Healthy Habits: Sciatica and Pregnancy

When Dr. Nicole Ceradini, Obstetrics & Gynecology specialist called upon me for spine care help for a 36 weeks pregnant patient with sciatica, I rallied intellectually to help. As a spinal surgeon, surgery is mostly contra-indicated. We both practice at Vassar Brothers Medical Center in the Hudson Valley, New York. As a New York-based spinal surgeon, I, Dr. Ken Hansraj developed a plan on how pregnant women can keep their spines in top condition during the full term of their pregnancy. According to researchers, evolution is the reason that pregnant women don’t just tip over. While researchers from Harvard University and the University of Texas have shown that evolution has given women a stronger backbone than men and a lower vertebra that reduces back pain during pregnancy, up to 70% of women still report experiencing lower back pain while pregnant. I developed a plan on how pregnant women can keep their spines in top condition during the full term of their pregnancy. By following these tips, pregnant women can alleviate their spinal pain and help keep their spines in top condition during the entire gestational period. EXERCISE: Even just a short walk can help! Walking helps to tighten stomach muscles for a few seconds and then allows them to relax. This tightening and relaxation process help to strengthen the abdominal muscles which in turn helps provide stability of the lower back. Additionally, walking is great exercise for anyone – pregnant or not – because it works the spinal nerves and spinal facet joints – which are as critical to your overall physical health as all of your other joints. Aquatic/water-based exercises are also a great option for pregnant women, as gravity is not as much of an issue, and will therefore not place any unnecessary pressure on the spine. PAY ATTENTION TO POSTURE: Due to their shifting center of gravity, pregnant women usually adjust their posture during the second trimester. I am a huge advocate for always paying attention to yourposture. He suggests that pregnant women do their best to try to stand as straight up as possible, without leaning too far back or slouching, as doing so can apply too much pressure to the spine. If pregnant women are having trouble with this, they should ask their physicians about a “sacroiliac belt,” which is a supportive device used to stabilize the sacroiliac joint which reduces pain in the pelvic and lower back region. BREATH: Breath work is critical in pregnancy, and especially recognized using the Lamaze techniques. Breathing moves the spinal nerves, spinal joints and restores spine function. SLEEP: Getting of rest during pregnancy is essential – as is getting the right support, if lower back pain is present. Pregnant women should always try to sleep on their sides, as this is the least pressure-inducing position for the spine. Additionally, women should look into special pregnancy pillows to place between the knees to eliminate additional pressure on the spine while sleeping. STRETCHING: Pelvic floor exercises will help decrease stress in the lower back and are a must for all pregnant women. AVOID HIGH HEELS: We see countless celebrities wearing high heels during pregnancy. While it may seem cool that they’re attempting to keep up appearances, I think that there is the danger of heels during pregnancy due to a women’s natural gravity shift and the lower back issues that most women experience while pregnant. Wearing high heels is simply an unnecessary risk. Pregnant women should wear comfortable shoes with appropriate support to avoid creating even more pressure on the spine and all other joints for that matter. Women can rock the high heels post- pregnancy of course. IF POSSIBLE GET AN MRI BEFORE PREGNANCY: Women with back pain may consider getting an MRI scan and x-rays before conceiving. This option is no longer available when you are pregnant. I recommend developing a relationship with your spinal specialist who would better be able to support you during pregnancy. START PHYSICAL THERAPY TREATMENTS: Similarly, I suggest beginning treatments with a physical therapist early. During pregnancy, women are typically not recommended to take medications that may hurt the development of the baby. Develop a relationship with a physical therapist during pregnancy that will support with massages, modalities and sometimes a deeply relaxing treatment called cranial osteopathy. MEDITATION DURING PREGNANCY: Meditation can help to diminish stresses and increase the sense of well-being during pregnancy. Meditation will ground you and connect you with your baby who is working as well on the inside. YOGA DURING PREGNANCY: There are many poses that a pregnant woman can do and reap the benefits of relaxation for herself and her baby while maintaining flexibility of the body and especially spine. An account of the pregnant woman’s activity level prenatally needs to be considered when implementing an exercise program of any kind. Care should be taken for the pregnant woman not to overstretch since the hormone relaxin is produced that expands the uterus and softens connective tissue. Also, while performing yoga one needs to listen to her body and gently back off of a pose and never force to the extremes in range of motion. Rhythmic breathing is essential for full benefit as well. One of the problems that pregnant woman suffer with during pregnancy is low back pain and here are a few exercises that can help: Seated side bending Seated forward bend Seated rotation of upper torso Cat-Cow Downward Dog Plank Seated right knee upon left knee and grasp feet to massage (then switch top and bottom knee) Remember to relax, breathe and enjoy your miraculous body!!!             PRODUCTS TO HELP PREGNANT WOMEN: Physical therapist Dr. Christian Campilii at the Center for Physical Therapy notes “Oh, when my patients’ backs go out, I start with lying them down on a floor in the 90/90 position with a WEDGIE cushion. Patent No.: USD824,695S    These sufferers gleam with excitement and can attest that this is the only pain free position “when their back goes out”. The WEDGIE is a spinal cushion whose unique shape and exact dimensions is primarily used to raise one’s legs to take the pressure off the lumbar spine.  This product is durable and transportable so that one can travel and then maintain the position.  It can be inflated and deflated to adjust to a person’s height.  The WEDGIE is used in physical therapy settings, hospitals and in homes. The belly serves as a fulcrum to load the spine in non-pregnant patients. With pregnancy the fulcrum enlarges with the growth of a baby. Belly bands, adjustable maternity comfort straps, and maternity belts help to diminish the forces on the lumbar spine. Pillows have been built to increase hip abduction when lying in bed, along with lumbar support memory foam pillows, C-shaped pregnancy pillows and lumbar supports in the sitting position. INTELLIGENT THINKING: Body support cushions, prone pregnancy cushions, for allowing a pregnant woman to lay on her abdomen,comfort pillows,  mattresses for pregnant women,  special adaptive clothes, maternity coats, and  pregnancy supporting lounge chairs are among some of the already patented solutions available. About Dr. Kenneth K. Hansraj: On the forefront of spinal surgery American surgeon Dr. Kenneth K. Hansraj (www.realspinesurgery.com) is a spinal and orthopedic surgeon specializing in cervical, thoracic and lumbar procedures for example laminectomies and spinal fusions. Dr. Hansraj believes in tailoring the operation to the patient using the latest spine technologies. Dr. Ken is the author of the internationally bestselling book,Keys to an Amazing Life: Secrets of the Cervical Spine, (January, 2013), which he was inspired to write based on this concept. Dr. Hansraj is also the author of Bloodless Spine Surgery: Pictures and Explanations. His goal with each of his books is to bring years of accumulated expert medical knowledge to the public at-large in an easy-to digest format and to help countless individuals with ongoing spinal and health issues. Dr. Ken Hansraj is TV and media trained and has extensive experience with national outlets such as CNN, HLN, CBS, FOX, NBC, ABC, NPR and has been featured globally. Cision® estimates his current media impressions at 9 Billion.