Pain in the muscles of pregnancy

Muscle pain during pregnancy is considered an inevitable phenomenon associated with natural processes, the change in the work of many organs and systems.

Literally from the first week of conception the smooth muscles that line the hollow organs (uterus), striated muscles, the vascular and hormonal system begin to "prepare" for childbirth. Such a general transformation of the future mother's body does indeed provoke discomfort of varying degrees of intensity, especially if the woman did not bother to exercise, strengthen muscle fibers, support the physical form before pregnancy. In this case, the contractile property of muscles is reduced initially, and the activation of muscle tissue function provokes a pain symptom in connection with chronic hypertension, overstrain.

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Causes of the pain in the muscles during pregnancy

Pregnancy, in addition to bringing joyful anticipation, sometimes causes quite explainable discomfort and even painful sensations. Most often the pain is concentrated in the muscle tissue and ligaments, because they are subjected to increased stress, stretching.

Causes of muscle pain during pregnancy can be both physiological and pathological. 

1. Physiological causes that cause muscle pain in pregnant women.

Before proceeding to the enumeration of causes, let us cite some statistical data: 

• The woman's body becomes like a "double" - it beats two hearts, own and the heart of the fetus, respectively, there is an additional circle of blood flow.
• The heart muscle of a pregnant woman experiences increased load and increases in size.
• The volume of blood flow increases to 6-7 liters.
• The body of a pregnant woman needs a double volume of oxygen for normal nutrition of tissues, including muscle.
• The spine and surrounding muscles undergo special stress, the weight of a pregnant woman can increase by 10-20 kilograms.
• 70-75% of women experience a pain symptom of this or that intensity in the back area due to temporary spinal dysfunction.
• The increase in the size of the uterus inevitably leads to a shift in the center of balance, the severity, respectively, the muscles of the waist and pelvis are subjected to increased stress.
• Changing the posture and gait of a woman, the muscles of the shoulder girdle, cervical, thoracic department have to work in the regime of hypertonia.
• The increase in body weight leads to a violation of the venous blood flow, respectively, the muscles of the legs ache.
• Overeating or vice versa, a lack of nutrients due to nausea and vomiting caused by toxicosis can disrupt the vitamin-mineral balance, accordingly, the muscle tissue does not receive proper nutrition, myalgia develops.

2. Pathological causes of muscle pain during pregnancy: 

• Disease of the cardiovascular system, decreased blood supply to muscle tissue.
• Atherosclerotic changes in the vascular system.
• Inflammatory processes in muscles, fascias, joints caused by infections.
• Neurological conditions associated with osteochondrosis of the spine.
• Fibromyalgia in the anamnesis.
• Local injury of the muscle (ossifying process).
• Nephropathology (pyelonephritis).
• Infectious pathology, most often genital herpes.
• Inguinal hernia, umbilical hernia.
• Varicose veins, including vaginal varicose veins.

In what areas can muscle pain develop during pregnancy? 

• The most susceptible to changes in the abdominal muscles are the rectus abdominal muscles. These skeletal muscles before pregnancy performed the function of maintaining an elastic press, forming it. After conception, the straight muscles must perform a completely different task - to maintain the uterus that grows in size. Atonic, untrained abdominal muscles are at risk of painful sprains, resulting in pain.
• Pelvic muscles that not only support the uterus and other organs in the proper places, but also directly participate in the process of labor.
• Muscles of the back can ache due to atypical displacement of the center of gravity, excessive load of the growing body. Atonic muscle corset is not able to cope with the extra load, muscles are stretched, inflamed, a woman feels pain in her back.
• Muscles of the legs that can ache from the first trimester. The most typical cramps of gastrocnemius in pregnancy, such a symptom often develops in the initial phase of sleep, or at night, less often in the morning.
• The muscles of the breast, which under the influence of changes in the hormonal balance, increase due to increased blood circulation, an activated lymph flow.
• Inguinal muscles can be ill for various reasons, but most often the pain symptom is caused by physical overstrain or the influence of the specific hormone relaxin on the ligamentous apparatus. Pain symptom in the groin may not touch the muscle tissue, but the sensations are reflected in the muscles, so it happens with nephropathology, digestive tract diseases and even with constipation. Also, pain in the groin muscles during pregnancy can be caused by a variety of non-physiological causes - varicose veins of the pectoral articulation, infectious diseases of the pelvic organs and others.
• Muscles of the vagina during pregnancy experience increased vascular load, the venous hemodynamics changes, the elasticity of muscle tissue decreases, pain appears.
• Statistics state that 70-75% of pregnant women experience pain in the lumbar region, the muscles of which are subject to increased stress due to increased body weight and physiological displacement of the internal organs

