SUGGESTIONS FOR THE ACHES AND PAINS OF PREGNANCY IN THE GROIN BACK AND/OR LEGS

Please remember to always consult your provider before following any advice or using any treatments.

      In general, the experience of pain is humbling, and especially in pregnancy, it can be a chance for personal growth, to learn patience, acceptance of normal bodily changes, and how to prioritize, delegate and let go of routine activities and allow others to help.  Here are some suggestions:

-                     For pregnancy related aches and pains in the groin, back, and/or legs, it is recommended that you consult a reputable chiropractor or osteopath who can successfully relieve strained muscles and correct a spine or pelvis that is out of alignment; other helpful professionals include a massage therapist who can do wonders to release tightened painful or aching muscles in spasm, a homeopath who can suggest a safe natural remedy to effectively treat your specific symptoms, and/or an acupuncturist; ask your provider for referrals to practitioners with expertise in this area.

-                     Sharp but short lived pain in the groin area that can sometimes travel down into the legs is related to the stretching of the round ligaments that hold and support your growing uterus within your abdomen, or to pressure of the uterus or baby on local nerves; this sort of pain usually occurs while walking and can be enough to stop you in your tracks

-                     For relief from round ligament pain: stop to rest; bend your knees onto your abdomen or get on to your hands and knees and rock your pelvis inward and outward; try a warm bath and/or heating pad; take your homeopathic remedy

-                     to minimize strain on these ligaments: take frequent breaks; use pillows under your uterus and between your legs when lying down on your side; roll on your side and use your hands and knees when getting up from a supine position; apply gentle pressure to the area when laughing, coughing, or sneezing; consider wearing a maternity support garment; practice your kegel exercises daily to strengthen your pelvic floor muscles that help support your uterus (these are the muscles you tighten when you stop the flow of urine midstream – hold them in for 10 seconds as many and as often as you can)

-                     high backache in pregnancy is related to breast enlargement and heaviness, which may produce strain in compensating back muscles , especially if your breasts are not well supported: wear a well fitting, comfortable and supportive maternity bra that lifts your breasts upward and inward; do shoulder rolls and arm exercises that tighten and release your upper back muscles; get a regular back massage

-                     aches and pains in the lower back are related to several factors: pressure of your growing uterus or baby on nerves; stretching of the ligaments that connect the sides of the enlarging uterus to the lower back; hormonal relaxation and increased mobility of your joints, especially in the pelvis; the shift in the center of gravity from your expanding belly, which leads your pelvis to tilt forward and your back to arch, thereby straining the back muscles; the problem is made worse by excessive weight gain, prolonged walking or standing, frequent bending or lifting with poor posture and improper body mechanics, ill fitting or high heeled shoes, and weak abdominal or back muscles.

-                     sciatica pain is caused by pressure of the enlarging uterus or baby on nerves that pass through the lower spine into the legs; this pain can travel from the back or thigh all the way down to the feet or toes, it can be severe and associated with other strange sensations like tingling or numbness.

-                     watch your weight gain; remember, under normal circumstances you only need to gain 3-6 pounds during the first trimester and ½ - 1 pound per weak thereafter, for a grand total of 25 – 35 pounds; regular moderate exercise (at least ½ hour 5 days per week of activities like brisk walking, swimming, cycling, dancing, and low impact aerobics), lots of water, a healthy diet high in fresh fruits, vegetables, whole grains, nuts, beans, seeds and lean protein foods (such as eggs, tofu, fish, skinned chicken or turkey, and low fat dairy), as well as low in sugar, white flour, saturated and partially hydrogenated fat and refined processed foods should be sufficient to maintain ideal weight gain throughout your pregnancy, but please ask us if you need help in this area.

-                     make sure you are eating enough calcium (found in dairy foods, sardines, salmon, ground sesame seeds/tahina, and dark green leafy vegetables excluding spinach) and magnesium (abundant in fresh green vegetables, apples, wheat germ, seeds, and nuts); you also need sufficient vitamin C, D, E , and B complex easily absorbed from a well-balanced diet or a food based prenatal supplement

-                     know your pregnant body’s limits and pay attention to what your symptoms are telling you; take frequent breaks or rest periods if you need to be on your feet for prolonged periods of time; cut down on added nonessential burdens in your life and be clear about your priorities; it is OK to say “no” or to leave the housework or pile of papers for tomorrow, or better yet for someone else; don’t be afraid to ask family or friends to help with chores or child care, or even better, treat yourself to hired help and healthy take-out meals

-                     avoid fatigue by making sure you are getting extra needed sleep by going to bed earlier, sleeping later, and/or taking naps

-                     pay deliberate attention to your posture, especially when standing or walking, by lifting your abdomen up, tucking your pelvis in to minimize the arch in your back, keeping your knees slightly bent and relaxing your shoulders down; even when sitting, take care not to slump by using your abdominal muscles to lift up and keep your back straight

-                     use a foot stool while standing for extra relief on your back muscles

-                     avoid heavy lifting; spread out bought items from the grocery into several bags and take more trips carrying a lighter load instead of a heavier one all at once, or better yet – ask for help

-                     watch your body mechanics by using your stronger stomach, arm, and leg muscles not your weaker back to lift, pull, or push something; instead of bending at the waist or lifting abruptly, bend at the knees with a broad base and lift carefully; instead of reaching for an abject, come closer to it; turn and twist more slowly and with caution; if a particular action feels even a bit uncomfortable – STOP!

