What is postpartum back pain?
Postpartum back pain, currently known internationally as "Postpartum pelvic pain syndrome", is believed to be closely related to postpartum sacroiliac joint and lumbar fascia and muscle imbalance. Many postpartum women experience pain in the lumbar and sacral regions, and those who undergo spinal anesthesia during delivery naturally assume that the pain is caused by anesthesia. So, is postpartum back pain really caused by anesthesia? In fact, some mothers who have not received anesthesia may also experience lower back pain, and postpartum lower back pain may not necessarily be related to anesthesia. Regarding this phenomenon, the field of traditional Chinese medicine orthopedics has long analyzed it, and its pathogenesis is the lack of coordination between the muscles and bones around the sacroiliac joint, known as "bone misalignment and tendon groove". Therefore, the infamous "anesthesia" is actually full of injustice.
2. Causes and manifestations of joint, fascia, and muscle dysfunction around the sacroiliac joint after childbirth
The sacroiliac joint is a highly stable and weight-bearing joint that can absorb the downward transmitted force from the spine and transfer it to the pelvis and lower limbs. At the same time, the sacroiliac joint is a micro motion synovial joint located between the sacrum and ilium, consisting of the ear shaped surfaces of the sacrum and ilium, wrapped by a complete fibrous capsule. The anterior lower 1/3 to 1/2 is the synovial joint, and the posterior upper 1/3 to 1/2 is the ligament part. The surrounding strong ligaments and muscles tightly wrap the sacroiliac joint, allowing it to only have a small range of motion.
During the first three months of pregnancy, changes in hormone levels and pelvic congestion can cause relaxation of the pelvic joints and ligaments around the sacroiliac joints, resulting in a wider range of sacroiliac joint opening and providing physical space for the fetus to enter the pelvic cavity. As the fetus enters the pelvic cavity, its volume and importance increase, the degree of sacroiliac joint opening and closing gradually increases. During delivery, if it is a vaginal delivery, it is more likely to increase the amplitude of sacroiliac joint opening on one or both sides.
If the position relationship of the sacroiliac joint continues to exceed the physiological range, this is the bone misalignment proposed by traditional Chinese medicine orthopedics. The joint surface that should have been tightly fitted is not matched, resulting in uncoordinated joint activity, and the tension balance of the muscles and fascia around the lumbosacral pelvis is also disrupted. The surrounding muscles may become tense, spasm, or inflammation and adhesion of the fascia may occur, leading to lower back pain. Therefore, the imbalance of the sacroiliac joint, lumbosacral joint, and surrounding muscle fascia is the main culprit of postpartum back pain!
As mentioned earlier, postpartum back pain is a manifestation of an imbalance in the sacroiliac and lumbosacral joints. When the sacroiliac and lumbosacral joints are in an imbalanced state, it can affect the overall joint stress state, causing force to concentrate in certain areas. Over time, accumulation can cause damage to stress concentration areas, such as lumbar disc herniation, lumbar facet joint inflammation, sacroiliitis, etc. In severe cases, it can damage the stability of the patient's spinal joints, compress nerves, and ultimately require surgical treatment.
How to treat postpartum back pain?
After a baby is born, if some mothers get enough rest, adjust their posture, and gradually engage in aerobic exercise, the sacroiliac joint can gradually return to its normal position through self-healing, so there will be no back pain; But some mothers may not be able to recover on their own due to lack of rest and exercise, or due to relatively severe joint misalignment, resulting in chronic back pain, which can seriously affect lumbar spine function. These patients can seek help from a specialist doctor.
At present, there are many treatment methods for postpartum sacroiliac and lumbosacral joint disorders. There is a relatively simple self-adjusting exercise method called the "lateral lying and oblique rotation exercise method". The exercise details include lying on the side of the bed, tilting the upper body backwards, straightening the lower leg, bending and extending the upper leg out of the bed, and completing the upward rotation movement of the upper leg from top to bottom. By using the gravity of the hanging upper leg, the sacroiliac joint can be adjusted. Through this exercise method, the stability of the sacroiliac joint can be increased, which is helpful for treating postpartum back pain and reducing recurrence. Patients who self treat or maintain the therapeutic effect after treatment can adhere to 2-3 sets of exercises per day, with each group performing oblique rotations about 10 times. If self adjustment is ineffective, patients should promptly go to the outpatient department for evaluation and treatment. In addition, there are several lifestyle suggestions: lifestyle habits, wear flat shoes in daily life, sit upright and avoid leaning forward, pay attention to keeping warm and avoid getting cold; In terms of diet, a reasonable diet should supplement nutrition; Local hot compress; Acupuncture and moxibustion physiotherapy, non drug treatment, develop good living habits.