Dorsalgia (upper back pain) and lumbalgia (low back pain) during pregnancy

Low back pain is present in almost fifty percent of pregnant women. Commonly, this pain during pregnancy is connected with the increased spinal load and weakened abdominal muscles due to their overdistension. As a rule such pain comes after the fifth month of the pregnancy, but it abates and passes off after childbirth. Sometimes the pain extends to the leg sharpening after physical activity, continuous walking, long-time standing, sitting in an uncomfortable position. The pain in the region of symphysis pubis (mons pubis) and sacroiliac joint (the pain is felt in the region of hip joint and anterior surface of the hip) is caused by the slight ligaments softening resulting from change in the pregnant woman’s endocrine profile and relaxin generation.

You can get rid of the pain using the calcium-rich diet that includes milk products, walnuts, fish, meat and greens. If the low back pain and pelvic bones pain occur regularly calcium carbonate or calcium lactate should be taken. A pregnant woman should also avoid any movements that increase the load on their back. You should squat down and toughen the muscles of arms and legs but not the muscle of back when picking up something from the floor. You should lean back when sitting, and never plump down and sit down abruptly, because it exerts a negative influence on intervertebral disks. You should choose a semirigid and elastic orthopaedic mattress for sleeping. The pillow should be middle-sized; it should better be anatomic-shaped considering natural spinal curvatures. You should wear comfortable low-heeled shoes with the firm heels. And, of course, the physical exercise strengthening the muscles of abdomen, back, hips and buttocks, aerobics, aqua aerobics and swimming are essential and indispensable.

Low back pain during pregnancy may also be caused by various neurological conditions, for instance, discal hernia, lumbosacral radiculitis. In this case the medical treatment provides for remaining at bed rest, spinal support or abdominal support, therapeutic physical training, and taking an anesthetic from time to time. The continuous pains in symphysis pubis and gait disorder are the signs of symphysitis, a hereditary disease connected with the significant symphysis pubis strain and softening and haemorrhage of it. In this case inpatient treatment is used, and the whole time of pregnancy is under the doctor’s vigilant surveillance.

If the low back pain is accompanied by rise in temperature, edema, headache and arterial hypertension, polyuria, and the urine becomes cloudy and change its colour, you must consult your doctor. These symptoms are the typical for renal diseases requiring inpatient treatment due to their negative influence on the gestation course, fetal state, woman’s health, and causing the severe complications. Commonly such symptoms discover pyelonephritis that is the inflammation of the kidney tissues and upper urinary tracts induced by infection.

Sharp, intensive, colicky pains in the small of the back accompanied by urination disturbance may be evidence of urolithiasis renal colic. Passing through the ureters the calculus injures them causing spasm and pains. That is why spasmolytics and analgesics are prescribed in case of nephrolithiasis. A medical treatment is administered by a doctor. Subsequently, the calculi composition is required to be diagnosed (their several types), and the diet and the treatment will be adjusted depending on it.

Occasional low back pains when uterus tension is felt (as if it turns to stone) occur in case of so-called Braxton Hicks contractions. These false labour pains, “training” labour pains in late pregnancy prepare a body to childbirth. However, if the duration of gestation is less than 37 weeks and the genital tracts discharge is present, and the underbelly pain is felt, and the labor pains intervals are reduced, this may be evidence of threatened miscarriage. In such situation you should immediately seek medical advice.

Abdominal pains

During pregnancy, especially in the first trimester of pregnancy, different phobias haunt an expectant mother and stick to her. One of them is an adverse pregnancy outcome. Abdominal pains during pregnancy are considered as the first sign of the ill-being. That is why it is necessary to note at once that the abdominal pains is not always the sign of the threatened miscarriage (misbirth) or any other pathology requiring surgery. Stomach convultions and enterospasm resulting from the improper feeding are quite often the source of the pain. The pains may result from the pre-existing colitis (intestinal mucous membrane inflammation) and intestinal disbacteriosis. Overeating or eating not quite good products lead to intensification of the intestine activity, boring and bursting abdominal pains. But normally such pains pass off and abate during one to two hours and do not recur until the next eating disorder. If such pains occur the remedies to be taken are activated carbon and spasmolytics. It is very important to comply with the nutrition prescription and elimination of the irritants.

