Pregnancy Aches & Pains?

All pregnancies differ, and even women who have had multiple pregnancies say that no two were alike.

When it comes to common discomforts during pregnancy, some women may experience only mild symptoms, while others complain of having a more difficult time. In any case, you should discuss all aches and pains with your healthcare provider, who can help you find relief.

Some of the more common issues you may experience — along with simple solutions and remedies — follow.

Heartburn
A common complaint for expectant moms, heartburn, in general, is a benign condition that will usually improve with over-the-counter (OTC) antacid medications. However, if you are experiencing severe heartburn — with vomiting, chest pain or an inability to keep food or liquids down — reach out to your provider right away.

Nausea
Like heartburn, nausea is common during pregnancy. It usually improves after the first trimester. HCG, one of the hormones elevated during early pregnancy, is thought to be correlated with the level of nausea experienced. Once HCG tapers off (usually around week 14 or 15), you will most likely feel better. A simple OTC remedy is taking vitamin B6 (25 mg every six hours). If you have little or no success with vitamin B6, ask your provider about taking an antihistamine sleep aid.

Backaches
In contrast to nausea, back pain tends to worsen as pregnancy progresses. The general location is the lumbar (lower-back) region. As your pregnancy advances and your uterus continues to grow, ligaments that attach your uterus to your sacrum (called uterosacral ligaments) begin to stretch.

The stretching that occurs may cause pain in the lower back. At the same time, your body makes a hormone called relaxin, which, while helping to make room for your growing uterus, can also cause some of the bones and ligaments in your pelvis and back to loosen slightly — thus causing pain.

Some effective backache remedies include sleeping on your left side, squatting down to pick things up (instead of bending over), and wearing a back brace for additional support.

Constipation
Your growing uterus is a major cause of constipation. Another reason for constipation is the increase of the hormone progesterone, which can slow the movement of waste through your gastrointestinal tract.

Constipation can become severe enough to cause abdominal pain, so it is important to consider if bowel movements are infrequent or stools are harder than usual.

Some safe solutions include increasing fiber in your diet with fruits, vegetables and bran and getting regular exercise. If these measures do not provide adequate relief, try a stool softener or a mild laxative that your provider recommends. Bottom line: Go for the least invasive approaches first (such as diet and exercise), then move toward medications. Most expectant moms find relief with diet changes and exercise alone.

Hemorrhoids
Many women develop hemorrhoids toward the end of pregnancy. Hemorrhoids can be related to constipation. A common cause of hemorrhoids is straining/pushing during a bowel movement. Avoiding hemorrhoids is another reason to treat constipation when it occurs.

OTC hemorrhoid ointments and creams can provide safe relief.

Swelling
Swelling, a common complaint that is often extremely concerning for pregnant women, can be explained by your growing uterus.

As your uterus grows during pregnancy, it can sometimes press gently on one of the major veins (called the inferior vena cava) that drains a majority of the fluid from your lower extremities. For this reason, many pregnant women complain of swelling in both legs.

Should you develop swelling in only one leg (especially if that swelling is associated with pain, redness or warmth), seek medical attention immediately.

Besides appearing in the legs, swelling can occur on the hands, the face or the lips, as expectant moms tend to retain more fluid toward the end of pregnancy.

The best initial treatment includes keeping your legs elevated, walking regularly and wearing compression stockings.

Skin Changes
Skin problems are also very common and tend to worsen toward the end of pregnancy. You may experience stretch marks as your belly continues to grow, dry skin and sometimes oily skin, which can cause acne. In general, dry or oily skin can be attributed to hormone changes.

Though there has never been a clinically proven way to prevent stretch marks, some women have found success reducing the appearance of stretch marks by using gel formulas that contain a mixture of onion extract and hyaluronic acid.

Remedies for dry skin include limiting shower temperature and duration (as hot, long showers can naturally dry skin even if you aren’t pregnant), using soothing bath treatments and applying calamine lotion. If these measures are not effective, talk to your provider about using hydrocortisone cream, which you should apply sparingly.

Acne should improve once hormone levels return to their normal state following pregnancy. However, if you choose to use OTC medications during pregnancy to improve acne, check with your healthcare provider first, and avoid those containing isotretinoin or salicylic acid, which can be harmful to your baby.

Insomnia
Up to 80 percent of expectant moms experience insomnia.

To treat insomnia (or any sleep problem), try to identify the cause. For example, if you are having back pain toward the end of your pregnancy, alleviating the pain may help with your difficulty falling and staying asleep.

However, if you are not able to pinpoint and address whats’ causing your sleep problems, some possible solutions include taking a warm bath prior to bed (as the cooling-off period after a bath can help you feel sleepy), playing relaxing or natural sounds in the room to help calm you, and exercising regularly during the day.

Exercise is very important for sleep, as your body breaks down sugar during activity, producing a chemical called adenosine, which naturally builds up in your body throughout the day and helps you feel sleepy at night. The more you exercise, the more adenosine builds up, and the sleepier you will feel at bedtime.

Shane Drahos, MD, is a primary care physician currently at Stanford University completing a fellowship in sleep medicine.

For more information on pregnancy, visit www.youandyourfamily.com.