When Pregnancy Pain Warrants A Check-Up
Many women view pregnancy as a special time in life, but research shows 45% experience low back and/or pelvic girdle pain during pregnancy. This pain often causes dysfunction, interfering with sleep, concentration, and lost time from work. If severe, it puts a woman at risk for experiencing back pain postpartum. Additionally, there is a correlation between postpartum back pain and depression.
Is Back Pain Normal During Pregnancy?
Many women are taught that back pain is normal when pregnant. What? There is nothing normal about back or pelvic pain at any time. Studies show that < 30% of pregnant women who report this pain to their physicians receive treatment, and 20% report avoiding future pregnancies because of their lumbopelvic pain.
What Can Be Done
Physical therapists are equipped to help these women by performing the same evaluation and treatment techniques as would be provided to men and non-pregnant women. Here are some precautions to help assure safety for both the pregnant mom and infant during PT.
- Take blood pressure at each visit. Blood pressure should never reach or exceed 150/90 mmHg (if so, contact the doctor from your clinic), and increases > 15 mmHg systolic or diastolic pressure from the woman’s baseline should also be reported. Regularly documenting blood pressure on the patient’s flow sheet more easily alerts a therapist to unusual changes.
- Avoid prone lying. Use modified positions during exam tests and treatments.
- Avoid prolonged supine positioning and watch for Supine Hypotensive Syndrome (or aortocaval occlusion). This syndrome occurs in 10% of pregnant women when supine, as the pressure of the baby occludes the inferior vena cava. It can result in the woman experiencing faintness, nausea, dizziness, or clammy skin. This can be easily relieved by having the patient roll onto her side for return to improved circulation. If she feels well after rolling on to her side, the treatment can be continued, and the woman is advised to avoid laying supine in her home to avoid this response.
Pregnant women tend to be motivated physical therapy clients. They can easily be helped with exercise, orthotics, and education in good posture and body mechanics. It is often a time in life when women want to improve their health and well-being in preparation for motherhood. These patients typically appreciate the skilled assistance and reassurance of a physical therapist!