Remedies for pelvic pain during pregnancy

What’s Causing It and How You Can Treat It

Message from our CEO Leighton McDonald

March 29, 2022

To Our Clients, Families and Caregivers,

It has been a long two years while we have all worked so hard together to manage the impact of COVID-19 in our own lives and in our communities. Throughout this time, CTG has been committed to continuing to safely deliver high quality care. I am happy to share that 99% of all CTG team members are fully vaccinated against COVID. A very small number of team members have been granted a vaccine exemption and these individuals test themselves for COVID on a regular basis.

As we enter this new phase of the COVID-19 pandemic in Canada, some public health requirements in public settings are changing. Changes such as no longer needing to provide proof of vaccination to dine in a restaurant or no longer being required to wear a mask when we go for groceries.

While these may be welcome changes in public settings, in home care we work in close proximity to people for periods of time and throughout the day we are often providing service to individuals who are vulnerable to becoming very sick due to a COVID-19 infection. As such, we must continue to work together to keep you, other clients and their families, and our CTG team members safe.

Our number one priority will always be the safety and well-being of our clients and CTG team members, every day and at every community, school, or clinic visit. CTG team members follow best practices in infection prevention and control, and we need you to be part of the safety team. Here’s what we can do together to keep everyone safe.

Before your visit

• A CTG team member will be asking you a series of screening questions the day before your visit and again at the time of your visit or appointment.

• It is critical that you answer all the questions honestly as it will help us keep everyone safe. Be assured that regardless of the screening results, you will receive the care you need but we may need to take additional precautions for your safety and the safety of others.

During your visit

• Your CTG health care provider will be wearing both a mask and a face shield or goggles. This is for both their protection and yours.

• You are asked to wear a mask when the CTG provider is in your home; if you do not have a mask, one will be provided to you. All nursing and physiotherapy clients will be provided a new mask when they arrive at a CTG clinic.

• Younger clients are also asked to wear a mask when receiving services in home or at school.

• If caregivers must be present and close by during a visit, they will be asked to wear a mask or face covering.

• Individuals in the home will be asked to maintain a 2 metre (6 feet) physical distance from the CTG provider unless they are an essential part of the care.

• Now that winter is easing, when possible, kindly open doors and windows in your home to take advantage of natural ventilation when a CTG team member is in your home.

• CTG team members will clean their hands frequently for your safety and we ask you do the same.

CTG prides itself on being a Team Made for Caring and our team includes you. Together we can continue to ensure you safely receive the high-quality care you deserve, and our team members remain safe.

If you have any questions or would like more information, please feel free to reach out to us. You can also find current information at www.ontario.ca/coronavirus or www.novascotia.ca/coronavirus

Sincerely,

Leighton McDonald

President & Chief Executive Officer

Closing the Gap Healthcare

How To Relieve Pelvic Pain During Pregnancy, 1st Through 3rd Trimester

March 22, 2022February 11, 2022 by arizonapain

If you’re expecting, you know by now that pregnancy can be both exciting and exhausting. While you’re dreaming of the moment you’ll finally hold your little one in your arms, you’re also probably looking forward to relief from the common side effects of pregnancy. Of the many ailments expectant mothers experience, pelvic pain during pregnancy is one of the most common complaints.

In fact, approximately 72% of pregnant women experience pelvic pain at some point. It’s commonly characterized by pain across the front of your pubic bone, level with your hips or across one or both sides of your lower back. While pelvic pain isn’t harmful to your baby, it can make your pregnancy uncomfortable. This post will cover why pelvic pain tends to occur at each stage of pregnancy, how to ease the discomfort you feel, and symptoms that could be an indication of something more serious.

Most women are surprised by the occurrence of pelvic pain in early pregnancy, but hormones are typically responsible for this sudden change. When you become pregnant, your body immediately starts to produce a hormone called relaxin. This hormone allows tendons and ligaments to stretch to allow the pelvis to open for birth.

While relaxin itself is not the cause of pelvic pain, the relaxed ligaments and tendons may lead your weight distribution to change, especially towards the end of your first trimester. This can cause both hip pain and pelvic pain during early pregnancy.

