About half of pregnant women experience low back pain. True disc herniation can be rare and most patients recover without the need for surgery. Herniated discs can be very painful. Pregnancy can make herniated discs even more painful. This condition is quite common in pregnant women, due to increased pressure on the spine and weight gain. Sometimes, a herniated disc will not cause symptoms in women. A herniated disc can cause severe pain during pregnancy, which may get worse as the baby grows.
Introduction
LBP is very common in pregnancy, with approximately half the women suffering from it. According to some authors, the hormonal changes that affect the pelvic joints may also cause changes in the intervertebral discs and posterior longitudinal ligament. This could lead to lumbar disc protrusion which can result in LBP. True disc herniation in pregnant women is only 1 in 10,000 cases of LBP. According to available data, only 15% of lumbar disc hernias cause severe neurologic deficits. This is the reason why patients need emergency surgery. Radiculopathy due to lumbar disc herniation is a condition that most patients are able to heal without the need for surgery. The health of a pregnant woman must be considered when treating her. Multidisciplinary teams are required for patient patients. They must include specialists in obstetrics and maternal-foetal medicine as well as neurosurgery, anesthesiology, and anesthesiology.
Conservative management has been shown to be very effective and remains the first choice for patients with herniated discs. If the patient does not have any neurologic deficits, there is very little need for neurosurgical intervention. These patients are likely to have a normal pregnancy that leads to childbirth.
It is not clear which method of delivery is best for women with lumbar disc herniation. This paper will provide further insight by examining the literature and performing a narrative review.
Is it possible to have a herniated disc during pregnancy?
A herniated disc is usually not caused by pregnancy. It is unlikely that a herniated disc developed during pregnancy unless the patient has osteoporosis and/or suffered a traumatic injury to their lower back. A herniated disc can also be caused by an underlying condition, injury, or injury. However, women are more likely to feel general back pains and aches that result from changes in the body and around their spine.
For perspective, herniated discs are most common in men between the ages 30 and 50. This doesn’t necessarily mean that women are immune to this condition. Herniated discs can also be developed by women, and can occur at any age. The majority of herniated discs in people between 25 and 55 years old develop in the lower lumbar region. People over 55 years old are more likely to have herniated discs above the L4/5 or L5/S1 levels.
Pregnancy back injury treatment
Simple exercises and support can usually fix a back injury that occurs during pregnancy. A herniated disc, which is a severe injury that can occur in pregnant women, is possible in very rare instances. If this happens, you may need surgery. However, back surgery is generally safe for both you and your baby during pregnancy.
Pre-existing back conditions can be a problem for many women before they get pregnant. Sometimes back problems improve during pregnancy. Other times they can get worse. It is important that you mention any back problems to your medical team.
If you feel the need to take medication to manage your pain, talk to your doctor. Paracetamol is one the most effective painkillers for pregnant women. While you’re pregnant, do not take aspirin and non-steroidal anti-inflammatory drugs like Nurofen.
A back injury should not interfere with labor or pain relief during labor. If you have a back injury, an epidural is usually possible. You can tell the hospital about your situation so they can help you with back pain.
How to protect your back
Preventing or changing certain actions can help protect your back in pregnancy. This is more important as you get further along in your pregnancy.
- Do not lift heavy objects. Do not lift anything heavy. Instead, bend your knees and straighten your back. Keep the object you are lifting close to your body. Let toddlers climb on your lap, into the car or bathtub, and then squat next to them instead of picking them up.
- Good posture is essential. Keep your pelvis aligned. Your weight should be evenly distributed on both your legs. Keep your back straight, your pelvis down and your spine straight. Do not stand for too long. If necessary, sit straight up with your back against the chair.
- Avoid activities that could cause injury to your back. Avoid bending, twisting, climbing ladders or walking up steep hills.
- Be cautious when you’re in bed. With a pillow between you knees, sleep on your back. Roll onto your back, bringing your knees together. Next, support your arms with your arms as you lift your legs off the ground.
- Shoes with low heels are best (not flats). These shoes provide good arch support. Avoid wearing high heels.
- You might consider a maternity support band.
Strengthening your back
Being active during pregnancy is good for your back and health. You can walk or do water exercises if your doctor allows it. For specific exercises that will strengthen your back, talk to a physiotherapist.
Your lower back can be stretched by kneeling on your stomach with your head aligned with your back. Bring your stomach in and wrap your back. For a few seconds, hold the position and then release. Repeat the process 10 times. With pelvic tilt exercises, you can strengthen your stomach muscles. Place your hands on the ground and lie on your back. Your pelvis and hips should be tilted backwards to ensure your back is flat on the ground. For 3 to 5 seconds, hold the position. This exercise can be done standing up, or on a stationary bike.