It should be noted that during pregnancy not all types of muscles spasmodic, there are also those that, on the contrary, are relaxed. Relaxation of smooth muscles on one side allows oxygen and nutrients to be delivered to the placenta, and on the other hand can cause reflex irradiating pains from excessively atonic organs (gallbladder, stomach, intestines).

Summarizing, it can be said that the organism of the future mother experiences at times an exorbitant load comparable only to the intensity of training of cosmonauts. Accordingly, the woman periodically experiences pain symptoms, most often localized in the back, pelvic region, abdomen and legs.

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Why do muscles ache during pregnancy?

Why does a pregnant woman experience muscle pain? The simplest answer is that - because of systemic physiological changes in the body. Stages and types of transformation can be designated in this way: 

1. Hormonal restructuring of the body.

• The level of progesterone and estrogen changes, elevated secretion of relaxin begins. Progesterone is needed to increase the tone of both the smooth muscles of the uterus and other muscle tissue, especially the development of progesterone in the first trimester, so that conception really passed into pregnancy, was fixed. In addition to influencing the condition of the uterus, progesterone promotes stimulation of breast development, the muscles of the mammary glands soften, the glands are enlarged. In addition to a clearly beneficial effect on the body, progesterone inhibits the activity of the immune system so that it does not reject the embryo (fetus) that has entered into the uterus during the "recognition" process. Thus, reduced immune defense is a potential risk of infectious, bacterial infections, diseases often accompanied by muscle pain. Also, progesterone can promote the retention of salt and fluid in the body, which in turn disrupts the rate of normal blood circulation, venous outflow and provokes pains of a different nature, including myalgia.
• Elevated levels of estrogen performs the task of activating the growth of the uterus, if too much estrogen, it works as a diuretin, sometimes too active. As a result, a violation of water-salt, electrolyte balance and pain in the muscles
• Chorionic gonadotropin and somatomammotropin do not provoke myalgia by themselves, but they accelerate all metabolic processes, and somewhat increase the muscle mass of the breast, less often the body's buttocks (buttocks, feet).
• Diseases of organs and systems of blood supply of a small pelvis in the anamnesis also can be the answer to a question - why muscles hurt at pregnancy. Among them are common and most often diagnosed the following:
  • Ovarian cyst.
  • Fibromioma of the uterus.
  • Adnexitis.
  • BPVM - varicose veins of the small pelvis

2. The causes of pain in the muscle tissue during pregnancy can also be such pathologies and acute conditions: 

• Pyelonephritis.
• Inflammation of the appendix.
• Cholelithiasis.
• Infringement of an inguinal hernia.
• Injury of the intervertebral disc.
• Risk of miscarriage.
• Constipation, flatulence.
• Sprain.
• Muscle injuries.
• Detachment of the placenta.
• IBS is irritable bowel syndrome.
• Intestinal obstruction.
• Genital herpes.
• Symphysitis (in the third trimester).
• General venous insufficiency, occlusion of veins.
• Urolithiasis disease.
• Braxton-Hicks contractions, false, training fights.

Symptoms

Signs and symptoms of muscle pain in pregnant women are often transient, more intense sensations, especially chronic ones, need immediate diagnosis, hospitalization and treatment.

Myalgia - pain in muscle tissue can be felt like: 

• Shooting pain.
• Sharp, daggerache (rarely).
• Aching, pulling (often).
• Breaking.
• Burning, tingling.

Depending on the provoking factor, the symptoms of muscle pain during pregnancy can be temporary, situational, transient or persistent, chronic. As a rule, the discomfort in this or that area of the body in the future mother is transitory, the pain can subside or even neutralize with the course of pregnancy, the change of trimesters. This is due to constant changes in the body of a woman who directly affect the condition of muscle tissue.

