What to expect while you’re expecting

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Half of all pregnant women can expect some back pain. Back pain develops for two reasons. One is simply the added weight caused by the pregnancy. Another may be that the extra weight is carried in the front of the body, shifting your center of gravity forward and putting more strain on the low back. The muscles in your back may have to work harder to support your balance.

How can you minimize the discomfort?

1. Stick with your exercise program. Find out from your doctor what abdominal and back strengthening exercises are safe for you, and how long you can maintain your regular exercise program. Swimming is an excellent way to keep fit and relieve the stress on your back from the extra weight of pregnancy.

2. Lifting. If you have to pick something up, kneel down on one knee with the other foot flat on the floor, as near as possible to the item you are lifting. Lift with your legs, not your back, keeping the object close to your body at all times. Be careful, though – it may be easier to lose your balance while you are pregnant. Whenever possible, get assistance in lifting objects.

3. Carrying. Two small objects (one in either hand) may be easier to handle than one large one. If you must carry one large object, keep it close to your body.

4. Sleeping. Sleeping on your back puts 55 lbs. of pressure on your back. Placing a pillow under your knees cuts the pressure in half. Lying on your side with a pillow between your knees also reduces the pressure.

How can you deal with the back pain related to pregnancy?

Fortunately, most back pain related to pregnancy is self-limited and will resolve. In most cases, medication is not a good option. Do not use any medication during pregnancy without permission of your physician. Some treatment options include learning exercises to support muscles of the back and pelvis, using supportive garments that may be helpful with certain causes of back pain in pregnancy and using spot treatments such as heat and cold. If your pain persists despite these measures, or you develop any radiating pain, numbness, tingling or weakness in your legs, you should consult with a spine physician with expertise in women’s health issues and/or pregnancy related disorders. They will be able to assist you in diagnosing and treating your specific problems.

About Lower Back Pain

The back is made up of several different bones, called vertebrae, which are stacked upon each other to form a strong column that supports the upper portion of the body. Bones near neck are called cervical vertebrae, those adjacent to chest are called thoracic vertebrae, those around the lower back are called lumbar vertebrae, and those at the back of pelvic are called sacrum and coccyx.

Most of the weight of the upper body is rests on the lumbar vertebrae, and it is here that most of the lower back pains are localized.

A number of medical and other factors contribute to the occurrence of lower back pain. These include injury to this portion of the spine, which could be either due to excessive strains, compressions, or factors related to the aging process, when bones tend to become weak and brittle. Disease like osteoarthritis (inflammation of the bone) and osteoporosis (reduction in bone mass) can cause severe lower back pains. Certain specific viral infections can also cause lower back pains. Recently, much research has been focused on a condition called cauda equine syndrome, in which vertebrae intrude into the spinal canal and compress highly sensitive spinal nerves and fibers in the lumbar and sacral region. Irritated nerves cause extreme pain in these regions and sometimes irreversible damage to the nerves.

On a physical level, a number of factors can be responsible for lower back pain. Chiefly, these include excessive body weight (which induces strain to the lower back), improper sitting or standing posture, and improper sleeping posture.

Lower back pain can be both acute and chronic. While the acute type lasts for a few days to a few weeks, chronic persists for three months or more. As far as the significance of lower back is concerned, both acute and chronic pains need timely investigation and treatment.

Back Pain – An Introduction

Since the spine is an amazing combination of bones, ligaments, tendons, large muscles, and highly sensitive nerves, any abnormality or dysfunction in any of these structures can trigger back pains of low or high intensity. For example, pain could occur on account of any irritability perceived by the large or small nerves that pass through or along with the spine. If these nerves are strained, again back pain can occur. The spaces created between the discs of the spinal column, which have to be otherwise suitably aligned, can be a very troublesome cause of back pain.

Depending on the severity of back pain, it can be classified into three categories. Back pains lasting not more than three months are termed as acute. When back pain occurs repeatedly, it is known as recurrent back pain. And back pain lasting more than three months and that doesn’t improve within three to four weeks of medication, is considered as chronic back pain. More than 50 million Americans suffer from chronic pain. Such back pains are often traced to more serious underlying bone or joint problems or other pathophysiologies; these need a specialist’s intervention to treat.

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Any such suspicion is ruled out by conducting an array of medical laboratory and imaging tests, including a magnetic resonance imaging (MRI), computed tomography (CT) scan, bone scan, and X-ray.

Testing For Back Pain

Medical Evaluation and Diagnostic Testing procedures should be performed prior to beginning any treatment in order to determine the treatment process that will be most effective. The following describes some of the evaluation testing procedures that can be performed to help confirm the cause of back pain.

The causes of back pain can be very complex, and there are many structures in the lower back that can cause pain. The following are used to test for the cause pain:

X-RAYS

An X-Ray provides an image that can be used to evaluate bones, joints and degenerative lesions in the spine.

CAT SCAN (CT)

Used primarily when problems are suspected in the bones or when a patient canÕt obtain an MRI

MAGNETIC RESONANCE IMAGING (MRI)

The most common test to evaluate the lumbar spine. Evaluates: *Vertebral bones * Discs * Joints * Nerves * Soft tissues

MYELOGRAM

where dye is injected into the spinal column and then the area is flexed and x-rayed.

DISCOGRAPHY

Discography is a diagnostic procedure used to determine the level of the painful disc.

EMG

The EMG/Nerve Conduction Study is a useful test to study the nerves in the arms and legs.

BONE DENSITY

Bone density testing is fast, painless, and noninvasive. During a test, patients lie fully clothed on a padded treatment table while the machine scans one or more areas of bone. The entire test normally takes only minutes.

BONE SCAN

A Bone scan in Nuclear Medicine is a procedure which involves two steps:

The patient is asked to arrive 3 hours before their actual scan to receive an injection of a small amount of radioactive tracer that is “tagged” to a calcium like material. Usually the tracer is injected in a vein in the arm of the patient. In some instances, other sites of injection are used especially for those patients that had difficult veins to find. The “radiopharmaceutical” has no side effects and because of this, the patient can be released from the department for 3 hours to give the calcium time to circulate and be taken up by the bone. There are no dietary restrictions so the patient may eat before and after the injection. After the three hours has elapsed, the patient returns to the Nuclear Medicine department for their scan. The patient is placed on a table a head to toe scan is performed by a “gamma camera”.