Back Pain And Pregnancy
Back pain during each trimester of your pregnancy isnt uncommon several causes can be to blame. However, you should be sure to talk to your doctor about what youre experiencing, in the event the pain may be part of a bigger problem.
Here are a few reasons why you may be experiencing back pain during pregnancy:
Shifting center of gravity
As your baby grows, the center of your bodys gravity moves outward. Your spine and back arch to make up for the change in balance. This put extra stress on the lower lumbar spine.
Weight gain
Weight gain can be a healthy part of pregnancy, but even the little bit youre likely to gain during those 9 months can put more stress on your back and core muscles.
Hormones
As your body prepares to deliver the baby, it releases hormones that loosen the ligaments that stabilize your pelvis and lumbar spine. These same hormones can cause the bones in your spine to shift, too, which may lead to discomfort and pain.
Medical History And Physical Examination
After discussing your symptoms and medical history, your doctor will perform a physical examination. The exam may include the following tests:
- Neurological examination. A neurological examination will help your doctor determine if you have any muscle weakness or loss of sensation. During the exam, he or she will:
- Check muscle strength in your lower leg by assessing how you walk on both your heels and toes. Muscle strength in other parts of your body may also be tested.
- Detect loss of sensation by checking whether you can feel a light touch on your leg and foot.
- Test your reflexes at the knee and ankle. These may sometimes be absent if there is a compressed nerve root in your spine.
Clinical photo of a doctor performing the straight leg raise test.
Reproduced from JF Sarwak, ed: Essentials of Musculoskeletal Care, ed. 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.
What Treatments Are Available
The treatment for back pain will depend on the cause of the pain. Each treatment option serves a different purpose and offers different benefits. In many cases, your doctor will recommend a particular combination of treatments designed to give you the best results. Before you begin any treatment program, your doctor will explain all of the pros and cons of each treatment. You will also have an opportunity to ask questions. Some of the treatments available from The Spine Center of Baton Rouge include:
- Spinal manipulation
- Interferential electro-therapy
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How Common Is Back Pain
If youre like most Americans, youll probably have back pain at some point in your life. Four in five adults suffer from low back pain. Luckily, most back pain goes away within one to two weeks. But if your pain is long-term or chronicand if you have certain symptoms with your low back painyou may want to see a spine specialist.
Internists And Family Practice Physicians
Internists and family physicians are the most typical entry into the world of medical treatment. The second most common reason for a visit to your primary care doctor is back pain. These individuals have one of the most difficult jobs. These doctors have to know about heart disease, circulation, lungs, liver, kidneys, diabetes, infectious disease, as well as spine. They have the hardest job in medicine.
These docs might initially use medications and activity restrictions. If their treatment is not effective, they might refer to a physical therapist. Some may refer to chiropractors. Osteopaths may treat the problem themselves with manipulation and muscle techniques. No matter to which you go, if the problem is resolved, obviously there is no further need of treatment.
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Lordosis In The Lower Back
Lordosis in the lower back, or lumbar spine, is the most common type. The easiest way to check for this condition is to lie on your back on a flat surface. You should be able to slide your hand under your lower back, with little space to spare.
Someone with lordosis will have extra space between their back and the surface. If they have an extreme curve, therell be a visible C-like arch when they stand. And from the side view, their abdomen and buttocks will stick out.
Unexplained Acute Low Back Pain
Unexplained low back pain means chronic pain that comes on gradually, over time, with no specific injury, event, or illness causing it.
Common causes:
- Prolonged sitting and lack of fitness can weaken back muscles and cause pain from lack of support.
- Ankylosing spondylitis, a form of arthritis.
- Spinal stenosis, a narrowing of the spinal column that puts pressure on the spinal cord.
- Certain types of cancer, in rare cases.
Those most susceptible are over 30, overweight and/or pregnant, and not physically fit. Smoking interferes with healing after any sort of stress to the back.
If there are additional symptoms, medical care should be sought: fever, unexplained weight loss, leg weakness or numbness, or trouble urinating.
An exact diagnosis is made through blood tests and through imaging such as x-rays, CT scan, or MRI.
Once more serious causes are ruled out, treatment may include medications to ease pain, swelling, and inflammation. Steroid injections are useful in some cases.
Overall, exercise and maintaining a healthy weight can be very helpful with easing chronic low back pain.
Rarity: Common
Top Symptoms: lower back pain, back pain that shoots to the butt, fever, back pain
Symptoms that always occur with unexplained acute low back pain:lower back pain
Symptoms that never occur with unexplained acute low back pain:buttocks numbness, thigh numbness, involuntary defecation, fever
Urgency: Self-treatment
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What Are The Symptoms
Depending on the cause, low back pain can cause a range of symptoms. The pain may be dull or sharp. It may be in one small area or over a broad area. You may have muscle spasms.