You can strengthen your pelvic floor and tummy muscles by gently drawing your lower tummy (below your belly button) towards the spine. Continue to breathe. Gradually increase the length of your posture. These muscles should be braced whenever you lift, push, or pull something heavy. Some women may find that complementary therapies like yoga or pilates are helpful, but it is important to talk with your doctor first.
What can you do to treat a herniated disc during pregnancy?
Women who experience severe to moderate herniated disc pain in pregnancy should remain positive and see a spine specialist. Herniated discs that are mild to moderately severe do not pose a danger to the baby’s health or safety. However, severe cases may need to be treated or rehabilitated.
Lower back pain and pelvic discomfort are common in pregnancy, particularly during the third trimester. To have a smooth and trouble-free pregnancy, it is important to keep a positive outlook and educate yourself about herniated discs. Talk to your OB/GYN if you are experiencing pain. NSAIDs, bed rest, safe exercises, etc.) To prevent injury or pain from occurring again.
The doctor may suggest that you coordinate care with a spine surgeon in order to discuss minimally invasive treatments or spine surgery after giving birth. These conservative and interventional options may be able to relieve your herniated disc pain temporarily. Please consult your doctor before you try any of these options.
- Stretches and exercises that are safe for pregnant women can be used in physical therapy
- Acupuncture
- Ice and heat therapy
- Prenatal massage
- TENS units
To prevent any further complications, your OBGYN might recommend bed rest for the time that the baby is born. To ensure your child’s safety and health, it is important that you follow the instructions of your OBGYN.
When should you see a doctor?
If the pain persists or is severe, consult your doctor. Sometimes, back pain may be an indication of premature labor or a urinary tract infection. If you have bleeding from the vagina, pain in your urination, or other signs of premature labor, see your doctor immediately.
Discussion
While symptomatic lumbar disc herniation is the most common spinal condition during pregnancy, it is much less common than pregnancy-related LBP. It is estimated that 1 in 10,000 pregnant women will experience this condition. A rise in the incidence of lumbar disc hernia among pregnant women can be expected due to the recent increase in the average age at which women become pregnant.
According to reports, the percentage of children born to women over 35 years old increased from 4% in 1990 to 21% in 2015. Nineteen of the 10 cases were older than 30, and four were over 35. LBP may be caused by hormonal changes, particularly a rise in serum relaxation.
Radicular pain is the most common symptom associated with lumbar disc herniation. Two of the 10 cases in this article presented with LBP. The other eight presented with either urinary problems, radicular discomfort, decreased sensation in one spinal nerve’s sensory distribution, or weakness in the muscles that are innervated through the motor root of a spinal nerve. Cauda Equina Syndrome, which is a criteria for emergency neurosurgical treatment, refers to radiating pain, numbness, and bilateral muscle weakness that affects both the lower extremities, bladder, and bowel dysfunction.
According to literature, only 15% of patients with lumbar disc hernias experience severe neurologic deficits. We reviewed a case with CES. The patient had laminectomy right after the caesarean section (CS). There were no neurological sequelae. Although MRI in pregnancy is now more accepted, the exact risk to the foetus remains unknown. Research needs to continue in this area. The MRI scans revealed lumbar disc hernia at the L5/S1 or L4/L5 levels in all cases. The majority of patients with lumbar disc hernia are able to heal themselves without the need for surgery, according to therapeutic management. Six of the 10 patients received conservative treatment. They had no neurological deficits or residual pain after delivery.
One patient presented with radicular pain at 33 weeks and then developed motor weakness the week after. The patient was delivered via cesarean section and underwent discectomy within minutes. She was discharged with no neurological deficit. Another patient had an epidural steroid injection. Her symptoms improved and she was discharged without any neurological sequelae.
The delivery method is still controversial. There is no published data on lumbar disc hernias in pregnancy. Based on MRI data, the decision to treat conservatively (“wait-and-see”) or surgically appears to be influenced largely by the cooperation between the obstetrician (or neurosurgeon).
Postpartum evolution was unpredictable. Cesarean section was offered to pregnant women suffering from lumbar disc hernia. This was followed by remission and no neurological deficit. Antepartum epidural steroid injection, vaginal birth and no neurological deficit during the postpartum period. Cesarean section for failed labor inducement at term. CES followed by immediate microdiscectomy. CES followed by operative vaginal extraction. CES followed by spontaneous vaginal deliveries.
These cases suggest that labor could increase the risk of neurological symptoms worsening in the postpartum period or CES development. CS may be a safer option for pregnant women suffering from symptomatic lumbar disc hernia.
Conclusion
It is unclear which method of delivery is best for women who have lumbar disc hernia. This is due to a lack of experience and a small number of cases. Collaboration between obstetricians, neurosurgeons, and MRI data seems to lead to the best decisions and results. Although limited data suggests that CS is preferred to vaginal delivery for avoiding symptom progression and avoiding symptom worsening, further research is needed.