Unfortunately, this hormone will continue to release throughout your pregnancy. This means your pelvic pain may worsen as the months go on.

While treatment options are often limited during pregnancy in order to protect your growing baby, there are some ways to relieve pelvic pain naturally.

However, always discuss your pain level and symptoms with your doctor before trying anything new. Be open and honest about how you’re feeling and how much pain you can tolerate.

Getting a specialized prenatal massage can help to reduce stress hormones, relax your muscles, and increase blood flow. The boost in circulation after a massage will not only ease your discomfort, but may also help you sleep better (a welcome benefit for women suffering from aches and pains associated with pregnancy).

While any masseuse can perform a prenatal massage, it is best to go to someone who specializes in maternal care and has extensive experience working on pregnant women. They will know what positions to avoid and what level of pressure is acceptable. This will guarantee the safety of you and your baby.

Chiropractic care is generally considered safe during pregnancy. In fact, all chiropractors go through training designed specifically for the care of pregnant patients.

Through spinal manipulation and adjustments, a visit to the chiropractor may help relieve some of your pelvic pain. Achieving proper alignment for both standing and sitting can help you maintain a posture that won’t put added pressure on your body. This is crucial as your weight distribution will continue to shift as your baby grows.

As always, check with your doctor for a referral before seeking chiropractic care during pregnancy.

If your doctor has cleared you for exercise, staying active within your pain limits is one of the best ways to prevent and ease pelvic pain during pregnancy. Your doctor may even recommend at-home exercises and stretches for your pelvic floor, stomach, back, and hip muscles. Pelvic tilt exercises in particular can help strengthen your muscles and improve your posture to provide relief from pelvic pain.

If you’re considering workout classes, prenatal yoga, water aerobics, and swimming are all great options for low-impact exercise. Gyms and fitness studios across the country offer classes that are specifically created for pregnant women. Talk to your doctor about any local ones they recommend.

Maintaining an exercise routine can help alleviate pain by keeping you limber, but most women enjoy many other additional benefits. Exercising will help you sleep better and can even improve the overall ease of your labor and delivery. Staying active during pregnancy may also make it easier to get back in shape after your baby is born.

Pregnancy pillows (also known as body pillows) have become popular for pregnant women, and for good reason. Sleep is crucial for maintaining a healthy lifestyle and pregnancy, but it can become increasingly difficult as you continue to grow and gain weight.

There are a variety of shapes and sizes when it comes to pregnancy pillows, but one that is specifically designed to be placed between your knees is best for relieving pelvic pain. This position will ensure that your hips are aligned, stable, and at the correct height at night to minimize pressure in the pelvic and hip region.

Another type of pregnancy pillow is in the shape of a wedge. It simply lifts your growing belly off the mattress to relieve the pressure and weight you’re feeling in that region, especially while lying down.

Belly bands and compression pantyhose are a great option for everyday wear as you continue to grow throughout your pregnancy.

Belly bands or maternity belts are designed to lift your belly, giving your back and pelvic area extra support and relief from the weight of your growing baby. Many of them can be heated in the microwave to provide soothing heat therapy for tight and sore muscles.

Compression pantyhose offer the benefit of lifting your belly and giving it support while also adding compression around your legs. This can be helpful if you’re suffering from excessive swelling in the legs and feet.

Pelvic pain during the second and third trimesters can still be attributed in part to relaxin. This hormone will continue to surge through your body, especially in the final weeks before you give birth. It will continue to loosen your ligaments and open your pelvis for labor.

In addition to the relaxin hormone loosening and stretching your tendons and ligaments, your growing belly also creates a shift in the way your weight is distributed. This can affect everything from your stance to the way you walk. This is why it can often be painful no matter what position you’re in. For this reason, it’s best not to stay standing or sitting for too long.

It’s important to note that pelvic pain can also get much worse about two to four weeks before delivery once lightening occurs. Lightening is when your baby drops into the pelvic area in preparation for labor. Once this happens, your baby’s head puts stress on the bones, joints, and muscles in your pelvis and back. The good news? This is another indication that labor is near and the end is in sight!

The previously mentioned treatment options for relieving pelvic pain during early pregnancy are still great options in your second and third trimesters, but with a few modifications.

