Pregnancy and Pain;
During and after pregnancy, which is considered a physiological event, some changes are seen in the musculoskeletal system and these changes can sometimes cause severe pain.
Waist region;
The growing uterus causes a shift in the pregnant woman’s center of gravity and causes an increase in the waist curve. An increase in the waist curve leads to an increase in pre-existing problems such as canal stenosis and herniated discs. It has been reported that 50% of pregnant women complain of waist pain. The increase in the waist curve creates mechanical pressure on the muscles and ligaments, which can cause increased pain that spreads to the hips and groins. When the weight increases in the lower and front part of the abdomen, the pregnant woman shifts her upper body backwards to protect herself from falling, which disrupts her back posture and creates a hunchbacked appearance.
Chest-back;
The growth of the breasts can make it difficult to stand upright and if the back muscles are weak, it can lead to a hunchbacked posture. The increase in the transverse diameter of the chest raises the diaphragm, the ribs rise and the tension of the vascular-nerve bundle causes pain, numbness and tingling symptoms radiating from the shoulder to the arms.
Weight gain;
The lumbar vertebrae, legs and hip joints, which are affected by hormonal and posture changes, are subjected to loads and strains as a result of weight gain and pain may occur.
The increase in the load on the knees and kneecaps may cause pain around the knees. In women with a pre-pregnancy cervical or lumbar disc herniation, numbness and tingling, and pain radiating from the waist to the legs may increase. Excessive weight gain may lead to the growth of hernias and the formation of muscle weakness. In patients diagnosed with scoliosis (heaviness) in the spine, the increase in the degree of curvature may cause movement restrictions.
Fluid accumulation;
Edema frequently occurs in the legs, ankles and feet in most women starting from the 6th-7th month of pregnancy and this leads to pain, cramps and cellulite formation. Due to edema, the median nerve is compressed while passing through the tunnel around the wrist and carpal tunnel syndrome may occur. Pain, numbness, tingling and muscle weakness may be observed in the thumb, index and middle finger of the hand. Similar findings occur in the feet with posterior tibial nerve compression.
Connective tissue changes;
Connective tissue changes are observed during pregnancy due to changes in estrogen, progesterone, endogenous cartisols and relaxin hormones. Increased joint laxity returns to normal approximately 6 months after pregnancy.
Treatment of pain related to the musculoskeletal system frequently seen during pregnancy;
Low Back – Neck Pain; A bed frame is given for 4-5 days in acute low back pain. Light heating and massage can be applied for spasm and pain. Appropriate postural adjustments should be made, face down should not be laid, necessary support forms should be provided. It is not appropriate to use painkillers during pregnancy.
Therefore, the problem of pregnant women with pain complaints should be solved with physical therapy. We can safely apply physical therapy in all periods of pregnancy. In pregnant women with cervical disc herniation or pain, in addition to pain, numbness in the arms and fingers, and weakness in the finger muscles may be observed, and sometimes the pregnant woman may not even be able to open the door. In such a case, it is necessary to inform the pregnant woman and explain that this condition is temporary. In addition to bed rest, vitamin B applications, infrared, massage, and TENS applications can be applied for lumbar disc herniation and pain. Mobilization techniques, exercise, and swimming are recommended with the help of a physiotherapist. Thoracic Outlet Syndrome; Shoulder pain during pregnancy is frequently seen due to compression of the shoulder vein-nerve bundle. In addition to massage, TENS applications that open muscle spasms around the shoulder, exercises that strengthen the muscles around the shoulder and neck are applied, and home exercises are planned.