If you’re expecting, you know by now that pregnancy can be both exciting and exhausting. While you’re dreaming of the moment you’ll finally hold your little one in your arms, you’re also probably looking forward to relief from the common side effects of pregnancy. Of the many ailments expectant mothers experience, pelvic pain during pregnancy is one of the most common complaints.

In fact, approximately 72% of pregnant women experience pelvic pain at some point. It’s commonly characterized by pain across the front of your pubic bone, level with your hips or across one or both sides of your lower back. While pelvic pain isn’t harmful to your baby, it can make your pregnancy uncomfortable. This post will cover why pelvic pain tends to occur at each stage of pregnancy, how to ease the discomfort you feel, and symptoms that could be an indication of something more serious.

Why does pelvic pain during early pregnancy occur?

Most women are surprised by the occurrence of pelvic pain in early pregnancy, but hormones are typically responsible for this sudden change. When you become pregnant, your body immediately starts to produce a hormone called relaxin. This hormone allows tendons and ligaments to stretch to allow the pelvis to open for birth.

While relaxin itself is not the cause of pelvic pain, the relaxed ligaments and tendons may lead your weight distribution to change, especially towards the end of your first trimester. This can cause both hip pain and pelvic pain during early pregnancy.

Unfortunately, this hormone will continue to release throughout your pregnancy. This means your pelvic pain may worsen as the months go on.

How can I relieve pelvic pain during early pregnancy naturally?

While treatment options are often limited during pregnancy in order to protect your growing baby, there are some ways to relieve pelvic pain naturally.

However, always discuss your pain level and symptoms with your doctor before trying anything new. Be open and honest about how you’re feeling and how much pain you can tolerate.

Prenatal massage

Getting a specialized prenatal massage can help to reduce stress hormones, relax your muscles, and increase blood flow. The boost in circulation after a massage will not only ease your discomfort, but may also help you sleep better (a welcome benefit for women suffering from aches and pains associated with pregnancy).

While any masseuse can perform a prenatal massage, it is best to go to someone who specializes in maternal care and has extensive experience working on pregnant women. They will know what positions to avoid and what level of pressure is acceptable. This will guarantee the safety of you and your baby.

Chiropractic care

Chiropractic care is generally considered safe during pregnancy. In fact, all chiropractors go through training designed specifically for the care of pregnant patients.

Through spinal manipulation and adjustments, a visit to the chiropractor may help relieve some of your pelvic pain. Achieving proper alignment for both standing and sitting can help you maintain a posture that won’t put added pressure on your body. This is crucial as your weight distribution will continue to shift as your baby grows.

As always, check with your doctor for a referral before seeking chiropractic care during pregnancy.

Exercise and stretching

If your doctor has cleared you for exercise, staying active within your pain limits is one of the best ways to prevent and ease pelvic pain during pregnancy. Your doctor may even recommend at-home exercises and stretches for your pelvic floor, stomach, back, and hip muscles. Pelvic tilt exercises in particular can help strengthen your muscles and improve your posture to provide relief from pelvic pain.

If you’re considering workout classes, prenatal yoga, water aerobics, and swimming are all great options for low-impact exercise. Gyms and fitness studios across the country offer classes that are specifically created for pregnant women. Talk to your doctor about any local ones they recommend.

Maintaining an exercise routine can help alleviate pain by keeping you limber, but most women enjoy many other additional benefits. Exercising will help you sleep better and can even improve the overall ease of your labor and delivery. Staying active during pregnancy may also make it easier to get back in shape after your baby is born.

Pregnancy pillows

Pregnancy pillows (also known as body pillows) have become popular for pregnant women, and for good reason. Sleep is crucial for maintaining a healthy lifestyle and pregnancy, but it can become increasingly difficult as you continue to grow and gain weight.

There are a variety of shapes and sizes when it comes to pregnancy pillows, but one that is specifically designed to be placed between your knees is best for relieving pelvic pain. This position will ensure that your hips are aligned, stable, and at the correct height at night to minimize pressure in the pelvic and hip region.

