Carpal tunnel syndrome is common in women during and after pregnancy. Symptoms include weakness, pain, numbness or tingling of the hand and fingers. Physical therapy treatment centers around decreasing irritation of the area, strengthening and stretching the muscles of the hand, wrist, and forearm.
Upper Back Pain
Pain in the upper back is usually a result of poor posture during activities. The upper spine becomes overly flexed causing over-stretching in some areas and compression in others.
Treatment focuses on postural re-education as well as addressing muscular imbalance. Physical therapists often emphasize proper positioning and support of the back with pillows during breastfeeding. They also tell mothers to bring the baby to the breast and not the breast to the baby.
Low Back Pain
The most common complaint during and after the prenatal period is low back pain; the incidence of pain usually increases in the post-natal period if it was present in the pre-natal period. Low back pain may be due to bad posture, weak abdominal wall, and/or weak back muscles. Low back pain may also be accompanied by Sciatica–a shooting pain down the back of the leg below the knee.
This is a broad term for pain in the groin, buttock, hip, sacro-iliac joint, vaginal, rectal, or tailbone area. It is described as a sharp, stabbing pain, which moves down the leg and increases when changing positions. Physical therapists can release tight muscles which is often helpful for relieving pelvic pain.
Pubic Symphysis Pain and/or separation
The pelvis is made up of three large bones that are held together by soft tissues. In preparation for delivery, a woman’s body releases hormones that increase the stretchiness of these connecting soft tissues to allow the baby to pass through the pelvis.
In some cases this can result in misalignment or an over-separation of the two bones that come together at the front of the pelvis (in the area called the pubic bone). Treatment can include manual therapy, muscle re-education, therapeutic exercise and a home program.
Pain in and around the coccyx or tailbone can be the result of a direct injury such as a fall (horseback riding, skiing); trauma during childbirth; direct pressure on the coccyx (prolonged sitting); or strain (cycling, rowing). Tailbone pain may result in difficulty with sitting, defecation, and sexual intercourse.
Often, tailbone pain involves the pelvic floor muscles and/or the gluteus maximus muscle. Treatment focuses on imbalances in these muscles, posture re-education and manual therapy.
Sacro-iliac (SI) Joint Dysfunction
At the back of the pelvis are two large joints where the pelvic bones join together with the sacrum (the lower bones of the spine). These joints can become injured or misaligned during pregnancy or childbirth. Pain in these joints can be felt in the lower back or down the back of the leg.
Treatment includes manual therapy, joint mobilization, stretching, and exercise.
Pudendal Neuralgia is most commonly associated with pain in the pelvic region that is made worse with sitting.
Leg and Foot Pain
Increases in weight and changes in posture that accompany pregnancy can result in pain of the feet and legs. This is commonly seen in the form of spasms/cramps in the lower leg as well as with conditions such as plantar fasciitis.
Treatments for musculoskeletal problems in the legs and feet include stretching, strengthening, manual therapy and postural re-education.