Low back pain can also cause leg symptoms, such as pain, numbness, or tingling, often extending below the knee.
A rare but serious problem called cauda equina syndrome can occur if the nerves at the end of the spinal cord are squeezed. Seek emergency treatment if you have weakness or numbness in both legs or you lose bladder or bowel control.
Most low back pain is short-term and will go away in a few weeks. It is more likely to become long-lasting if you are depressed or under stress.
When Should I See A Doctor For Back Pain
When your back first starts to hurt, try taking an over-the-counter pain reliever and applying ice in the first 48 hours. You may apply heat after 48 hours. You may need to take it easy for a while, but its best to stay as active as tolerated, and to avoid absolute bed rest, said Dr. Guo.
If your back pain lasts more than two weeks and keeps you from participating in normal, daily activities, see your family doctor. If your pain is severe, you should see a doctor sooner. You should seek urgent medical care if you have:
- Fever associated with back pain
- Back pain after trauma
- Loss of bladder or bowel control
- Loss of strength in your arms and legs
- Unexplained weight loss associated with back pain
Also, always be more cautious if you have special risk factors for cancer, infection, or fractures that may affect the spine.
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How Is Back Pain Diagnosed
Most people who develop low back pain that comes on suddenly have nonspecific low back pain. If there are no other associated symptoms and the pain is not too bad, many people are confident to just ‘get on with it’ and treat it themselves – and indeed most get better quickly. However, if in doubt, see your doctor for a check-over and advice.
A doctor will usually want to ask questions about your symptoms and to examine you. Basically, the symptoms are usually as described above, with no other worrying symptoms to suggest anything serious or another cause of back pain . The examination by a doctor will not detect anything to suggest a more serious cause of back pain. Therefore, a doctor can usually be confident from his or her assessment that you have nonspecific back pain.
As a general guide, if any of the following occur then it may not be nonspecific low back pain, and there may be a more serious underlying cause. But note: the vast majority of people with low back pain do not have any of the following symptoms or features. They are included here for completeness and as an aid to what to look out for and to tell your doctor should they occur.
Its Difficult To Know Whats Causing Your Pain
Sometimes pain in the back or the neck is acute. It often results from an injury maybe you moved heavy furniture without warming up your muscles, you made a sudden movement working in the yard, or youre ill. Acute pain typically goes away on its own without treatment after a few days or weeks.
However, chronic pain lingers and persists for more than 12 weeks. It can be constant or it can come and go, but it typically requires some type of treatment.
Several things can cause back pain and neck pain:
- sedentary living
- kidney stones
- illnesses
Its important to see a medical professional because there are so many possible causes for your pain. A neurologist can help diagnose the source of your back pain, and recommend the best treatment approach, which may involve physical therapy, seeing a pain specialist, or consulting with a surgeon.
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Uncommon Causes Of Lower Back Pain
The NINDS has identified nine uncommon causes of lower back pain.
- Infections Infections of the vertebrae can cause pain. These conditions include osteomyelitis, discitis, and sacroiliitis.
- Tumors Cancerous masses can trigger lower back pain.
- Cauda equina syndrome This rare complication results from ruptured disks. Their material pushes out into the spinal column, then compresses the lumbar and sacral nerve roots. Cauda equina syndrome causes patients to lose bladder and bowel control. It may result in permanent damage if not treated.
- Abdominal aortic aneurysms -This dangerous health disorder causes the abdominal vessel supplying blood to the lower body to swell. Severe back pain can signal that the aneurysm is large enough to rupture. This condition requires immediate medical attention.
- Kidney stones Patients with this issue suffer from sharp, lower back pains on one side.
- Arthritis These disorders include osteoarthritis, rheumatoid arthritis, and other inflammatory joint diseases.
- Osteoporosis This progressive metabolic bone disorder causes vertebral fractures and decreases in bone density and strength.
- Endometriosis Tissue can leave the uterus and migrate to other areas, causing lower back pain.
- Fibromyalgia This disease causes chronic pain, soreness, and fatigue.
What Is An Orthopedic Spine Specialist
Approximately 80% of Americans experience back pain, and it sometimes falls to specialists to determine why.
Orthopedics is a category of medicine that focuses on the musculoskeletal system. Spine specialists, of course, focus only on the diseases and issues associated with the spine.
These physicians are trained to detect and treat conditions impacting or stemming from the spine through surgery or other means. Consequently, an orthopedic spine specialist is sometimes called a spine surgeon.
Orthopedic specialists know their stuff. They spend at least eight years in school, learning the ins and outs of their trade. Several of those years are spent in clinical fields, where soon-to-be surgeons learn even more through residencies and specialized fellowships.