Another type of pregnancy pillow is in the shape of a wedge. It simply lifts your growing belly off the mattress to relieve the pressure and weight you’re feeling in that region, especially while lying down.

Pregnancy support garments

Belly bands and compression pantyhose are a great option for everyday wear as you continue to grow throughout your pregnancy.

Belly bands or maternity belts are designed to lift your belly, giving your back and pelvic area extra support and relief from the weight of your growing baby. Many of them can be heated in the microwave to provide soothing heat therapy for tight and sore muscles.

Compression pantyhose offer the benefit of lifting your belly and giving it support while also adding compression around your legs. This can be helpful if you’re suffering from excessive swelling in the legs and feet.

What causes pelvic pain during pregnancy in later trimesters?

Pelvic pain during the second and third trimesters can still be attributed in part to relaxin. This hormone will continue to surge through your body, especially in the final weeks before you give birth. It will continue to loosen your ligaments and open your pelvis for labor.

In addition to the relaxin hormone loosening and stretching your tendons and ligaments, your growing belly also creates a shift in the way your weight is distributed. This can affect everything from your stance to the way you walk. This is why it can often be painful no matter what position you’re in. For this reason, it’s best not to stay standing or sitting for too long.

It’s important to note that pelvic pain can also get much worse about two to four weeks before delivery once lightening occurs. Lightening is when your baby drops into the pelvic area in preparation for labor. Once this happens, your baby’s head puts stress on the bones, joints, and muscles in your pelvis and back. The good news? This is another indication that labor is near and the end is in sight!

How can I relieve pelvic pain during pregnancy in the second and third trimester?

The previously mentioned treatment options for relieving pelvic pain during early pregnancy are still great options in your second and third trimesters, but with a few modifications.

Your doctor will advise you to sleep on your side after your first trimester. This is because your growing uterus can put pressure on blood vessels, restricting the blood flow to both your heart and your baby’s heart. This same rule applies during exercise or any other activity that requires you to lie down, such as a prenatal massage. It’s always best to seek out instructors and practitioners who are specifically trained to work with pregnant women so that they’re aware of these guidelines.

Basic lifestyle changes should also be made during your second and third trimesters. Wear comfortable shoes with little to no heel and plenty of support, especially if you plan to be walking or exercising. You may also want to consider adding a warm bath to your nightly routine, as this can often help relieve pain and relax your muscles before bedtime.

When should I see my doctor for pelvic pain during pregnancy?

As always, it’s important to contact your doctor if you feel like something isn’t right. While it’s normal to feel aches and pains as your pregnancy progresses, there are times when pain can be a sign of a more serious problem.

Be open and honest about the level of pain you’re experiencing during appointments. Call your doctor immediately if you have any of the following symptoms:

• Pain that you can’t walk or talk through
• Bleeding
• Fever
• Chills
• Severe headache
• Dizziness
• Sudden swelling of the hands, feet, or face
• Persistent nausea and vomiting

In rare, but serious cases, pelvic pain can be a sign of complications or miscarriage, especially if it is paired with other symptoms. These are some of the serious causes of pelvic pain that you should be aware of.

Ectopic pregnancy

While it is considered rare, one in 50 pregnancies are classified as an ectopic or tubal pregnancy. This is when the egg implants outside of the uterus, most often in the fallopian tube. Symptoms include intense pain and bleeding. This happens most commonly between the sixth and tenth week of pregnancy.

Unfortunately, ectopic pregnancies can’t continue and must be treated immediately. If you have taken a positive at-home pregnancy test and are experiencing these types of symptoms, you should contact a doctor immediately. A medical team will use an ultrasound to confirm whether the egg has implanted in the uterus.

Preterm labor

If you have persistent back and pelvic pain that comes and goes (with no relief after resting and lying down), you could be experiencing preterm labor.

Be sure to contact your doctor immediately if you think you could be feeling contractions, rather than basic pelvic pressure and pain.

Preeclampsia

According to the Preeclampsia Foundation of America, 5-8% of all pregnant women experience preeclampsia. The condition, characterized by high blood pressure and protein in your urine, can develop at any time after 20 weeks.