Your doctor will advise you to sleep on your side after your first trimester. This is because your growing uterus can put pressure on blood vessels, restricting the blood flow to both your heart and your baby’s heart. This same rule applies during exercise or any other activity that requires you to lie down, such as a prenatal massage. It’s always best to seek out instructors and practitioners who are specifically trained to work with pregnant women so that they’re aware of these guidelines.

Basic lifestyle changes should also be made during your second and third trimesters. Wear comfortable shoes with little to no heel and plenty of support, especially if you plan to be walking or exercising. You may also want to consider adding a warm bath to your nightly routine, as this can often help relieve pain and relax your muscles before bedtime.

As always, it’s important to contact your doctor if you feel like something isn’t right. While it’s normal to feel aches and pains as your pregnancy progresses, there are times when pain can be a sign of a more serious problem.

Be open and honest about the level of pain you’re experiencing during appointments. Call your doctor immediately if you have any of the following symptoms:

• Pain that you can’t walk or talk through
• Bleeding
• Fever
• Chills
• Severe headache
• Dizziness
• Sudden swelling of the hands, feet, or face
• Persistent nausea and vomiting

In rare, but serious cases, pelvic pain can be a sign of complications or miscarriage, especially if it is paired with other symptoms. These are some of the serious causes of pelvic pain that you should be aware of.

While it is considered rare, one in 50 pregnancies are classified as an ectopic or tubal pregnancy. This is when the egg implants outside of the uterus, most often in the fallopian tube. Symptoms include intense pain and bleeding. This happens most commonly between the sixth and tenth week of pregnancy.

Unfortunately, ectopic pregnancies can’t continue and must be treated immediately. If you have taken a positive at-home pregnancy test and are experiencing these types of symptoms, you should contact a doctor immediately. A medical team will use an ultrasound to confirm whether the egg has implanted in the uterus.

If you have persistent back and pelvic pain that comes and goes (with no relief after resting and lying down), you could be experiencing preterm labor.

Be sure to contact your doctor immediately if you think you could be feeling contractions, rather than basic pelvic pressure and pain.

According to the Preeclampsia Foundation of America, 5-8% of all pregnant women experience preeclampsia. The condition, characterized by high blood pressure and protein in your urine, can develop at any time after 20 weeks.

This condition is dangerous because blood pressure can constrict the blood vessels in your uterus that supply oxygen and nutrients to your baby. In severe cases, symptoms of preeclampsia can include abdominal pain.

Your placenta typically implants high on the uterine wall and doesn’t detach until after your baby is born.

In rare cases, though, the placenta can separate from the uterine wall, causing constant and worsening pain in the lower abdominal region. Depending on the case, you may go into labor naturally. If not, your doctor will opt to either induce labor or perform an emergency cesarean section.

Most common during childbearing years, noncancerous growths on the uterus are known as fibroids.

Pregnancy will often cause them to get larger and increasingly painful. Most doctors will simply keep an eye on them during your pregnancy. Only in rare cases is it necessary to remove them in order for the pregnancy to progress.

This is a special time in any woman’s life. Don’t let pelvic pain during pregnancy overshadow the anticipation and joy of welcoming a baby to your family. Talk to your doctor about what treatment options are right for you.

If you live in Arizona, get in touch with our pain specialists at Arizona Pain today. We have skilled physicians with extensive experience in pain management. We will tailor your treatment plan to ensure safe and successful pain relief during your pregnancy, coordinating with your other care providers.

Methods for the prevention and treatment of pain in the lumbar region and pelvic region during pregnancy

Review question

We were looking for evidence of the effect of any treatment used to prevent or treat low back pain, pelvic pain, or both during pregnancy. We would also like to know if the treatment reduced disability or sick leave, and if the treatment caused any side effects for pregnant women.

Relevance

Pain in the lumbar region, pelvic region, or both is a common complaint during pregnancy, often progressing as the pregnancy progresses. This pain can interfere with the daily activities, work, and sleep of pregnant women. We wanted to find out which treatment or combination of treatment options would be better than conventional prenatal care for pregnant women with these complaints.

