For medical professionals only
It has nothing to do with confinement or painless childbirth
In order to create a suitable environment for the baby, pregnant mothers need to make a series of changes, such as weight gain and hormone fluctuations, resulting in increased joint stress, lumbar precocity, lumbar ligament relaxation, pelvic forward tilt, fluid retention and a series of changes, which in turn leads to low back pain during pregnancy.
Most pregnant mothers will naturally heal after giving birth to a child, but some mothers have persistent waist pain after giving birth, even lasting more than 3 months, becoming chronic pain.
Many mothers and the elderly will feel that the low back pain after childbirth is caused by the failure to sit well in the confinement, which is "confinement disease".
Is this really the case? From a scientific point of view, it is currently thought that postpartum low back pain may be associated with the following six factors:
(1) Weight before pregnancy
Preconception body mass index (BMI) > 25 kg/m2 are more likely to experience postpartum low back pain. BMI is the body mass index, which is calculated as BMI = weight÷ height2. Therefore, when preparing for pregnancy, expectant mothers need to control their weight.
(2) History of low back pain before or during pregnancy
Mainly women who have a history of low back pain before pregnancy, and women who have pelvic joint pain during pregnancy.
(3) Depression during pregnancy
Pain is a subjective feeling that is influenced by many factors. Depression itself can lead to pain, and long-term chronic pain can also lead to depressive states and even depression.
For pregnant women, it is very important to maintain a good mood throughout pregnancy and avoid depression, which helps to avoid the occurrence of postpartum low back pain.
(4) The workload during pregnancy is large
When you are pregnant, don't do too much, let your family share some, and avoid making yourself too tired.
(5) Caesarean section
A study of 284 women through questionnaires and clinical physical examination showed that the incidence of pelvic pain after caesarean section was 33%, compared with only 8.3% after vaginal delivery. Another study also showed that caesarean section increased the risk of persistent pelvic pain for 6 months after surgery relative to vaginal delivery.
(6) Multiple births
Although the country has now liberalized the second or even multiple births, the risk of low back pain after childbirth will increase if there are multiple births, especially women who have ≥ three births.
In addition, there is a question that everyone asks more, that is, whether the painless delivery and anesthesia will cause postpartum low back pain.
At present, the main anesthesia method for painless delivery is epidural analgesia, and the concentration of anesthetic drugs used is very low. The current research results have shown that epidural analgesia does not increase the risk of long-term postpartum low back pain, so from this point of view, painless delivery is still a very safe way of delivery.
How should women who have developed postpartum low back pain respond?
First of all, for pain that lasts more than 3 months, it belongs to the scope of chronic pain, which needs to be treated as a disease and cannot be left unchecked.
Exercise is good for chronic low back pain, and it is done according to your own situation. For example, walking, aerobic exercise (cycling, swimming, treadmill exercise), stretching, Pilates, yoga and tai chi.
Alternatively, you can also choose the way of massage and massage, while being careful not to use mattresses that are too soft or too hard.
When the pain is more severe, it is also necessary to take pain medication. NSAIDs are still preferred, and if you are a lactating mother, ibuprofen is recommended, and the safety of use during lactation is relatively high. If the efficacy of nonsteroidal drugs is not good, tramadol or duloxetine can also be selected under the guidance of a doctor or pharmacist.
If the above measures have been taken and the pain is still not relieved to the ideal state, then do not delay, go to the hospital orthopedics, pain department or rehabilitation department as soon as possible to seek professional help.
Source of this article: Ji Lianmei pharmacist
The author of this article: Li Jun Ji Lianmei
Editor-in-Charge: Ichikawa