This condition is dangerous because blood pressure can constrict the blood vessels in your uterus that supply oxygen and nutrients to your baby. In severe cases, symptoms of preeclampsia can include abdominal pain.

Placental abruption

Your placenta typically implants high on the uterine wall and doesn’t detach until after your baby is born.

In rare cases, though, the placenta can separate from the uterine wall, causing constant and worsening pain in the lower abdominal region. Depending on the case, you may go into labor naturally. If not, your doctor will opt to either induce labor or perform an emergency cesarean section.

Uterine fibroids

Most common during childbearing years, noncancerous growths on the uterus are known as fibroids.

Pregnancy will often cause them to get larger and increasingly painful. Most doctors will simply keep an eye on them during your pregnancy. Only in rare cases is it necessary to remove them in order for the pregnancy to progress.

Get help with your pelvic pain during pregnancy

This is a special time in any woman’s life. Don’t let pelvic pain during pregnancy overshadow the anticipation and joy of welcoming a baby to your family. Talk to your doctor about what treatment options are right for you.

If you live in Arizona, get in touch with our pain specialists at Arizona Pain today. We have skilled physicians with extensive experience in pain management. We will tailor your treatment plan to ensure safe and successful pain relief during your pregnancy, coordinating with your other care providers.

If you’ve ever had a migraine, you know how crippling the pain can be. This type of headache is usually described as a throbbing pain in the temples, as well as the front and base of the head. It can be very intense, which makes a migraine in pregnancy especially hard to cope with. While expectant mothers are often limited in their treatment options, there are ways to reduce the intensity or frequency of a migraine during pregnancy. This post will cover some of the best methods of migraine treatment during pregnancy.

What is a migraine?

A migraine is one of the most severe types of head pain. Symptoms can build up gradually, but last anywhere from hours to days.

Most often, throbbing occurs on one or both sides of the head. Some patients describe the pain as a pulsing sensation. It can often come along with nausea or vomiting. For many people, aura also occurs before or during a migraine. Aura is a sensation that involves various visual disturbances, such as seeing spots, bright lights, and shapes.

Other examples of migraine symptoms include:

• Tingling in the arms or legs
• Vision loss
• Numbness in the face or one side of the body
• Difficulty speaking

Patients who suffer from chronic migraines often report certain symptoms one or two days before the onset of their migraine. Doctors refer to this as the prodrome period. Subtle changes that can warn of an upcoming attack may include:

• Stiffness in the neck
• Constipation
• Increased thirst and urination
• Cravings
• Mood changes

Can pregnancy cause migraines?

Researchers continue to study the cause of migraines, but genetics, hormones, and environmental factors all likely play a role. Whatever the cause, constricted blood vessels often lead to migraine headaches. These can result from low serotonin, a pain management chemical in the body. Estrogen has also been found to trigger migraines and increase pain.

During pregnancy, your hormones shift as the days, months, and trimesters go on. These hormonal shifts are a key reason why experiencing a migraine during pregnancy is relatively common.

Whether you’ll experience this type of headache during pregnancy is difficult to predict. And, if you already had migraines, studies actually show a potentially beneficial effect of pregnancy on migraine frequency, mainly during the second and third trimester. Many women with menstrual migraines also find their condition improves when they are pregnant, but every case is different.

For some women, though, pregnancy will be the first time they experience a migraine headache.

What are safe migraine treatments during pregnancy?

Pregnancy comes with enough aches and pains. You shouldn’t have to suffer from migraines on a routine basis. Here’s a look at safer and effective methods of migraine treatments during pregnancy.

As always, talk to your doctor about the right option for your specific situation. Always defer to their recommendations for your unique case.

1. Migraine medications for pregnancy

Most people can take over-the-counter medications without any cause for concern. When you’re expecting, that all changes. There are many medications and even supplements that aren’t safe for your growing baby.

One type of drug that is generally considered safe for pregnant women is acetaminophen, commonly known as Tylenol. Most doctors will approve of the occasional use of Tylenol throughout all three trimesters of pregnancy.

On the other hand, you should avoid aspirin, ibuprofen, and naproxen. The brand names you may know these drugs as include Advil, Motrin, and Aleve. These drugs are generally unsafe for pregnant women as they could lead to birth defects.

