[Why 100,000 orthopedians]
002. Why are pregnant women always prone to low back pain
Hao Gang, Orthopedic Hospital of Shanxi Provincial Hospital of Traditional Chinese Medicine
The mothers of the world know that it is not easy for a life to have a life. Many physical and psychological changes to be experienced. Many expectant mothers will frequently encounter low back pain, and they will often last for a long period of postpartum for a long time.The drug intervention methods that can be taken during pregnancy and lactation are extremely limited. Many pregnant women can only endure it by silence.And what caused all of this?
First of all, we have to "rehabilitate" the aggrieved husband and the mother -in -law who often carry the black pot -it is really not that the confinement is not serving.In this case, there is a special medical term: pregnancy-related lower back pain (Pregnancy-Related Low Back Pain (PLBP), especially the pain between the 12th rib and the buttocks caused by pregnancy factors, and some occur in pregnancy.During this period, after childbirth, pain repeatedly or exists.The main responsible person that caused this series of issues was that the cute baby -he or her test of his mother did not start with the tutoring assignment, but from the moment the mother was pregnant!
There are not many research in our country in this regard, but a retrospective survey on 569 Norwegian pregnant women shows that the cumulative prevalence of low back pain during pregnancy is as high as 70.4%; and about 65.3 pregnant women who have lower back pain during pregnancy are about 65.3% Of the 12 months of pain after giving birth, and 15.3% of the mothers have sustainable lower back pain -note that "persistent" means that it has lived with low back pain.But expectant mothers do not have to panic, and the joy of breeding a small life must not be replaced by anything.As for the problem of low back pain, knowing why it knows why, there is naturally a way to prevent and solve it.
It is currently believed that the development of back pain related to pregnancy is caused by the changes in biomechanical factors and related hormones.
First, let’s talk about the problem of hormone changes.For example, a considerable part of pregnant women have not changed significantly in the early stages of pregnancy, that is, lower back pain occurs, which is related to the changes in hormones in pregnant women.The great mothers felt the birth of the baby. The first thing I thought of was to prepare "a warm housing", so they took the initiative to change themselves.Relaxin, rlx "", which relaxes the pelvic, lumbosacral, and tail joint ligament, especially the relaxation of the united pubic bone, and the joint movement is increased, which provides a loose and comfortable living environment for babies in the abdomen.Lost stability of the pelvic and spine’s original stability stimulates peripheral nerves and blood vessels, causing pain.The postpartum lower back pain is because although the level of the postpartum RLX is returning to normal, if the lack of scientific postpartum rehabilitation exercise, the relaxed joint ligament will not be restored strictly.
Furthermore, it is the factor of biomechanics.As the fetal weight increases, expectant mothers have to move forward to ensure the stability of the body when they stand upright. The cost is that the shear force of the lumbosacral region increases, and the muscles on the back of the waist are overwhelmed and damaged.In addition, our traditional understanding of the improper concept of "big tonic and restraint" of pregnant women, a large amount of high nutrient intake leads to too much weight increase in weight, and the amount of exercise is seriously insufficient.It is more difficult to bear the burden of rapid growth.
After clarifying the reason, you can be targeted and targeted, and then introduce the five secrets of the expectant mothers to defeat waist and leg pain:
1. Reasonable diet
Dietary nutrition during pregnancy must not only ensure the sufficient and balanced intake of protein and fat, and ensure the normal development of the fetus, but also pay attention to controlling to avoid excessive weight and excessive growth.Therefore, the intake of protein is recommended to be rich in high -quality protein -rich fish, lean meat, soybean foods. Fat intake can choose vegetable oil and nut plant fat.Early pregnancy response and frequent vomiting mothers can also supplement the appropriate amount of vitamins and trace elements under the guidance of a doctor.At the same time, you should remind expectant mothers that they must be overwhelmed to the market, saying "no"!
2. Proper rest and high -quality sleep
Specific mothers with severe symptoms of waist and leg pain, especially in the acute period of back and leg pain, can be appropriately used in short -term bed rest, prohibit heavy objects, prohibit the use of legs, hips, and backs.Push but do not heavier, but long -term bed rest is not worth recommending. Unless measures that have to be used due to fetal protection have to be used, it is necessary to cooperate with appropriate functional exercise.The bed should be moderate and moderate, the sleeping posture should be taken to lying on the left side, flexion and knee, and fully relax the back muscles of the waist and back.