-                     take extra precautions during activities requiring balance and walking on wet, icy or slippery surfaces; remember your sense of balance is changed, your gait is more awkward and you have an increased tendency to fall (use a nonskid floor mat in the bath and shower)

-                     wear supportive, well-fitting comfortable shoes and save the high heels until after the baby

-                     if you can not tolerate your usual exercise routine, do regular but more gentle exercise (1/2 an hour 5 times a week); ideally take a prenatal dance, yoga or pregnancy exercise class, as a good instructor can help you maintain proper posture, learn how to strengthen your abdominal and extremity muscles, and do pelvic rocking motions and back stretches that help relieve backaches; swimming is another option, as it allows you to get great exercise without any weight on your back

-                     rest on a firm supportive mattress or use a bed board, and sleep with pillows positioned to straighten your back and alleviate strain or pulling (some women find the floor or a futon helpful); lying on your side especially takes the strain off your back

-                     sit on harder more supportive chairs

-                     put on a maternity support garment before you start each day, especially if you were out of shape before the pregnancy or have poor abdominal muscle tone after several children, if you are overweight, carrying a big baby or twins, or on your feet a lot; many specialty stores or catalogs stock lightweight maternity girdles with soft elastic fronts and an adjustable belt; ask us for a recommendation

-                     stress leads to increased muscle tension and pain; although easier said than done, limit your stress and inner tension and increase feelings of calm, by  taking  a “healing interval” a few minutes several times each day to sit quietly with your eyes closed and think and do absolutely nothing, meditate, practice your relaxation techniques, or take a walk outside in nature; life is stressful and always has been, and eliminating all outside stress is not an option; but you can learn to activate your own relaxation response and quiet your nervous system with breath work and awareness, meditation, imagery and visualization, progressive muscle relaxation, yoga, and self mastery over your thoughts and reactions to difficulties; try to stay away from things, sounds and people that agitate your mind and raise your internal tension, and instead surround yourself as much as possible with calm centered persons, things and sounds that inspire, relax and restore you to inner peace and serenity; make a conscious effort to work on increasing your own positive feelings while letting go of negative feelings; become conscious of anxiety provoking, tension causing thought patterns that are not serving you, and literally stop them or shift your attention to something more positive like slow deep breathing and ultimately change your inner mental state; you have the ability to alter your attitude and reaction to stressful  life experiences to more health enhancing responses (for example, you can surrender to and totally accept unpleasant events over which you have no power, and/or you can view them as a wake-up call, an opportunity for personal growth and redirection)

-                     Before going to bed each night, as well as before rising in the morning and whenever you feel stressed, practice the following breathing exercise: exhale slowly through your mouth with an audible sigh, then inhale slowly through your nose for a count of 4, hold for a count of 7, then exhale slowly through your mouth for a count of 8, and repeat this cycle a total of 8 times – this is a natural tranquilizer, especially if you do it often; another great breath work technique that disengages your conscious attention from thought and relaxes the nervous system, and can be done anytime (like when traveling, waiting in line, resting, bathing or on the toilet) is forced exhalation: after a normal breath, try squeezing as much air out as possible using your intercostal muscles in your chest, then allow breath to come in naturally and deeply, but automatically, and repeat the cycle for several minutes – these techniques are easy to do, totally safe, health enhancing and without side effects, and will help you to relax yourself whenever you feel tense

-                     when your back hurts: allow time to rest and get into a position that eases the pain (some women find stretching or pelvic rocking helpful), take slow deep breaths in through your nose and out through your mouth, and focus on releasing your tense muscles head to toe; one of the most pleasant ways to relieve backache is a massage to the painful area before sleep, ideally with the essential oils of Ginger, Juniper, Lavender, Marjoram, and/or Rosemary diluted in a massage base-oil like almond or olive, macerated herbal oils of Comfrey, St. John’s Wort or rubs of Tiger Balm, Olbas, Wintergreen and/or Zheng Gu Shui (a product containing a of these soothing herbs can be purchased at many health food stores); after the massage, apply local moist heat (using a hot water bottle, a hydroculator, or a towel dipped in hot water), sit in the shower and direct hot water onto your back, or soak in a warm bath for ½ hour with a few drops of any of the above essential oils; some women find that ice packs or cool compresses helps to relieve the pain, especially during the first 24 hours after an injury

-                     for acute spasm of your back muscles: apply an ice pack for the first 12-24 hours; once the pain begins to subside, apply moist heat; absolute rest and immobility are essential for the first 1-2 days in positions that feel best; sometimes the only tolerable position is lying flat on your back on the floor with your buttocks up against a bed or a chair and your legs raised at a right angle with your calves resting on the mattress or seat; place 4-5 pellets of  homeopathic Arnica 30c under your tongue every hour while awake, every 2 hours the next day, then 4 times per day for 4-5 days; apply topical Mineral Ice or Tiger Balm (this can lessens the effect of your homeopathic remedy for some); get a deep muscle massage and/or acupuncture needling of trigger points; emotions greatly influence nerve and muscle interaction -- try to put yourself in a more positive happier state by reading uplifting books, watching movies and listening to tapes that make you laugh, and spending time with those who bring out your best moods

-                     it is OK to take an occasional dose of acetaminophen (Tylenol), or an occasional ibuprofen (Advil) in the first or second trimester only,  but avoid other drugs before consulting with us, since many are not safe for use during pregnancy (including aspirin, certain muscle relaxants, and anti-inflammatory medications)

-                     avoid hot tubs and whirlpools because getting your body to such high temperatures without allowing you to sweat to cool you body down may not be safe for the baby; a very warm bath at home is fine

-                     remember that not all aches and pains can be blamed on pregnancy; consult your provider if the above suggestions do not help, the pain is different than usual, severe, persistent, or continuous, associated with other unusual symptoms like fever, chills, changes in bowel or bladder habits, vaginal bleeding or leaking of water-like fluid, regular pelvic pressure, uterine hardening or cramping, a local area of increased pain, redness, swelling, and redness on your leg, difficulty moving, or if you have a history of serious back problems, injury, or surgery