Discuss your migraines with your doctor to learn more about safe medications that could help.

2. A good night’s sleep

Sleep is hard to come by during pregnancy, especially during your third trimester, but it’s very important. Aim for eight hours in bed to ensure at least seven hours of sleep per night. This gives you plenty of time to unwind and relax in order to fall asleep.

Try out a pregnancy pillow to relieve pain and get in a comfortable position. These can be found in various shapes and sizes, depending on your preferences. Doctors also recommend sleeping on your left side to ensure proper blood flow to your heart and growing baby. This may be very difficult for women who slept on their backs or stomachs before pregnancy. A pregnancy pillow can help you get into a comfortable position.

If other symptoms or issues are getting in the way of your sleep routine, talk to your doctor. Many women suffer from extreme cases of heartburn and indigestion that worsens while lying down. Your doctor may recommend over-the-counter medication to treat your symptoms so you can get a better night’s rest.

3. Lifestyle changes

Hormones have an effect on whether you’ll experience a migraine in pregnancy, but there are other contributing external factors. By avoiding possible migraine triggers, you may be able to reduce the frequency or intensity of your migraine headaches.

Some of the most common triggers include:

• Coffee
• Alcohol
• Chocolate
• Aged cheeses
• Intense physical activity
• Stress
• Abrupt weather changes
• Sensory stimuli
• Sleep changes
• Hunger or dehydration

With these common migraine triggers in mind, consider lifestyle changes during pregnancy. Be sure to take care of your body and avoid things that could prompt a migraine headache. If you do get a migraine, track what triggers may have led to it during your day. You may be able to figure out patterns to reduce those triggers in the future.

4. Prenatal yoga

Yoga provides health benefits for people of all ages, and pregnant women are no exception. This form of exercise can boost circulation and loosen your muscles. Some poses can help you prevent headaches, while others may be used at the first sign of a migraine.

In addition to the physical benefits, yoga is a unique form of meditation that can help calm your mind. Stress can be a major contributor to migraine in pregnancy. Practicing yoga can help you take control of anxiety, depression, and stress, all of which could trigger migraines.

Look for a studio that has prenatal yoga classes created with pregnant women in mind. These unique classes and specialized teachers will ensure that you’re practicing yoga safely. If you can’t find prenatal yoga classes near you, take a gentle yoga class. Talk with the instructor before class begins. Let them know you’re pregnant and ask for pose modifications when necessary.

5. Meditation

As previously mentioned, stress is a common migraine trigger. Women juggling work, family life, and the anticipation of a new baby may experience higher levels of stress and anxiety.

While it’s easier said than done, keeping stress to a minimum is essential during these 40 weeks. Meditation is one way to focus your mind on positive things that will keep you feeling healthy. Yoga and other activities that promote mindfulness may reduce feelings of depression during and after pregnancy. Just 30 minutes per day can do the trick.

Not sure where to start? Direct your gaze at a point directly in front of you (or simply close your eyes). Slowly breathe, focusing on each inhale and exhale with intention. Stay in the moment and continue to focus on your breath even if your mind begins to wander. You may do this in complete silence or with soothing sounds, a guided program, or music.

6. Temperature therapy

Hot and cold therapy is an easy and often effective way to treat various forms of pain. From sore muscles to swelling, temperature therapy can calm sources pain, migraines included.

For a migraine in pregnancy, an ice pack or cold compress is typically the best way to find relief. The simple numbing effect of a cold pack can help some patients feel more at ease.

While cold therapy is typically recommended for a migraine, others may find relief from hot therapy. This can be in the form of a hot pack, heating pad, or a warm bath/shower. In general, this is a better remedy for tension headaches because the warmth allows your muscles to loosen up.

Talk to your doctor about this type of treatment to decide whether hot or cold therapy is best for your head pain.

7. Massage

Migraines and other form of head pain are often a result of tension in the neck, back, and shoulders. When you’re pregnant, there is even more stress put on the body due to your growing belly.

