Dealing with back pain in pregnancy

Pregnancy often brings with it a whole range of new niggles, aches and pains. Your ankles swell, your feet are sore, you've got heartburn like never before, and your back... Oh, your aching back! It's not just that you've gained weight, it's that the weight you've gained isn't spread out evenly over your whole body -- it's that the weight is all centred in the front of your body, putting great strain on your back and causing discomfort and difficulty sleeping.

OHbaby! asked Garry Trainer, celebrity osteopath and acupuncturist and co-author of Back Chat: The Ultimate Guide to Healing and Preventing Back Pain (Aurum, $34.99), to give us some tips on dealing with back pain in pregnancy. Here's what he had to say:

OHbaby!: As you note in Back Chat, and as pregnant women throughout history have noticed and suffered, back pain in pregnancy is especially common and often excruciating to deal with. Because pregnant women are often unable to turn to "conventional" methods of pain relief, what do you recommend for dealing with very painful back issues during pregnancy?

Garry: During pregnancy, the hormone relaxin is released in to the system to loosen off the ligaments of the pelvis and birth canal preparing the pelvic area for birth, so many ligaments become over mobile thus prone to over extension and ensuing pain. I would recommend a sacro-iliac (where the pelvis connects to your back) support belt, which offers excellent support to the lower back area.

I also would recommend having regular massage during pregnancy - many clinics have special sculpted support cushions that allow you to lie down on your front and supports the body in all the right places.

Invest in a TENS machine. These have been proven effective in some cases for pain relief without resorting to medication. TENS are a non-drug form of pain relief that stimulates the body's own natural painkillers - endorphins. These are excellent for pain management as they scramble pain impulses from the brain. A mild electrical current is introduced via adhesive pads which are attached to the areas of pain.

OHbaby!: Carrying small children around on women's hips can often cause or aggravate existing back pain, yet there is no simple solution for this -- we have no choice but to lift and carry our kids when they're little! Do you have any suggestions for ways to reduce back pain when carrying children around, such as wearing a back brace or belt, using a baby front pack, etc?

Garry: Yes, absolutely. All these products are excellent aids. Back braces support the structure of the back. There are some fantastic baby carrying devices on the market. I saw one recently that has a small ledge on a belt which sits just above your hip helping to evenly distribute the weight load. 

Again, sacro-iliac belts are great means of support. 

Also, don't forget your post natal strengthening exercises and to shift the baby to different hips every so often if you have to.

OHbaby!: Studies have shown that children who are "worn" (ie carried in slings or close to the body) cry less and are more attached to their parents, so the "baby-wearing movement" is gaining great credence among contemporary mothers. What are your views on baby front packs, baby backpacks, and baby slings? Are any of these options better or worse than others in terms of reducing or minimising back pain while carrying children around?

Garry: I really advocate front packs for carrying your baby, especially in the early days, not only for the bonding experience but also for the carrying experience. A weight that is kept close to the body is easier to lift than a weight lifted with extended arms or at a distance so remember when you pick up your child, bend your knees and lift them in towards you rather than out from you. I was recently in Mauritius and didn't see a single pram, buggy or push chair. All children are carried from birth and there seems to be an incredible familial bond. Was quite taken by it.

OHbaby!: Do sleeping positions make a difference to back pain, particularly to pregnant women? Pregnant women are discouraged from sleeping flat on their backs and cannot sleep on their stomachs, so tend to spend hours at night tossing and turning, and fluffing various configurations of pillows to find a comfy position. Do you have any advice for pregnant women with sore backs who desperately want quality sleep?

Garry: Yes, very much so. One simple technique I would advise is to try sleeping with a regular pillow or cushion between the knees whilst on your side or a pillow under your calf muscles whilst lying on your back (if it is comfortable for you to do so). This will help stabilize and relax the pelvis and lower back. There are specially designed and shaped pillows available to buy. If not a rolled up towel will work equally as well. Alternatively, ask your husband or partner to massage areas of tension. This can often aid relaxation and sleep. Ditto, a hot bath. 

OHbaby!: What do you think of "pregnancy wedges" (triangular wedge-shaped bits of foam that women put under their backs when sleeping) and full-body pillows? Do these help or hinder back-pain-reducing sleeping positions?

Garry: I think they are really good, as I mentioned earlier, and many of my clients have found them extremely beneficial. So all the feedback I've received has been wholly positive. Can't say I've had any personal experience, but trust my client's feedback. 

OHbaby: Does massage benefit or hinder back pain? Are any particular types of massage more effective than others? What about massage for back pain in pregnancy?

Garry: I have always used massage before any osteopathic or acupuncture treatments because it is a fantastic way to relax the muscles and mind. I am a huge advocate of massage for many conditions, but for back pain and pregnancy, it really is an optimum treatment. The deeper tissue massage techniques are more effective than shallow stroking techniques. Sometimes, if a back problem is really acute (very painful) gentle massage is probably better than any manipulation.

OHbaby!: Many pregnant women find it extremely difficult to find effective treatment for back pain simply because medical and health professionals refuse to work with them out of fear or ignorance. What can pregnant women look for in medical and health practitioners to help them with back pain, and what can they say to those who refuse to treat them?

Garry: A doctor who has a referral network that appreciates and utilizes the benefits of physical therapy eg physiotherapy is always a good one to go for, especially for muscular-skeletal complaints ie back pain, pelvic pain. Talk to girl friends who have had babies as word of mouth referral can't be beaten. If medical or health practitioners refuse to treat you, don't worry and say that you are going to seek another form of treatment. There are some great alternatives and practitioners outside of the conventional medical approach eg acupuncture, reflexology, massage and gentle osteopathy. These are all fantastic treatments when pregnant, but please remember to check practitioners credential's or that they are registered members of the various governing bodies.