How To Ease Pelvic Pain During Your Last Trimester

Pregnancy teaches pragmatism. It throws us challenges, and we have to learn that “resolved” is far more valuable than “resolved in the way I planned before I had the challenge.” Pregnancy teaches us to listen to what is, and to meet the situation where we are right now, and rather forcibly helps us leave behind the tendency to resolve issues based on preconceived notions.

One of the dubious gifts that pregnancy offers our ever-evolving personal growth is the gift of pain. Pain is a many-splendored opportunity to practice listening to our bodies. Pain talks, loudly and clearly.

Learn to listen to your pain, with respectful, patient, and attentive ears. It's telling you something you need to know about the state of your body. Let it talk, so you can have a discussion with it, and work together toward a mutually beneficial solution.

One common pregnancy-related pain is last-trimester pelvic pain. There are many reasons why you might feel last-trimester pelvic pain. You might feel pelvic pain if your baby is sitting on a nerve, or swelling if the baby is pinching a blood vessel and impeding regular blood flow. You might be sitting still too long.

Another common cause is related to the hormone relaxin, which softens up your joints so that the pelvis can spread and make it easier for your baby to come out. This softening of your ligaments increases movement, which can cause a misalignment of your pubic symphysis (that's where the two sides of the pelvis come together in front), which can cause pelvic pain.

Get to know your pelvis. Have a pain discussion with it, and discuss ideas from many sides. Together, you will find solutions.

Here are seven two-sided discussions you can have with your last-trimester pelvic pain:

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7  Help Yourself From The Inside

Prenatal yoga, Pilates, and swimming (but not breaststroke) are good low-impact ways to relieve pain, get gentle exercise, strengthen the body, and help realign joints. (If this were the '80s, I would also suggest water aerobics, but I haven't seen such a thing offered for years.)

As an added bonus, exercise fills your brain with feel-good chemicals that distract its focus and make it happy. Also, group classes can boost your sense of community solidarity, thus cheering your psyche. And a happy psyche makes physical pain matter less.

Or Help Yourself From The Outside

You can also help yourself from the outside, via external supportive devices. Wear flat shoes to reduce postural strain on your spine and hips. Try a girdle, a brace, a prenatal belt, a walker, or even crutches, to take the weight and pressure off your irritated areas. (Bear in mind that crutches might exchange one problem for another: the compensatory mechanics involved in walking with crutches cause all kinds of strains and aches).

At night, prop yourself with pillows, to keep your natural alignment straight and reduce pressure. Put a pillow between your knees, make sure you have a supportive pillow for your neck and head, maybe cuddle one sideways. When I was pregnant we bought aTempur-pedic pillow and mattress that supported spinal curves, and I slept without pain.

6 Massage

Massage encourages fluid circulation through the body, it produces feel-good hormones and sense-of-security hormones, it reduces stress, it lengthens tissues, and it eases bodily restrictions. It makes your body feel good, it makes your mind feel good. Try it.

Or Medication

Tylenol is your friend. Tylenol (acetaminophen or paracetamol) relieves pain. Even though this old chestnut is used all the time, researchers still don't know why it works. Various theories include: it helps transmit serotonin (a feel-good chemical) in the central nervous system. Under certain conditions it inhibits enzymes that form prostaglandins, molecules that send pain and inflammation messages.

And recently, Swedish researchers are finding thatacetaminophen works on two channels in the brain and spinal cord that also respond to cannabinoids. (Cannabinoids are mind-altering chemical compounds including those found in pot.) ….Anyway, although we aren't sure how it works, it works. Offer some Tylenol to your pelvic pain. As always, discuss this and other medication with your doctor.

5 Affecting Your Muscles Through Temperature — Heat and Ice

As a bodyworker, I favor current research that says heat and ice don't resolve your inflammation or reduce its duration, andcan actually increase its duration. Their benefits are luxurious, not curative. Heat and ice are there to make you feel good, and that's it. But in this case, that's plenty!

Heating the area around your pubic symphysis can ease muscle spasm and tightness, and ice on the pubic symphysis can ease its inflammation. But, heat can increase inflammation and ice can increase muscle tightness and pain. So, see how it goes.

Or Affecting Muscles Through Chemistry

What if your issue is muscular pain? Your pelvis is a basket of muscles. Muscle pain in pregnancy can be caused by magnesium deficiency. Remember—you have a little friend inside you getting first pick of the nutrients in what you eat, and your body is doing tricks that affect its daily nutritional needs.