Many wonder whats the difference between a specialist and a chiropractor? Chiropractors manipulate the spine for relief, but only specialists can conduct surgeries.
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What Doctor Should I See For Back Pain
If your back pain is from a recent strain or mild injury, your primary care doctor can probably help. But if the pain is severe, ongoing, or accompanied by other symptoms such as numbness or tingling in your arms or legs, it may be time to see a back doctor. Start with someone who specializes in nonsurgical treatment for back pain. This can include a physiatrist, chiropractor, physical therapist, or orthopaedic physician assistant. They can evaluate your condition and offer appropriate treatment to help alleviate your pain. Depending on your circumstances, they might also refer you to another type of back specialist — for example, a pain management specialist or spine surgeon.
How Is Back Pain Treated
Acute back pain usually gets better on its own. Acute back pain is usually treated with:
- Medications designed to relieve pain and/or inflammation
- analgesics such as acetaminophen and aspirin
- non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen may be sold over the counter some NSAIDS are prescribed by a physician
- muscle relaxants are prescription drugs that are used on a short-term basis to relax tight muscles
- topical pain relief such as creams, gels, patches, or sprays applied to the skin stimulate the nerves in the skin to provide feelings of warmth or cold in order to dull the sensation of pain. Common topical medications include capsaicin and lidocaine.
Exercising, bed rest, and surgery are typically not recommended for acute back pain.Chronic back pain is most often treated with a stepped care approach, moving from simple low-cost treatments to more aggressive approaches. Specific treatments may depend on the identified cause of the back pain.
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What Happens When I Visit A Back Doctor
We gather a full medical history of your back problems and perform detailed physical examinations, said Dr. Guo. That includes checking for tenderness, spine range of motion, strength, sensation, and reflexes. Depending on your symptoms, we may perform provocative tests to find out what triggers your pain. We may order imaging studies, such as X-rays, MRIs, or CT scans. We may order electromyography and a nerve conduction study, which assess whether you have muscle and/or nerve problems that may cause your symptoms. We use all the information to help identify the cause of your back pain and associated symptoms, and provide the most appropriate treatments for you.
What Causes Spine Curvature Disorders
There are a number of health problems that may cause the spine to curve more than normal or be misaligned.
The following conditions can cause lordosis:
- Achondroplasia. A disorder in which bones do not grow normally, resulting in the short stature associated with dwarfism
- Spondylolisthesis. A condition in which a vertebrae, usually in the lower back, slips forward
- Osteoporosis, a condition in which vertebrae become fragile and can be easily broken
The following conditions can cause kyphosis:
- Abnormal vertebrae development in utero
- Poor posture or slouching
- Scheuermann’s disease, a condition that causes vertebrae to be misshaped
- Arthritis
- Spina bifida, a birth defect in which the spinal column of the fetus does not close completely during development inside the womb
- Spine infections
- Spine tumors
Doctors do not know what causes the most common type of scoliosis seen in adolescents. However, doctors do know that scoliosis tends to run in families. A disease, injury, infection, or birth defect also may be to blame.
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Less Common Causes Of Low Back Pain
Inflammation of the joints of the spine sometimes causes back pain. Osteoarthritis is the common form of arthritis and usually occurs in older people. Ankylosing spondylitis is another form of arthritis that can occur in young adults and which causes pain and stiffness in the lower back. Rheumatoid arthritis may affect the spine but you are likely to have other joints affected too.
Various uncommon bone disorders, tumours, infection and pressure from structures near to the spine occasionally cause low back pain .
The rest of this leaflet is mainly about nonspecific low back pain – the common type of low back pain.
Can Lower Back Pain Be Related To Weather
If you feel like your lower back pain worsens on days when its cold or the weather is changing, you are not imagining things. Back pain can indeed be related to barometric pressure and outdoor temperature. Changes in pressure can sometimes cause pain in arthritic joints, including the spine. Muscles and joints in general react to the environment, which can make them stiffer and more likely to suffer an injury.
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One: Before You Visit A Surgeon See Your Family Doctor
Every patient should visit their primary care physician before seeing an orthopedic spine surgeon. Your family doctor will perform a medical exam to identify the cause of your condition. He or she can prescribe medicines for non-chronic lower back pain . These treatments may include analgesics, non-steroidal anti-inflammatory drugs, anticonvulsants, and counter-irritants.
Additionally, your doctor can order chiropractic care or physical therapy as a first-line treatment option. Chiropractors are specialists that use spinal manipulation and mobilization to provide pain relief. Physical therapists use techniques including traction, massage, muscle manipulation, and biofeedback to relieve aches and mobility issues. These therapies may not alleviate your pain. If this happens, your primary care doctor will refer you to an orthopedic surgeon. Contact an experienced orthopedic surgeon who can diagnose your lower back pain..