Symptoms of physiologically tolerable conditions: 

• Aching in the legs, stopping at the change in the body posture, at rest.
• Drawing pains in the back, stopping at a lek massage, relaxing procedures.
• Pain in the groin, stopping at rest.
• Spreading, pulling back pain, in the pelvic area, caused by sprain of the ligament.
• Cramping pain associated with training spasms, Braxton-Hicks contractions.

Disturbing signs that call for a doctor, examination and medical care: 

• Sudden, spontaneous severe pain with a tendency to increase.
• Pain that does not subside in rest or when the posture changes, the position of the body.
• Myalgia, accompanied by an increase in body temperature.
• Muscle pain, which lasts more than 2-3 days, is not even acute and not intense.
• Pain in muscles of a cramping character with atypical discharge from the vagina (blood).
• Symptoms of "acute abdomen" - pain, falling blood pressure, tachycardia, cyanosis of the skin.

Pain of abdominal muscles in pregnancy

A painful abdominal symptom in a pregnant woman is vainly considered a common occurrence, a natural signal of muscle strain due to the increase in the uterus. Indeed, every day the uterus becomes more and more, especially in the second trimester, when the displaced center of balance provokes a change in the gait of a woman. The pain of the abdominal muscles during pregnancy can indicate a pathological development of the process of carrying out the fetus or other serious diseases - cyst, inflammation of appendicitis. Fortunately, the pain symptom in pregnant women in the abdomen in 75-80% is due to the tension and stretching of the round ligament, which performs the function of supporting the uterus. The bottom of the pelvis is lined with a three-layered muscular tissue and fasciae, this provides support for almost all organs of the reproductive system, as well as for the abdominal organs. The uterus is supported by thick ligaments, one of which is round directly holding the uterus in place. The increase in the size of the uterus provokes the stretching of the round ligament, which is quite naturally accompanied by pain in the abdominal region.

Similarly, the musculature, especially the smooth (the walls of the uterus) and the abdominal muscles, also undergo stress. If the expectant mother did not strengthen muscle tissue beforehand with the help of sports, exercises, the straight muscles and muscles of the press during pregnancy stretch or over-strain, as they have to participate in supporting the growing uterus. It is too rapid stretching, hypertonic muscle provokes pain symptoms, lead during the gestation of the baby, the waist volume can almost double, for example, from 65 to 100 centimeters.

The pain of the abdominal muscles during pregnancy most often does not require the intervention of a doctor and special treatment, but a woman needs to be alert if the pain symptom does not subside when you change your posture, rest, relaxation. Therefore, in any disturbing painful sensations, it is better to consult a treating gynecologist.

A list of the main emergency conditions in which a painful muscle symptom in the abdominal region may appear: 

1. Obstetrical conditions: 

• Risk of miscarriage.
• Septic miscarriage (clinic of an acute abdomen).
• Ectopic pregnancy, ectopic pregnancy.
• Fibromioma.
• Detachment of the placenta.
• Aneurysm rupture (splenic artery, renal artery and others).
• Stretching and rupturing of the uterus.

2. General pathologies, manifested by pain in the abdomen, including muscular: 

• Pyelonephritis in acute form.
• Appendicitis.
• Spontaneous hematoma in the rectus abdominis muscle (hemorrhage into the muscle tissue).
• Acute cholecystitis.
• Cystitis (pain in the lower abdomen, in the perineum).
• Chronic inflammation of the ovary.
• Umbilical hernia.
• Hernia of the groin.

If the leg muscles hurt?

Most often, pain in the legs of pregnant women is either vascular disorders (varicosity) that provoke aching, pulling pains, or cramps, especially at night.

Why do leg muscles hurt during pregnancy? 

• Ploskostopiya, which, of course, was before pregnancy, but the period of bearing the fetus aggravates the load on the muscles and provokes their overstrain (hypertonus). For the prevention of pain symptoms, which are most often localized in the calves of the legs and strengthened when walking, a woman should purchase orthopedic insoles and choose shoes on a stable, medium heel with a stiff enough, fixing foot, sole.
• Vascular dysfunction. An increase in the weight of a pregnant woman inevitably entails an additional burden on the vascular system. If pre-pregnancy history has already had varicose veins, you should wear compression underwear, stockings, to reduce pressure on the walls of blood vessels. Muscles with varicose enlargement hurt because they do not receive proper nutrition.
• Failure to comply with the rules of a full-fledged, rational nutrition, as a result of which the muscle tissue lacks the necessary proteins, carbohydrates, vitamins and trace elements. Often a convulsive syndrome is observed in women who adhere to a strict vegetarian diet.