You may well be deficient in something. Magnesium deficiency is easily addressed. You can drink milk of magnesia, if you are not me. I find its texture disgusting but you may be fine with it. You can also absorb magnesium by taking a bath with Epsom salts.

4 A Full-Body Soak Or A Sitz Bath

A warm bath may do wonders. It will loosen your muscles, ease your stress, and relax your mind. You can put fun things in your bath, like Epsom salts, essential oils, or The Atlantic Monthly. And, as with massage and acupuncture, you can accomplish many positive things within the same bath. —Asitz bath is a bath you sitz in. (From the German, Sitzbad, “a bath in which one sits.”)

It increases the flow of blood to the general area of your perineum and pubic symphysis. You can buy a sitz bath that goes on top of your toilet, or you can use your own bathtub. Fill the tub with lukewarm water up to your thighs and sit in it. This can reduce swelling.

Or Showers

On the other hand, sitting in a bath means sitting on a hard surface, which may not be great for your pain, and it also means having to get up and down, which might also bother your mobile pelvic joints. Standing in a shower eliminates the hard surface and the awkward clambering.

Also, a warm bath might feel great, but on the other hand, the warmth loosens the pelvis, which might cause more pain, and the warmth could also exacerbate potential inflammation of the pubic symphysis. So...try a tepid shower.

3 An Eastern Approach

Even though I don't understand acupuncture, it works. Sticking needles into people in specific places really can positively affect a wide range of health issues. More and more, Western doctors are admitting that acupuncturesometimes works better than Western approaches. Acupuncture can help with pelvic pain.

A 2005 Swedish study of about 400 pregnant women showed that the women receiving acupuncture for pelvic pain felt more relief than women receiving standard Western treatments of education, rest, a pelvic belt, and an exercise program.

Or A Western Approach

I love complementary approaches; Eastern and Western medical practices. Try everything that makes sense. You might go to a physical therapist. Not all physical therapists are created equal; whom you get will affect on what happens in your sessions. But possibilities include soft tissue mobilization and massage, pelvic girdle and pelvic floor strengthening and stabilization exercises, postural exercises, and body mechanics training.

You might also (or instead) go to a chiropractor. I have to put a red flag in front of this one. Good, trustworthy chiropractors have been known to do beneficial work for many people. On the other hand, there are chiropractors who are neither good nor trustworthy, and they're working with your spinal column: one slip, and you could be living with serious consequences.

If you want to go to a chiropractor, they may help you. But you owe it to yourself to research anyone you're considering. They have your life in their hands.

2 Incorporate Exercise Into Your Daily Life

Walk around to keep your circulatory systems going. Make lots of small movements, don't sit for hours at a time. Move around as part of your daily routine. Change positions, and fidget. Roll around on a birthing ball, making sure it's the right size for you. Lie on the floor with your legs up a wall: it's great for getting the blood circulating properly.

Engage your pelvic muscles before doing an activity you know is painful. Counteract the global pandemic of horrible seated posture, which can cause lower back pain for anybody and surely isn't doing your pelvic pain any favors. Abandon the Hacker's Hunch and ease the burden on your pelvis and lower back.

Or Don't Go Crazy With The Exercise, And Slow Down

You need a balance of healthy movement and rest, not training for a triathlon. And while it's good to incorporate movement into your daily life, not all movements are created equal. Avoid squats, keep your legs together, and don't push yourself. Don't twist deeply. Sit down while dressing.

Move both sides of the body together and symmetrically instead of spiralling with your legs apart: for instance, when getting into a car, sit down first with both legs out of the car, and then bring both legs in; when getting out of a car, bring both legs out of the car at once and then stand up on both legs.

Basically, imagine how your loose pubic symphysis would move, and organize yourself in ways that keep it moving as one thing instead of creating opportunities for misalignment. And Slow down. If an activity like getting up off a seat or doing errands hurts, do it slowly and take breaks. If you want to include sound effects, go for it. Have someone else carry heavy objects for you. Take the elevator instead of the stairs.

1 Do Your Kegels

Do a few goodKegels. Strong, healthy, active muscles are muscles that will support you and can help stabilize alignment. Think of lifting and drawing up, not of squeezing.

Or Don't Do Your Kegels

Don't do too many Kegels. Too many strains the weaker muscles around them. Kegels are a focused, specific exercise, and right now you don't want to overtire or imbalance your pelvic floor's strength.

After the baby, you can do squats and Kegels and strengthen that whole muscular network, and it will be awesome. But for now, keep your Pitta, Type A tendencies in check.

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