Study profile

This evidence is current to 19 January 2015. We included 34 randomized trials with 5,121 pregnant women aged 16 to 45 in this updated review. The women were between 12 and 38 weeks pregnant. Studies have looked at various treatments for pregnant women with low back pain, pelvic pain, or both types of pain. All treatments were added to routine antenatal care and only compared to routine antenatal care in 23 studies. Symptoms in women in the studies were assessed in many ways, from self-reported pain to sick leave with the results of special tests.

Main results

Pain in the lumbar region

When we combined the results of seven studies (645 women) that compared any form of physical exercise with routine prenatal care, exercise (lasting five to 20 weeks), we found that women with low back pain improved and disability rates decreased .

Pelvic pain

Less evidence is available for the treatment of pelvic pain. Two studies showed that women who participated in group exercise and received training in pain management reported no difference in pelvic pain compared to women who received routine prenatal care.

Pain in the lumbar region and pelvis

Results from four studies (1,176 women) when combined showed that an 8 to 12 week exercise program reduced the number of women who complained of low back and pelvic pain. In two studies (1,062 women), ground exercises of various formats also reduced sick leave-related low back and pelvic pain.

However, two other studies (374 women) found that group exercise and education was no better in preventing pain, both in the pelvic region and in the lumbar region, compared with conventional prenatal care.

There have been a number of separate studies that have evaluated different treatment options. These results confirm that craniosacral therapy, osteomanipulation therapy, or multimodal intervention (manual therapy, exercise, and education) may be beneficial.

When side effects were reported, there were no long-term side effects in any of the studies.

Quality of evidence and conclusions

There is low-quality evidence that exercise reduces pain and disability in women with low back pain, and moderate-quality evidence for the effect of exercise on reducing sick leave and reducing the number of women with both lower back and pelvic pain complaints. The quality of the evidence depends on problems with study design, small numbers of women, and variable results. Ultimately, we believe that future research is likely to change our findings. There is not enough good quality evidence to make confident decisions about the treatment of these complaints.

Translation notes:

Translation: Kong Hong Han. Editing: Gamirova Rimma Gabdulbarovna, Ziganshina Lilia Evgenievna. Project coordination for translation into Russian: Cochrane Russia - Cochrane Russia (branch of the Northern Cochrane Center on the basis of Kazan Federal University). For questions related to this translation, please contact us at: [email protected]

Pinched sciatic nerve during pregnancy: symptoms, treatment

For the female body, pregnancy is a difficult test. It is during this period that all hidden pathologies can appear or those that were known before pregnancy can worsen. Not a rare case during the period of bearing a child for a woman is such a neurological disease as a pinched sciatic nerve (another name is “sciatica”). How this disease manifests itself and how you can fight it without harming the unborn baby will be described in this article.

Causes of pinching of the sciatic nerve in pregnant women

Among the most common causes of pinched sciatic nerve during pregnancy are:

• Pressure on the sciatic nerve of the enlarged uterus. Accordingly, as the fetus grows in the uterus, this pressure increases.
• Displacement of intervertebral discs in the lumbar region. This, in turn, can occur due to excessive weight gain, multiple pregnancies, polyhydramnios.
• Traumatic injuries of the spine in the lumbar region.

In cases where sciatica has already occurred in a woman's history, but after appropriate treatment, its symptoms have disappeared, a relapse may occur during pregnancy. In addition, pinching, inflammation of the sciatic nerve during pregnancy can be the result of an intervertebral hernia, diabetes mellitus, a malignant or benign tumor, osteochondrosis and other diseases. That is why, in order to be able to prevent the occurrence of sciatica or be ready for its manifestation, a woman needs to tell her doctor everything about her health. At risk of pinching of the sciatic nerve together with a gynecologist a woman will be observed by a neurologist .

Symptoms

Pinched sciatic nerve during pregnancy does not go away without symptoms and often the disease is urgently required. Usually, this pathology is manifested by pain that occurs in various areas of the lower body and has different intensity and frequency of occurrence. The main symptoms of sciatica include:

• Discomfort or pain in or just below the lumbar region. Further, the pain can move to the sacrum, and then go down to the very foot.
• Pain may present as shootings and occurs only at certain points along the path of the sciatic nerve.
• Pain may occur when bending the torso, with sudden movements, turning the torso.
• In cases where the compression of the sciatic nerve is too strong, the pregnant woman may have trouble walking. There may also be numbness and loss of sensation in areas of nerve damage.
• When inflammation of the sciatic nerve occurs due to pinching, body temperature may rise.
• Violation of the process of urination, disruption of the intestines.