Often during pregnancy, the leg muscles in the calf region, that is, the calf muscles, are hurt. Convulsions are a severe pain that women describe in such a way - "reduces legs". The most common night cramps calf muscles, which is due to natural body relaxation and dissonance between relaxation and chronic muscle hypertension. Also often happen and hypnagogic spasms, that is, spasms of the muscles before the phase of deep sleep. Convulsive syndrome in 65% of cases is diagnosed in the middle of pregnancy, when the needs of the developing fetus are growing rapidly, and the resources of the mother organism have already been significantly depleted.

Possible causes of seizures:

• Deficiency of vitamins of group B, magnesium, potassium, calcium.
• Preservation of bad habits - smoking, abuse of caffeinated drinks.
• Reduction of blood sugar.
• Anemia, a decreased level of hemoglobin.
• Phlebeurysm.
• Syndrome syndromum venae cavae inferioris - the lower genital vein, when in the horizontal position (at night) the uterus presses on a large vessel, the venous outflow is disrupted, convulsions develop. This syndrome occurs in 80% of pregnant women in the third trimester.
• Abuse of diuretics to eliminate puffiness.

If the pregnancy hurts the muscles between the legs?

Despite all the joyful and exciting moments of expectation of the baby, the period of his bearing is accompanied by temporary uncomfortable sensations. In addition, that the future mother hurts in the lower abdomen, in the lower back, there are many symptoms that can further complicate pregnancy, for example, muscles between the legs hurt. In fact, such pain, most likely, does not appear in the muscles, but in ligaments, nerve endings. 

This is due to the increased secretion of a specific hormone - relaxin. Its main task is to reduce (inhibit) the contractile function of the uterus in the first trimester in order to keep the pregnancy. In addition, later relaxin is needed to relax, soften the pelvic bones, symphysis, prepare them for labor. Relaxin begins to be developed literally from the first week of conception, but the effects of its influence are felt later, in the 2nd, and especially in the 3rd semester. Usually a pregnant woman makes a complaint "the muscles ache between the legs" on these terms, the pain is also felt in the hips, in the pubic area, in the lower abdomen. 

Another reason that provokes a pain symptom in the inguinal area, between the legs, may be a neurological factor - a pinch of the sciatic nerve. The pinching of the nerve roots is due to the pressure of the enlarged uterus, and the pain is projected onto the buttocks, the groin area, and the lower extremities. Such a pain can not be attributed to true myalgia, although it affects the muscle tissue. 

Pregnancy, muscle aches between the legs - this condition can be caused by banal overstrain, when a woman overestimates her own physical abilities and continues to engage in sports exercises without regard for her special situation. Such cases are not uncommon for professional dancers, sportswomen, who continue to work during pregnancy.

What can remove the pain in the muscles between the legs? 

• Rest and reasonable physical activity (refusal of overloads).
• A bandage supporting muscles, ligaments.
• Gentle physiotherapy procedures (only by doctor's prescription).
• Warm compresses.
• Implementation of a set of special exercises for pregnant women on the preparatory stretching of muscles.

If the muscles of the groin hurt during pregnancy?

The entire period of pregnancy there is an increase in venous pressure, especially in the vessels of the lower limbs. This process is caused by increased venous pressure of the enlarged uterus and at the same time a slower pressure in the veins of the groin and legs. The growing uterus compresses the pelvic veins, the outflow of blood from the legs is difficult, this is one of the reasons why the muscles of the groin hurt during pregnancy.

In addition, pain in the groin is explained by another physiologically acceptable cause.

In the second trimester, the round ligament is significantly stretched, the task of which is to support the uterus. Pain in the groin when stretching the ligament can be very acute, but short-term, it can be felt like a spasm, a cramp that radiates down the abdomen.

