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With a sudden weight gain of 5 kilograms (11 pounds) or more, most people start complaining of back pain. During pregnancy, most women experience weight gain larger than 10 kilograms (22 pounds), making their backs vulnerable to pain.
Among pregnant women, 50 to 80 percent experience some form of pain, be it in their pelvic area or back region. Yet, the majority of those women regards such pain as nothing more than a common pregnancy-associated pain, or chooses not to seek diagnosis and treatment for the fear that such treatment may harm the baby. Although in most cases the pain naturally disappears several weeks or months after childbirth, approximately 10 percent of women suffer from pain years after a pregnancy. Such patients may experience even more severe pain during their next pregnancy, and thus such pain should be monitored carefully.
Commonly, back pain will occur five to seven months into the pregnancy, but may start as early as eight to 12 weeks. Women who have experienced this pain prior to pregnancy are more prone to pregnancy related back pain, and during earlier periods than others.
Causes for pregnancy related back pain can be traced to changes in either hormones or body shape. Hormonal changes during pregnancy loosen joints and ligaments destabilizing joints, which can cause pain. In such cases, most doctors will take the “wait and see approach” rather than immediately giving treatment. Back pain that requires treatment is usually caused by changes in body shape. As the fetus grows and the belly becomes larger, the spine is pulled forward and the natural gradual c-curve of the spine becomes more pronounced, putting greater pressure on the lumbar vertebrae. Also when the breasts become larger during pregnancy, the upper back naturally bends forward to support the increased weight, and the neck extends into a forward head posture. Such changes increase tension across the spine, which causes pain.
Treatment can begin during pregnancy. In oriental clinics, acupuncture and Chuna-chiropractic treatment can be safely administered. However, as most pregnant women are cautious about undergoing any type of treatment, in reality, patients opt to be treated after childbirth. As previously mentioned, once the body weight returns to normal, pain can naturally subside and ease up, but breast-feeding, baby-nursing, and other household chores can compound the pain in the back, pelvis, neck and shoulders. In such cases, acupuncture, along with cupping and moxibustion treatment, can be effective in relaxing the tense back and pelvic muscles. Chuna-chiropractic treatments can restore the body shape to its pre-pregnancy state. If the patient suffers from exhaustion after childbirth which can hinder the pain treatment, herbal medicine is recommended at the same time. If the weight that was gained during pregnancy remains, this alone can cause back pain. In such cases, weight-loss treatment along with pain treatment can remedy the pain effectively.
Some patients complain that although they have lost all the weight, they cannot get into the pants they used to wear or when they do, the pants are very tight around the thighs. During pregnancy, the c-curve of the spine can become overly pronounced and the pelvis can tilt forward. If the tilted pelvis does not return to normal after childbirth, it will make the woman appear to have a larger pelvis because a tilted pelvis makes the protruded pelvic bones appear more pronounced, which can be visible even to the naked eye.
Also, the femur, or thighbone, tends to rotate medially, or inwards, to extend the flesh outwards, making the thighs appear thicker. This is different from the widening of the pelvis which allows the baby to pass easily through the birth canal during childbirth. It is a symptom caused by the change in body shape where the orientations of the vertebral, pelvic and femoral bones have been altered. In such cases, correcting the body shape to restore the tilted pelvis would be the most effective treatment.
The writer practices Korean Oriental Medicine at UN Oriental Medical Clinic in Hannam-dong, Seoul. He can be reached at sung_hun@naver.com.