Since many pregnant women experience musculoskeletal pain, which can significantly impact their daily lives and overall well-being, it is crucial to understand this type of pain during pregnancy. This pain is often caused by the physical and hormonal changes that occur as the body adjusts to accommodate the growing baby.

Pregnancy-related musculoskeletal discomfort commonly manifests as leg cramps, lower back pain, pelvic girdle pain, and pain in the hips, knees, and feet. Understanding this pain is essential, as it helps expectant mothers, their partners, and healthcare providers recognize and address symptoms early, minimizing discomfort and preventing complications.

Awareness of the factors contributing to this pain—such as changes in posture, weight gain, and ligament relaxation—enables improved management techniques, including proper exercise, prenatal yoga, physical therapy, and the use of supportive footwear or belts.  

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In a conversation with Jagran English, Dr. Monalisha Naik, a Consultant Obstetrician & Gynecologist at Ankura Hospital for Women & Child in Bhubaneswar, discussed musculoskeletal pain in pregnancy, which is a common occurrence and often trivialized.

According to Dr. Monalisha, pregnancy is an exciting yet challenging time. Pregnant women often experience low back pain, pelvic pain, sacroiliac joint pain, and hip pain. About 52.7% of pregnant women develop low back pain, and 16-20% experience pelvic girdle pain, leading to a poor quality of life and loss of productivity.

Rapid changes in body weight, a growing fetus, increased blood circulation in the pelvis, and muscle weakening lead to adaptive changes in the body, which cause these symptoms. As the uterus enlarges, the lower back is pulled forward, causing the upper back to curve more and the ribs to splay. This puts pressure on the knees and feet, resulting in a waddling gait and foot pain or plantar fasciitis, she explained.

Hormonal changes, including the effects of the hormone relaxin, relax the joints, muscles, and ligaments. Abdominal muscles weaken, and the back muscles compensate, leading to fatigue, loss of stability, and an increased risk of falling. Most musculoskeletal symptoms appear in the late second trimester. Low back pain in the first trimester is due to congestion in the pelvis.

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Dr. Monalisha further explained that low back pain often presents as a constant, dull ache that worsens towards the end of the day but improves with rest. Pelvic girdle pain starts in the pelvic region as intense, sharp pain that may radiate to the groin or feel like burning, which can interfere with daily activities. Deficiencies in calcium, vitamin D, and microminerals can cause cramps in the upper and lower limbs. Wrist and palm pain due to soft tissue edema, known as carpal tunnel syndrome, is also more common during pregnancy. Nerve compression in the thigh and lower back can cause burning pain in the thigh. Most symptoms improve within the first three months after delivery.

Tips For Managing Musculoskeletal Pain During Pregnancy:

Symptomatic relief can be achieved with hot or cold pads. Over-the-counter counterirritants are safe, and paracetamol can be used in severe cases. Avoid NSAIDs as they can cause fetal anomalies.

Maintain proper posture and regulate weight gain to prevent aches. Use soft pillows for back support while sitting and pillows between the knees to prevent low back instability. For women in prolonged sitting jobs, using a footstool and taking short walks at work can help. In advanced pregnancy, use proper techniques to stand from a sitting position or get up from a lying position to prevent injuries.

A pregnant woman's diet should be balanced with good sources of protein, vitamin D, and calcium. Eggs, various nuts, and millets are good sources of these nutrients.

Exercise:

Pregnant women should stay physically active with prenatal yoga or Pilates under expert guidance and after consulting their doctor. Regular light exercises are beneficial for the spine by enhancing flexibility and strengthening core muscles, providing support for spinal health. Strenuous activities should be avoided.

Physiotherapy:

Physiotherapy can also relieve debilitating back and hip pain. Your physiotherapist can recommend suitable exercises. Advanced methods like TENS and acupuncture, when performed by specialists, can help. Using braces and pelvic girdle supports can also improve symptoms.

Refrain From Lifting Heavy Objects:

As this can increase back pain. Practice relaxation techniques such as meditation and breathing exercises.
Join support groups where you can share your experiences and connect with other pregnant women facing similar challenges.

Addressing musculoskeletal symptoms in pregnancy can improve the quality of life and pregnancy outcomes. Simple measures can prevent long-term issues.