In addition to physiological stretching, the explanation why the muscles of the groin hurt during pregnancy can be such factors: 

• Inguinal hernia. The pain is localized to the right or left as a result of a decrease in the tone of the local supporting muscular tissue. As a result, the intestinal loops can slip under the pressure of the enlarged uterus right into the groin. The hernia looks like bulging in the groin area, with the infringement of the muscles it provokes pain. Infringement requires urgent medical attention to avoid necrosis (blood supply is blocked) and a rupture of the intestine.
• Enlargement of lymph nodes located in the groin. Increased lymph nodes may be a sign of an infectious inflammatory process in the pelvic organs. As a rule, a pregnant woman undergoes a thorough examination during registration, and inflammations are fixed in the card. However, the very process of bearing a fetus can provoke an aggravation of such diseases as adnexitis, parametritis, proctitis, endometritis, as a result, a pain symptom develops, including in the muscles.
• Urolithiasis also provokes pain, which can be reflected in the muscular tissues of the back, thighs or groin depending on the location of the calculus. If the stone is localized low, the pain will manifest itself in the groin area.
• Pain in the muscles of the groin during pregnancy can be reflected when, due to increased strain on the spine, infringement of nerve endings in the lumbosacral region occurs.
• Contusion, punch stroke.
• Genital herpes, which manifests itself in the form of erythematous papules, itching, vaginal discharge, enlargement of lymph nodes, myalgia and hyperthermia.
• BPVM - varicose veins of the small pelvis, a disease that develops asymptomatically, but in pregnancy acquires a sharp form. Venous hemodynamics is disturbed, pulling pains in the groin, in the legs develop.

When hurt the muscles of the perineum during pregnancy?

Muscles of the intestine, gall bladder, esophagus and stomach during pregnancy are physiologically more relaxed, as they directly participate in the fetal nutrition, however, the muscles of the back, abdomen and perineal muscles are subjected to increased stress and strain. This is perhaps the first and most common reason for explaining why the perineal muscles ache during pregnancy.

In addition, perineal muscle tissue can ache due to the pressure of the enlarged uterus on the nerve endings and ligaments located in this zone. As a rule, pain in the perineum after childbirth subsides irretrievably, which proves the physiology and naturalness of the pain symptom. An exception may be painful sensations caused by a strong stretching of the perineum due to symphysitis, which develops in the second half of pregnancy.

Symphysitis, in turn, is due to calcium deficiency in bone tissue, primary or secondary. Pain with symphysitis is aching, pulling, the sensation of an ache spreads in the pelvic region, in the groin, in the perineum, especially if the woman, lying in bed, tries to straighten her legs.

Overloads and a kind of "softening" of the pelvic bones, which, in addition to being subjected to pressure from the uterus, are "prepared" for childbirth (the organism secrets relaxin for this), lead to a pain symptom. It can be felt as a drawing or shooting pain in the lower back, in the lower abdomen and in the muscle tissue of the perineum. As a compensatory consequence of muscular hypertonia, hypotension develops, a decrease in the elasticity of the bladder, the urethra. For expectant mothers, involuntary urination is typical, even with mild straining of the abdominal muscles or back - with laughter, with coughing. The same symptom is observed in some women when squatting or exercising perineal muscles.

Also, during the period of gestation, a woman can have muscle aches in this zone because of venous congestion, insufficiency. If a varicose veins is listed in the history, most likely a pain symptom in the groin, in the perineum, in the legs will be inevitable, but reversible with the right treatment.

Why do the muscles of the vagina ache during pregnancy?

The vagina is an organ containing a lot of nerve endings, receptors, vessels, so it is very dependent on the quality of the circulatory system.

Are the muscles of the vagina ache during pregnancy? The reasons can be several: 

• Weight load on the pelvic area, respectively, a decrease in active blood flow and a decrease in the supply of vaginal tissues. Stagnant phenomena, puffiness is a typical condition accompanying pregnancy, the result of which is transient pain in the groin area and in the vagina. In addition to the pain symptom, a woman can feel itching, tingling, which, as a rule, subsides at rest, in a horizontal position (outflow of blood).
• Varicose veins, varicose of the labia. This pathological phenomenon can be associated only with the period of pregnancy, but can be observed before it. Varicose veins may be due to a weak valve system of blood vessels, excessive weight, inflammatory processes in the internal organs of the small pelvis, permanent physical overstrain (weight bearing). In addition, varicose veins of pregnant women can be explained by increased secretion of progesterone and estrogens, lengthening and widening of the entire blood supply network, starting from the 10th week after conception. Uterine blood flow is activated during the entire gestation period and reaches a peak (600-700 ml per minute) at the time of birth. Accordingly, the fallopian tubes inevitably thicken and hyperiminate, the cervix swells, the labia and the labia swell, painful sensations appear.