Prenatal massage is a form of complementary care that can work wonders for aches and pains, as well as migraine headaches. Massaging trigger points around the head, neck, and shoulders can relax muscle spasms and tension. It can even improve blood flow and reduce swelling.

There are many spas and massage centers that offer prenatal massages tailored to pregnant women. Many of them even have special pillows, wedges, and massage tables. These are designed to get you into the best position for where you are in your pregnancy.

8. Chiropractic care

A chiropractor can help with a range of pregnancy-related issues. They most often make adjustments to help with pain in the back, pelvis, and hips, but alignment can have an effect on other parts of the body, too.

Through various massage techniques focused on trigger points within the back, neck, shoulders, and head, many patients report finding head pain relief from chiropractic care. In addition, a gentle adjustment can help relax tense muscles that may eventually lead to a migraine in pregnancy.

Look for a chiropractor with experience performing prenatal adjustments. As always, consult with your OB/GYN before seeking any type of migraine treatment during pregnancy.

9. Acupuncture

While you’re probably tired of the poking that comes along with pregnancy appointments, you may also consider acupuncture for migraine relief. This form of treatment involves a practitioner inserting thin needles into specific points to correct imbalances in the body.

Acupuncture points generally correspond to nerves that may be activated by the needle prick. This prompts your brain to release endorphins, which lessens pain signals. In the case of a migraine during pregnancy, this can be a particularly noninvasive form of treatment.

Acupuncture is often credited with helping women with many other common pregnancy issues. This includes morning sickness, depression, lower back pain, pelvic pain, hip pain, and insomnia.

Though this type of treatment is generally considered safe for pregnant women, talk with your doctor before making an appointment. As always, do extensive research before choosing an acupuncture specialist. Search for someone who has experience working with pregnant patients.

When should I see my doctor for a migraine in pregnancy?

It’s important to be open with your doctor about how you’re feeling throughout your pregnancy. Symptoms that seem minor could be a sign of something serious. Be open and honest about how you’re feeling during every appointment with your OB/GYN.

Some cases may warrant an immediate call to your doctor, though. If you’re experiencing any of the following symptoms with your migraine, seek medical attention right away:

• A fever
• Dizziness, blurred vision, or blind spots
• Severe pain that persists for several hours and/or is recurring

While it is normal for some women to experience their first migraine during pregnancy, also consider your medical history. If you’ve never been one to get headaches, but are dealing with chronic migraines and pregnancy, talk with your doctor. In rare, but serious cases, a migraine during pregnancy can be a symptom of bigger complications.

Get help with chronic migraines during pregnancy

Pregnancy is a time of excitement and anticipation. Don’t let pain rob you of your joy during these special months. Talk with your doctor about how you’re feeling throughout your pregnancy, especially if you’re suffering from migraines. Once your doctor rules out serious underlying causes, discuss the option of visiting a pain specialist.

At Arizona Pain, your safety and comfort is important to us. We have pain doctors and chiropractors that will work together as a team to develop a comprehensive approach to manage your pain.

At Arizona Pain, we can work through different types of migraine treatments to find an option that is both safe and effective for you. If you’re in Arizona, get in touch with us today.

Women are more likely than men to experience chronic pain, however emerging research into the gender of pain management shows that females are less likely to receive medications and may suffer more as a result. And the medications they do receive sometimes cause more harm than good.

Women are, on average, smaller than men and have a higher percentage of body fat, which means their bodies metabolize drugs differently. Although researchers believe some gender discrimination may be at play, biological disparities sometimes can and should influence how doctors prescribe drugs, scientists say.

Part of the problem is that women are underrepresented in medical research and so researchers aren’t clear of the differences among genders when drugs come onto the market. However, the medical community is increasingly aware of the issue and federal guidelines are beginning to change.

One change happened in 2013, when the Food and Drug Administration (FDA) recommended cutting doses of the popular sleep drug Ambien for women because they remained drowsier for longer periods of time than men, reports The New York Times. Women take longer to metabolize the drug, and the disparity in biochemistry affects other drugs, too.

Women and men process drugs differently, which means doses should vary by gender, researchers say.