During pregnancy the intestinal peristalsis becomes worse, and the food moves slower. The pressure of the growing uterus on the intestine just worsens the problem. Constipations are a frequent problem of the expectant mothers, and they also may lead to severe underbelly pains. To avoid the constipations you should eat vegetables, stewed dried fruit, bran and increase the quantity of the liquid to be drunk. Walking and easy physical exercise facilitate to normalize the intestine functions.

The other common cause of abdominal pains is a strain and tension of ligaments that support the proper position of the uterus. The ligaments come from the different sides of the uterus and are attached to the pelvic walls. The ligaments are sprained as the duration of gestation grows. This process is accompanied by pains. Commonly, the pains occur when changing the position of the body, making fast movements, sneezing, coughing. The pains may be acute, sharp, but short-time. It disappears soon. There is no need to take any medicines in this case.

The abdominal pains resulting from the excessive tension of prelum abdominale may also occur when performing a physical exercise or work requiring a great physical strength. You should just relax and have some rest, and next time you should reduce the load.

Acute abdominal diseases requiring a surgical treatment (acute appendicitis, ileus, pancreatitis) are rarely present during the pregnancy. They are accompanied by the pains that constantly increase, as well as sickness, vomiting, liquid stool, vertigo, general weakness, and temperature rise.

However, sometimes abdominal pain during pregnancy is a sign of obstetrical problems. The problems may be associated with the pregnancy course as well as with the general well-being. One of the reasons of the pains during pregnancy is a threatened miscarriage. In this case the pain is constantly tensive and cramp-like; it is felt in the lower abdominal segment and loins, and it does not disappear without taking the medicines. The pain may be accompanied by the genital tracts blood discharge having different intensity. This is the cause to consult a doctor immediately, appoint an integrated examination and treatment, perhaps, inpatient treatment. The examination includes a medical inspection, analysis of the features of health status and the course of pregnancy, carrying out an ultrasound investigation. The specialized laboratory investigations make it possible to specify hormonal, immunological, infectious and genetic factors that could result in complication of the course of pregnancy and disturbance of the fetus development.

We can help mentioning the extrauterine pregnancy when the ovum is attached to the uterus wall. In this case the test for progesterone content on blood is positive but ultrasound investigation discovers no ovum into the uterus. The fertilized ovum cannot grow beyond the uterus for a long time. Such pregnancy is terminated soon (5 to 7 week). It is accompanied by severe intra-abdominal hemorrhage and acute abdominal pain that extends t the rectum and leg. Vertigo, emesis, syncopic state may also be present. The situation is very serious and requires an intermediate medical intervention and surgical treatment.

Commonly, it is hard for a pregnant woman to understand the cause of abdominal pains. That is why it is important to be able to communicate to a doctor observing the course of pregnancy ant discuss the state of health with the doctor that will help to overcome excessive fears and provide treatment as needed, and bear the fetus until the full term without any problem.

Cephalalgia (headache)

Many expectant mothers know migraine and so-called exercise-induced headache.

Migraine is connected with the biochemical disturbances in the brain and change in cerebral vascular tone. Very often migraine is present during the menstruation and ovulation but in case of pregnancy these promoters are excluded. But there are a lot of other ones: stress, overfatigue, lack of sleep or oversleeping, change in the weather, too bright light, too loud sound, starvation, smoked-filled air. An attack may be caused by the chocolate that you so like, the Chinese dishes as well as walnuts, yoghurts, chicken liver, avocado, citrus fruits, bananas, canned and pickled products, tea, coffee, cola, sausage, red wine, cheese… The changes in the endocrine profile may also lead to the shifting of various biochemical indices. Subject to these changes the pregnancy may provoke migraine attacks, and, vice versa, it may stabilize the course of disease. In many patients suffering from migraine a pause occurs in the second or third trimester of pregnancy. Occasionally the course of migraine worsens or it appears for the first time in those who have never suffered from headache; as a rule it occurs in the beginning of pregnancy.

Migraine may be ordinary and classic (“migraine with the aura”). In the beginning the aura appears, and one sees a flash flickering, moving blinking spots, luminous zigzags, and in this case sometimes changes in the skin sensitivity may be observed. And then, not later than hour following the aura appearance, a pulsing headache comes, as a rule it affects only one side of the head and commonly accompanied by nausea, vomit and photophobia.