Symptoms of varicose can manifest itself in such symptoms:

• Drawing pain in the groin, in the vagina.
• Sensation of opening in the labia.
• Puffiness of the vagina.
• Dryness, lack of lubrication, itching.
• Perhaps the appearance of visible varicose nodules on the labia, in the groin.

If the muscles of the vagina hurt during pregnancy, the cause can be sought in the past. If a woman long before conception systematically took hormonal contraceptives or hormonal drugs to treat a chronic disease, her vascular system was used to helping hormones. During pregnancy, without the usual dose of hormonal substances, the vessels can not work at full strength, venous outflow is disturbed, stagnant phenomenon develops in the lower abdomen and pain, including in the vagina

When are the muscles of the press hurt during pregnancy?

The abdominal muscles, which before the conception were responsible for the condition and appearance of the press, during pregnancy should perform a completely different task. Support for the uterus, other internal organs - this is a new function of the rectus muscles, which are localized in the anterior part of the peritoneum. The muscles of the press are two muscles, the right straight line and the left straight line, which connect in a place called very poetic - the "white line" of the abdomen. Straight muscles originate from the lower part of the sternum, from the lower ribs, extending downward vertically along the abdominal area, reach the pubic bone, where they are fixed. Straight muscles are intersected by specific tendon elements - bridges, it is this combination of straight and transverse muscles that gives the desired visual effect of the "cube" of the press. However, for a normal pregnant woman, cubes are not as important as the baby's health and her own health, which sometimes is clouded by uncomfortable pain. Straight muscles (press) for 9 months are subject to changes, because they have to keep the growing uterus all the time. In this state they are able to permanently close in place of the "white line" and gradually evenly spread out along the sides. It is this phenomenon called diastasis, it explains why the muscles of the press are hurt during pregnancy.

Diastasis may not be for every future mother, for those who previously practiced sports, led an active lifestyle, was on the move, strengthened the press, diastasis is very rare. However, those who have not paid any attention to sports and "acquired" diastase during pregnancy, it passes 2-4 months after birth, this is the unique adaptive property of muscle tissue.

If the muscles of the press are hurting during pregnancy, this is a perfectly acceptable phenomenon, but under certain conditions and sensations: 

• The muscles of the press ache only in the navel area, the pain is transient, appear after the 12th week with gradually subside as adaptive muscle stretching.
• Straight abdominal muscles hurt only with physical activity.
• Pain in the area of the press is not associated with an increase in body temperature, does not move down the abdomen and is not acute, intense.
• All other pain symptoms in the area of the rectus muscles need to be observed by the doctor, in this sense it is better to be safe and minimize the risk of possible complications.

Why does inguinal muscle ache during pregnancy?

The pain symptom in the groin area of pregnant women can be provoked by various factors, the diagnosis of which is rather difficult. The point is that the groin area is not considered a separate anatomical unit, but rather it is a zone of hip joint and articular articulation. In the groin is attached a large number of different muscles, which are called adductor muscles, they are responsible for the movement of the hips and their attachment to the pelvis. Also in the inguinal area there is a canal, which includes some of the largest arteries of the body - femoral vessels, there is an important element - a round ligament of the uterus, which during pregnancy is subject to severe stretching.

Usually, inguinal pain is well known to athletes and those who are subjected to intense physical activity, but also inguinal muscles ache during pregnancy.

The reasons why there is pain in the muscles of the groin in a pregnant woman? 