About any of the listed symptoms, and even more so if they are observed in combination, a pregnant woman should be told to her doctor.

How to diagnose pinching during pregnancy?

What to do if during pregnancy there is a suspicion of a pinched sciatic nerve? First of all, consult a doctor for a diagnosis. To confirm this diagnosis, doctors conduct an external examination, palpation, and also ask the woman to perform several simple motor tests (for example, tilt the torso, lie on her back and raise one leg without bending). If during palpation, with certain movements of the body or legs, a woman feels pain, then most likely the nerve is pinched.

Also, as part of the diagnosis, standard blood tests are prescribed to assess the general health of a woman, to understand if there is inflammation in the body. Diagnosis of sciatica during pregnancy is difficult because not all possible and informative methods can be used. For example, X-rays and tomography are contraindicated during pregnancy, although these diagnostic methods could give the most complete picture of the development of the disease.

How to treat?

Any treatment during pregnancy requires special care. When prescribing certain methods of treatment, the doctor must evaluate the intended benefit to the mother and the possible risk to the fetus. If it is possible to postpone treatment for the postpartum period, then this path is chosen. If the painful condition of a pregnant woman prevents her from moving normally, resting, she is tormented by unbearable pain, then a course of treatment is necessary. For help in the treatment of sciatica, as well as many other diseases, including during pregnancy, you can contact the qualified specialists of the Energo clinic.

exercise therapy and gymnastics

With the help of physical therapy and special gymnastics, you can fight various neurological diseases, including sciatica. Specific types of exercises to be performed should be prescribed by the doctor, assessing the general condition of the patient. Basically, each exercise is aimed at strengthening the muscles of the back. One of these exercises is the arching of the back from the starting position while standing on all fours (the so-called "kitty").

Massage

Massage for pinched sciatic nerve allows you to relieve tension from the muscles, increase their tone, improve the general condition of the patient, improve blood flow and metabolism. It can be done only when there are no acute attacks of pain. This applies not only to pregnancy, but also to the general appointment of massage for pinched sciatic nerve.

Warm-up

Warming can be used to relieve pain. To do this, you can use, for example, a belt made of dog hair, pads with buckwheat or flaxseed and other coolants.

Yoga

Calm, relaxing yoga classes help restore emotional balance, relieve muscle tension, increase muscle tone. After yoga, many pregnant women notice that their overall health improves, their mood improves, their appetite is restored, which, of course, has a positive effect on the development of the fetus.

Manual therapy

Manual therapy helps relieve pain and reduce its attacks. The impact occurs on certain points on the back, legs, where pain is localized.

Compresses

For compresses and rubbing, you can use herbal tinctures. This should be done with great care, following the clear instructions of the doctor, since almost all such tinctures contain alcohol. You also need to remember that in the presence of an inflammatory process in the body, elevated temperature, compresses are contraindicated.

Prenatal Band

To reduce the load on the spine, to maintain it in the correct position, it is recommended that pregnant women wear a prenatal bandage. Doctors usually recommend wearing it from the middle of the second trimester. No need to wear it all day - about 2-3 hours. The bandage makes it easier to walk or stand. Sitting and resting in it can be uncomfortable.

Medical treatment

Drug treatment during pregnancy is rarely used. Most drugs have a number of contraindications in their description, which almost always includes pregnancy (especially the 1st and 3rd trimesters). In extreme cases, painkillers, B vitamins, anti-inflammatory drugs may be prescribed.

Preventive measures

Any disease is easier to prevent than to treat it later. Sciatica is no exception. As a preventive measure for this disease, women planning a pregnancy, as well as everyone else, should lead an active lifestyle, attend aerobics, yoga classes, go to the pool and so on several times a week. Strong physical exertion, which can adversely affect the condition of the spine, should be avoided. You also need to avoid sudden movements, hypothermia. If during the treatment of any disease the doctor prescribes intramuscular injections, only a trained specialist should do them.

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