The general waist circumference is not suitable for pregnant women, but the abdomen belt is tailor -made for expectant mothers who are troubled by waist and leg pain: hold up the lower abdomen with the belt, which can effectively reduce the burden on the waist muscles and relieve low back pain.It should be noted that when wearing, the increased abdomen should be lifted from the slightly tilted part of the lower abdomen. At the same time, it should be tight and moderate. Do not be too tight.It is best to stay in bed with fixed belly and stand before standing, which can better support the effect.
4. Shoes options
Pay attention to the choice of pregnant women’s shoes: safe and comfortable.Safety is to remind expectant mothers to temporarily cut love for high heels, and give priority to ensuring the stability and non -slip performance of shoes during walking.And comfort means that a pair of suitable pregnant women’s shoes should have good arch support and appropriate heights.The flat shoes or soles are too thin. When walking, the vibration will spread directly to the feet, further aggravating the symptoms of waist and leg pain.At present, the best choice is a 15-25mm high-soft low-heeled shoes, which can reduce waist force and relieve low back pain.Professional arch supports insoles. It also has a good effect on keeping the arch shape, reducing the sole pressure, and relieving the fatigue of the lower limbs.
5. Scientific exercise
Preferential pregnancy exercise for preferred mothers is -swimming, swimming is the best and safest exercise method during pregnancy.The float effect of water can reduce the burden on the body and relax the muscles. At the same time, it can exercise the waist and pelvic muscles, ligament strength and stability. It has a very clear effect on relieving waist and leg pain, and at the same time, it is also good for cardiovascular function.
There are simple pregnant women exercises at home, such as anal lifting exercises -take a sitting position, relax after each time the anal sphincter is about 3 s, and repeat one after breathing.10/group, each group is 5 min, 3 groups/time; or the leg movement -take the standing position, hold the horizontal rod with both hands, lean forward slightly, do straight leg extension, 30 times on each side.
"Swiss trunk muscle stability training" and "core stability training for pregnancy" in Western countries have clear effects in preventing and controlling the low back pain during pregnancy and enhancing muscle neurological coordination.At present, there are also many professional institutions and conditions for hospitals in China that are actively carried out. Swiss trunk stability training is to use Swiss ball unstable appearance to face the human torso -waist — 骶 — pelvic muscle group.Comprehensive training of equivalent abilities, stabilize the muscle group and enhance the strength of the muscles, expectant mothers can conduct targeted pregnancy training under professional guidance.
In addition, the traditional acupuncture therapy of Chinese medicine is relatively clear about the treatment of lower back pain related to pregnancy. It is worth thinking about that the relevant research comes from foreign countries -a study from the United Kingdom in 2106 confirmed that acupuncture therapy combined obstetric care is decreased.The degree of pain in lower back pain related to pregnancy has a clear effect.A clinical study from the United States in 2014 confirmed that the acupuncture acupoint application treatment of the ear also had a good effect on pregnancy -related lower back pain (two documents showed the tail of this article).Instead, our domestic doctors are more cautious about patients with acupuncture in pregnant women. Maybe they have nothing to do with our intense medical environment!
All in all, pregnancy -related lower back pain is a common phenomenon among pregnant women. It does not have to be too panic and worry. Through scientific and reasonable protection and rehabilitation exercises, it can be far from this problem to the greatest extent.
This article is mainly referenced
1.Prevalence of Low Back and Pelvic Pain During Pregnancy in a Norwegian Population. (PMID: 22632586)
2.PregnancyRealELELELELELAT PACK PAIN and PELVIC GIRDLE PAIN Approximately 14 Months After Pregnancy-PAIN Status, Self -Rated Health and Family Situation. 7)
3. Pelvic disease and treatment related to pregnancy.Journal of Peking University (Medical Edition), 2015
4.Evaluating Acuncture and Standard Care for Pregnant Women with Back Pain (Ease Back): A Feasibility and Pilot Randomised Trial.
5.The Safety of Acupuncture During Pregnancy: A Systematic Review. (PMID: 24554789)