• Physiological stretching of the round, supporting the uterus, ligaments.
• Varicose veins.
• Infectious inflammatory diseases of organs located in the pelvic region. Inflammations cause an increase in lymphatic inguinal nodes, pain.
• Adnexitis, inflammation of the appendages, ovaries.
• Calcium deficiency associated with its increased consumption during pregnancy.
• Spreading pain in the back, giving away in the groin, may not have to do with muscle tissue, but it is felt like a pain in the muscles. It happens with urolithiasis, its aggravation, renal colic.
• Pain in the groin can be triggered by constipation-both a physiological, hormonal factor, and caused by the psychoemotional state of a pregnant woman (neurotic spastic constipation).
• Inguinal hernia.
• Varicose veins of a large leg vein, located under the skin in the groin area.
• Injury, contusion of groin.
• Symphysitis in the second half of gestation (softening, sprain of the bones of the lone articulation).
• Excessive strain on the muscles of the thighs when doing stretching exercises for pregnant women.

If the back muscles hurt during pregnancy?

About 70-75% of pregnant women experience pains of a different nature in the back, lower back.

Why do my back muscles hurt during pregnancy? 

• Physiologically acceptable hormonal changes, secretion of relaxin, the consequence of which is the expansion and relaxation of pelvic bones, intervertebral ligaments. Muscles at the same time still try to perform a "corset" function, but are subject to increased stress, are in hypertonia. Such pain subsides after the 20-22th week, when the body is already prepared and the development of relaxin is reduced.
• Displacement of the main center of gravity due to the increase in the weight of the future mother's body. The center is significantly shifted forward, respectively, all the back muscles are straining with a double force. Sometimes the woman aggravates the pain symptom, as she does not follow the posture, the back is too bent forward after the abdomen.
• The pressure of the increasing, growing uterus on the nerve endings of the spinal column, and the blood vessels are also squeezed, blood flow and nutrition surrounding the vertebral disks of the tissues are disturbed. Especially typical are shooting, strong, but short-term pain in the lumbosacral region of the back.
• A significant increase in the body weight of the pregnant woman provokes varicose veins, disrupts the venous outflow of blood in the pelvic region, aching legs, lower back.
• Incorrectly selected shoes, especially for high heels, which in principle are not useful, as they provoke a nonphysiological gait, increase the load on the spine. For pregnant women, a high heel is taboo.
• Osteochondrosis and other diseases of the musculoskeletal system in the anamnesis before the onset of pregnancy.
• Pain in the back muscles during pregnancy can be due to the pressure of the fetal head, especially this is characteristic of the last month of gestation.
• Fibromyalgia, a myofascial syndrome in the anamnesis before the onset of pregnancy.
• Back pain in the last days of pregnancy can be a harbinger of close birth.

When the pain in the muscles of the back should alert? 

• The pain is permanent, accompanied by a high body temperature.
• Back pain is caused by a bruise, a fall.
• Pain in the muscles of the back is accompanied by a loss of sensitivity in the legs, buttocks, thighs.
• The pain is accompanied with incontinence or vice versa by a delay of urine, feces.
• Pain symptom develops shortly before birth.
• Back pain is combined with nausea, vomiting, and a drop in blood pressure.

Diagnostics of the pain in the muscles during pregnancy

Any complaint about the discomfort arising from a pregnant woman should be taken into account and taken into account during routine examination. Diagnosis of pain in muscles during pregnancy is also difficult, as is the determination of the root cause of myalgia in non-pregnant women. The symptomatology of muscle pain is nonspecific, often the pain localization zone is determined by conducting several tests within 2-3 days (pain monitoring in dynamics). In addition, it is difficult to diagnose and undetected hidden diseases of internal organs and systems. This is especially characteristic for dysfunction of the musculoskeletal system, the spine. Any kind of osteochondrosis, which in itself represents a diagnostic problem, can become a serious obstacle in the rapid diagnosis of myalgia.

In order for the diagnosis of muscle pain in pregnancy to be accurate and specific, such questions are clarified and the following actions are taken: 

1. Re-collection of anamnestic data, including hereditary data.
2. A clear definition of the nature and prevalence of pain is diffuse or localized.
3. Clarification of the time of appearance of the symptom, its periodicity, duration and dependence on movements, changes in the position of the body.
4. Clarification of the area of distribution and source of pain - localized myalgia, somatic pain, reflected or radiating pain.
5. Determination of trigger zones for suspected fibromyalgia or MFBS is myofascial pain syndrome.
6. Palpation of the pain zone and revealing reflex pain response to palpation.
7. Elucidation of possible combined symptoms - muscle pain and nausea, muscle pain and dizziness, temperature, muscle pain and constipation, and so on.