To get rid of migraine you should first eliminate the promoters, for example, you should cut out the “harmful” products from your food. When treating pregnant women’s migraine Paracetamol is used, and, if necessary, antihistamines (Suprastin, Fencarol, Diazolin). Expectant mother are not allowed to take some medicines arresting the migraine attacks: Aspirin and Nurofen increase the malformation risk and internal hemorrhage risk, Ergotamine causes uterine action, and Propranolol delays the fetus development.

Exercise-induced headache as well as migraine is benign. Most commonly it can be observed in the first and second trimester of pregnancy. A head is as if trussed with a retention hoop, and the feeling of heaviness, pressure, inconvenience is present. The state worsens if stressed. In such headache, especially during pregnancy, pharmaceutical drugs are rarely prescribed. Only in difficult cases a doctor may recommend taking antidepressants.

However headache is not always harmless. In some cases it may be a symptom of life-threatening diseases. Thus, in the second and third trimester of pregnancy the risk of cerebrovascular diseases – cerebral infarctions, thrombosis in the cerebral veins, hemorrhage, and intracranial pressure rise. Headache may be one of the signs of raised arterial pressure that is the main symptom of essential hypertension, renal diseases as well as severe gestoses (late pregnancy toxicoses). These states have adverse effect both on the expectant mother’s health and her child’s health. So she must promptly consult a doctor and strictly follow the doctor’s instructions.

Stethalgia (chest pain)

Due to progesterone’s activities mammary glands begin increasing in size; changes in their structure occur as they are prepared for lactation. Sometimes these processes are accompanied discomfort and soreness. It cannot be treated, and there is no need in it, but you may diminish the unpleasant symptoms.

Firstly, you should select the proper underwear. You should feel comfortable in your bra, it should be made of natural materialлов and it should fit. It should not tighten and squeeze your mammary glands nut it should support them well. The position of raised breast facilitates its blood circulation preventing it from haemostasia.

Secondly, you should remember about sanitary procedures. You should wash your breast with water having a room temperature and then wipe it on a wet towel.

Thirdly, simple physical exercise will help you. It will strengthen your muscles and ligaments that support mammary glands, and lymph outflow from the breast.

Urinary bladder pain and rectum pain

With increase of the time of pregnancy a woman can observe polyuria (frequent urination): the growing uterus presses on the urinary bladder. But if acute and lancinating pains occur during urination, and if you feel urinal dissatisfaction and frequent vesical tenesmuses you should suspect cystitis that is an inflammation of the urinary bladder. As a rule it is caused by bacteria. Exacerbation of cystitis or acute cystitis occurrence is frequently present during pregnancy. The disease is treated by rest cure (including total sex abstinence), diet, uroseptics, antibiotics, and sometimes spasmolytics on doctor’s order. Such folk remedies as cranberry drink and cowberry drink having a diuretic action, are good help. For the purpose of prophylaxis of the acute attack of the diseases you should avoid hypothermia and follow the recommendation of your physician in charge.

Pain during pregnancy in defecating in the area of anus, perianal itch and bleeding may be the symptoms of hemorrhoids. Women’s rectus varix dilatation is mostly present in the course of pregnancy, confinement and in the postpartum period. The doctor may prescribe harmless and effective medicines that strengthen vessel walls, and rectal suppositories reducing unpleasant sensations. In order to alleviate your state you should satisfy the following some simple requirements: you should wash one’s lower parts every time you visit the toilet, use wipes, take hipbaths with the decoction of chamomile, sage and marigold. Constipations provoke hemorrhoids, so you should keep to your diet and watch that your bowels move on a regular basis.

Leg pain

Constant boring pain during pregnancy in the legs, especially after long standing or walking is commonly related to lower extremities varix dilatation. Vein wall weakness is inherited. During pregnancy this problem is only worsened due to the increased blood volume, relaxing action of progesterone and relaxin to the vessel walls, and uterus pressure on the pelvis veins. As a result, the veins are dilated and stretched, and the vessel valves that normally prevent the retrograde blood flow, are not able to cope this task. All this leads to the congestion of blood and feebleness of circulation in the lower extremities. Protuberant varicosities may hurt; the sensation of “distention” is present. You should treat varicosity in order to avoid any complications (for instance, trombophlebitis). The most popular varicosity treatment method during pregnancy is elastic compression that is wearing of special “anti-varicosity” stockings and tights. You should put on your tights and bandage your legs with elastic bandage while lying, after 20 to 30 minutes of rest; it is better to do it in the morning, after sleeping not lowering your legs from the bed. You should raise your legs slightly, forget about the proprieties and put your legs on the table.