For example, men and women react differently to anesthesia. However, in this case, women need more than men. This complicates the gender of pain management issue because women do not automatically need smaller dosages of every drug; it depends on the type of drug, according to The New York Times.

Because chronic pain affects 100 million people in the U.S., a large number of them women, the issue is critically important. And unfortunately, women’s concerns of pain are often overlooked, according to a research review conducted by the American Society of Anesthesiologists.

ASA Dr. Donna-Ann Thomas says:

“I can’t tell you the number of women I see who have been told they just have to live with the pain…It’s just heart breaking because many of these women have been suffering a long time. Women, especially older women are less likely to speak up and seek treatment for their pain.”

Researchers say the types of pain women needlessly suffer from include back pain and pain resulting from breast cancer surgery, which ASA says sometimes compares to phantom limb pain resulting from an amputation.

Doctors are often unaware of the different ways men and women experience pain, but the gender of pain management is a hot area of research.

ASA’s review of studies revealed that while women sometimes receive opioids, the drugs are frequently prescribed incorrectly and end up causing more harm than good. Proper use of anesthesia is also critically important during breast cancer surgery and can impact how well a woman recovers.

Some of the optimal ways of using anesthesia are not commonly used today. For example, ASA’s review showed the best anesthesia for breast cancer surgery is actually regional numbing combined with a nerve block injection, and not general anesthesia.

For other types of pain conditions, doctors are not aware of the array of effective alternatives to painkillers, researchers say. For example, music has been found to ease labor pains, yoga has been found to be a helpful tool in the fight against back pain, and rose oil reportedly helps relieve menstrual pain.

Researchers emphasized the importance of visiting a doctor who specializes in pain treatments since general practitioners may not have knowledge of alternative methods.

The potential damage from misusing pain medications is becoming more apparent every day. The ASA review found one in seven pregnant women are prescribed opioids for pain, a practice that may harm the unborn baby. Another ASA study revealed that opioid use has caused a growing addiction problem among pregnant women.

The number of opioid-dependent pregnant women has skyrocketed 127% in the last 14 years, leading to an increase in rates for maternal death and stillbirths.

Women taking opioids while pregnant were also more likely to deliver by cesarean and stay in the hospital longer, according to ASA. Study author Dr. Lisa Leffert says:

“Our study shows that these patients are at very high risk for developing complications. Given the rapid rise in opioid abuse and dependence in these patients, there is an urgent need to understand the link with bad outcomes and to develop interventions to prevent them.”

Women in pain are also more likely than men to be diagnosed with mental illness.

Beyond medicinal disparities in the gender of pain management, there’s a significant psychological component. Doctors are more likely to dismiss pain reported by females as having an emotional source, reports The New York Times. Because doctors are less likely to take women’s reports seriously, women are less likely to receive appropriate pain treatment.

And while women’s pain may continue unabated, they may receive wrongful primary diagnoses such as depression, which, the Times reports, could lead to treatment for mental health conditions that don’t exist.

Conditions like fibromyalgia are a good example of the tendency among medical professionals to dismiss women’s complaints of pain. Although awareness about fibromyalgia has grown, for a long time women reporting the condition’s vague symptoms were thought to be making them up.

As late as 2008, when the first drug for fibromyalgia appeared on the market, some doctors said they didn’t believe the disease existed, reports the The New York Times. The article says:

“(Some doctors say) diagnosing the condition actually worsens suffering by causing patients to obsess over aches that other people simply tolerate.”

Fast forward about seven years, and now doctors may assign the fibromyalgia label to anyone experiencing pain that doesn’t fit into simple diagnostic criteria, writes pain advocate and author Laurie Edwards.

Edwards suffered from strange symptoms throughout her life, which she says were often dismissed by doctors as the result of anxiety and other emotions. Then at 23, Edwards was diagnosed with a rare lung disorder. Finally, her lifelong troubles were vindicated by a diagnosis.

But many other women continue to fall outside the neat confines of a diagnosis, leaving them searching for answers in a medical system that often fails them, Edwards says.

What are your experiences about disparities in the gender of pain management?

Image by Pedro Ribeiro Simoes via Flickr