Methods that involve the diagnosis of myalgia in pregnant women should be as gentle and non-traumatic as possible for the future mother and fetus. One of the problems of clarifying the provoking factor is the inadmissibility of conducting X-rays to identify a possible cause in the spine, in the joints.

Pregnant you can carry out ultrasound, prescribe laboratory tests of blood, urine and feces, determine hormonal balance, but as for muscle tissue, the old, proven methods of questioning, examination, palpation come to the doctor's help. All these methods must be combined with professionalism and, most importantly, a practical positive experience of the doctor.

It is unacceptable to self-diagnose or determine non-existent pathologies with the help of compassionate all-knowing relatives, girlfriends and questionable quality of one-time magazines. If a woman will visit the gynecologist on a scheduled basis, undergo regular check-ups, then it will be much easier to diagnose muscle pain in the same way as treating her.

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Treatment of the pain in the muscles during pregnancy

Medical measures that help to relieve muscle pain, spasms in pregnant women, are always symptomatic. Even if the doctor found out a pathological provoking factor, medication can be started only after childbirth. Of course, acute conditions, the so-called "obstetric" indications require immediate action, they include: 

• Increased and threatened ruptures of the ovarian cyst. Treatment with the help of minimally invasive surgery, endoscopy.
• Torsion of the legs of the cyst, which is often manifested by the clinic of the "acute abdomen", including muscle pain (hypertension of the rectus muscles). Treatment is surgical.
• Gallstone disease, exacerbation.
• Surgical intervention, endoscopy.
• Detachment of the placenta. Treatment is prescribed depending on the degree of severity of the process, usually conducted in the hospital.

Muscle pain associated with physiological factors - the increase in the uterus, stretching muscles, are treated only with the help of local effects:

• Appliques with relaxing ointments, rarely with ointments based on non-steroidal anti-inflammatory drugs.
• Warm short baths, baths.
• Cooling compresses.
• Gentle prenatal massage.

Excellent effect gives swimming in the pool, dosed, taking into account the condition of the woman. The same relaxing and at the same time strengthening effect can be exercised by yoga, pilates, collanetics. Among the most popular methods of treatment and prevention of pain in the muscles of the perineum, groin and pelvis are the exercises tested by not one decade of the Kegel method (strengthening the muscles of the sphincter, the vagina, the groin).

One of the most effective and simple ways to reduce, and even completely neutralize the risk of muscle pain, is the bandage. Elastic, comfortable, it gently but surely holds the belly of the future mother, reducing the increased load on the muscles, ligaments of the abdomen and spine. In addition, those who wear a properly selected bandage are 1.5-2 times less likely to have postnatal stretch marks on their skin. The bandage is not worn constantly, giving the skin and muscles the ability to breathe and work independently, but it is a necessary remedy with a significant increase in the weight of the pregnant woman.

Prevention

The main method that helps to prevent muscle stretching and, hence, pain in a pregnant woman, is exercise, motor activity and strengthening of muscle tone long before conception. If you systematically deal with the health of your body in conjunction with reasonable physical loads, then at a time when one muscle is shortened, and others are stretched, preparing for childbirth, a woman will not practically feel pain.

Prophylaxis of pain in the muscles during pregnancy can begin even during the gestation, today there are many sets of exercises for sparing the stretching of ligaments, muscle tissue. Fortunately, the muscles are a very grateful material in the sense of training, their structure quickly adapts to the new regime and, having learned, they again fulfill their tasks - protection of internal organs and systems, distribution and maintenance of organs according to the normal anatomical structure.

Gradually strengthening the muscles of the back, chest, groin, woman facilitates the work of the spine, supporting the function of ligaments, especially in the abdominal region. In addition, preventive measures to neutralize pain during pregnancy can help in the future, when the mother will have to carry a baby for a day.

Muscle training includes strengthening, increasing the elasticity of muscles and ligaments, as well as learning to relax. It is relaxation that helps to relieve muscle spasms, hypertonia and allows you to resume blood supply in the muscles. Also, as a prophylaxis of pain symptoms, respiratory techniques are effective, timely delivery of carbon dioxide or oxygen provides normal nutrition, the work of the vascular system, and consequently, the muscles.

[8], [9], [10], [11],