nerve pain is often caused by pressure and inactivity. It will be a shooting pain and often affects just one side. To reduce stiffness, stand straight, legs slightly apart and sway your hips from side to side. Now, keeping your back straight, hold your hands behind your back and bend slowly forward, as far as possible. Hold for the count of 30. Now release your hands from behind your back, and try to touch the floor.

Hold for the count of 30.

Stand up slowly, and gently sway your hips from side to side. ●