Gastrocnemius muscle spasms may be evidence of calcium deficiency. “Restless legs syndrome” is commonly developed against the background of iron deficiency, anemia, excessive drinking of coffee. Commonly expectant mothers get a cramp in their legs at night; they suffer from it very much especially during late pregnancy. The fact is that the fetus grows and needs more and more different trace elements and calcium, so he or she takes them from the mother without shyness. The doctor will help you prescribing the calcium, iron and folic acid medicines.

Toothache and sore throat

The problems with teeth may be caused by hormonal changes that are inevitable during pregnancy, and by acute attack of the chronic diseases, compromised immunity, change in phosphorus and calcium metabolism, lack of the vitamins and mineral substances… Only a dentist can determine an exact cause of the toothache.

Pained reaction on cold, hot and sweet products may be connected with the enamel mineralization disorder that is with caries. Inflammation of gums (gingivitis) and inflammation of deeper tissues surrounding the tooth (periodontitis) often develop. Constant toothache preventing from sleeping is evidence of extension of the pathology to the soft tissues of a tooth, pulp containing nerves and blood vessels. Pulp inflammation (pulpitis) requires immediate medical intervention because further development of the process will lead to the inflammation of periosteum and gnathic osseous tissue. All this is accompanied by excruciating pain, inflammation of the neighbouring lymph nodes, temperature rise, chewing and swallowing difficulties. Eventually the problem will be solved by a dental surgeon.

Ideally, oral cavity sanation should be made even before pregnancy. There is no reason for an expectant mother to be racked with aching tooth or tremble nervously at site dental drilling machine. But the main cause of troubles is not in it. The matter is that carious cavities and inflamed gums are the source of the chronic infection which may have negative influence both on the expectant mother’s health and on her child’s health.

If the pregnancy goes on and the toothache is present you should not delay visiting dentist’s. Modern diagnostic methods (using visiograph, a modern X-ray unit combined with the computer), methods of anaesthetization and treatment have no harm for a child’s health and may be used in treatment of the expectant and nursing mothers.

Commonly sore throat is present in case of infectious and inflammation process in the tonsils. Nature has wisely cared of us by the “sentries” protecting the body. The “sentries” are the immune system organs. Peripheral organs of the immune system are located at the border of the external and internal environment. Those are the five tonsils in the ring of pharynx and many of the lymph nodes scattered all the mucous membrane of pharynx. Their mission to stop and kill viruses and bacteria prevent them from entering the body. Unfortunately in compromised immunity (during pregnancy it is a naturally determined process) and in case of severe infection the “sentry posts” of our body are not able to manage and become inflamed. Tonsillitis (inflammation of the palatine tonsils), quinsy or pharyngitis (inflammation of the lymph nodes of the mucous membrane of pharynx) developed.

In acute pharyngitis the sensations of dry mouth, burning occurs, the throat smarts or there is tickling in the throat, the temperature rises, and it hurts when you swallow. And to swallow the saliva is more painful than to swallow the food. Oral rinsing, such as chamomile decoction, sage decoction and alkaline solutions are used in pharyngitis treatment.

Acute tonsillitis and quinsy are severe diseases. One of the main symptoms of quinsy is the sensation of pain during pregnancy when swallowing saliva or food. The general intoxication symptoms, such as weakness, feeling jaded, headache, appetite loss, temperature rise. When examining the tonsils are red and swollen; and there may be fur in them. Neighbouring lymph nodes (in the area of lower jaw and neck) become enlarged, unhealthy. The treatment of quinsy must be performed under the doctor’s supervision. You must not have quinsy without proper treatment because the multiple complications may develop. Therefore, an absolute bed rest, ample drinking, digestible, high-calorie, vitaminized food and frequent throat wash are necessary. Antibiotics should be prescribed for the treatment of quinsy, antiallergic drugs at night, and sometimes antipyretic. Most harmless and safe drugs having no threat for the health should be prescribed for pregnant women.