What can you do about low back pain during pregnancy.

Exercise

You may feel more like curling up in bed than exercising if your back hurts, but don't take to your bed for long periods. Bed rest is generally not helpful in the long run for low back pain and may even make you feel worse. In fact, exercise may be just what you need.

Check with your caregiver before beginning an exercise program.

• Strengthening exercises to help build the muscles that support your back and legs, including your abdominal muscles.
• Stretching exercises to help the muscles that support the back and legs become more flexible. Be careful to stretch gently, because stretching too quickly or too much can put further strain on your joints, which have been made looser by pregnancy. Prenatal yoga is one good way to stay limber, and it can help improve your balance, too.
• Swimming is a great exercise option for pregnant women because it strengthens your abdominal and lower back muscles, and the buoyancy of the water takes the strain off your joints and ligaments. Consider signing up for a prenatal water exercise class, if one is available in your community. These can be very relaxing, and there's research suggesting that water exercise may decrease the intensity of back pain during pregnancy.
• Walking is another option to consider. It's low impact and easy to make part of your daily routine.
• For lumbar pain, try doing pelvic tilts, which can ease back pain by stretching your muscles and, over time, strengthening them as well. Here's how: Get on your hands and knees, arms shoulder-width apart and knees hip-width apart. Keep your arms straight, but don't lock the elbows. Tuck your buttocks under and round your back as you breathe in. Relax your back into a neutral position as you breathe out. Repeat at your own pace.
• Pregnancy may require you to change some of your usual exercise routines. (If you're new to exercise, check out our exercise suggestions for beginners.) In fact, there are some specific guidelines for exercising safely during pregnancy – such as not lying flat on your back and not getting up too quickly – that you'll want to keep in mind.
• Whether you're an athlete or a newcomer to exercise, listen to your body and don't do anything that hurts. Finally, watch for warning signs that you may be overdoing things or developing a problem that needs medical attention.
• Be aware of positioning and proper body mechanics.
• Stand up straight. This gets harder to do as your body changes, but try to keep your bottom tucked in and your shoulders back. Pregnant women tend to slump their shoulders and arch their back as their belly grows, which puts more strain on the spine.
• If you sit all day, be sure to sit up straight. Supporting your feet with a footstool can help prevent lumbar pain, as can using a small pillow called a lumbar roll behind your lower back. Take frequent breaks from sitting. Get up and walk around at least every hour or so.
• It's equally important to avoid standing for too long. If you need to stand all day, try to take a midday break and rest lying on your side while supporting your upper leg and abdomen with pillows.
• Be aware of movements that make the pain worse. If you have posterior pelvic pain, try to limit activities like stair climbing, for example. And avoid any exercise that requires extreme movements of your hips or spine.
• Wear comfortable shoes and avoid high heels. As your belly grows and your balance shifts, high heels will throw your posture even more out of whack and increase your chances of stumbling and falling.
• Always bend from your knees and lift things from a crouching position to minimize the stress on your back. This isn't the time to risk throwing your back out, so let someone else lift heavy things and reach for high objects. Avoid twisting movements, too. Pass up activities like vacuuming and mopping that require you to bend and twist at the same time. If there's no one else to do these chores, move your whole body rather than twisting or reaching to get to out-of-the-way spots.
• Divide up the weight of items you have to carry. Carrying a shopping bag in each hand with half the weight in each is much better than the uneven stress of carrying one heavier bag.
• Take care when getting out of bed: Bend your legs at your knees and hips when you roll to the side, and use your arms to push yourself up as you dangle your lower legs over the side of the bed.
• To get a good night's rest, try sleeping on your side with one or both knees bent and a pillow between your legs. As your pregnancy advances, use another pillow or wedge to support your abdomen.
• Treat yourself to a massage. Prenatal massage by a trained therapist may provide some relief. If your insurance plan doesn't cover therapeutic massage and paying for one will strain your finances, you may want to enlist your partner or a friend to give you a gentle back rub – it may not address the underlying problem, but it might help you relax. (Most insurance companies don't cover massage, though a referral from your caregiver might do the trick. It's worth looking into.)

What kinds of low back pain are common in pregnancy?

Experts describe two common patterns of low back pain in pregnancy: Lumbar pain occurs in the area of the lumbar vertebrae in your lower back, and posterior pelvic pain is felt in the back of your pelvis. Some women have symptoms of both types of low back pain.

Lumbar pain is like the low back pain you may have experienced before you were pregnant. You feel it over and around your spine approximately at the level of your waist. You might also have pain that radiates to your legs. Sitting or standing for long periods of time and lifting usually make it worse, and it tends to be more intense at the end of the day.

Even more pregnant women have posterior pelvic pain, which is felt lower on your body than lumbar pain. You may feel it deep inside the buttocks, on one or both sides or the back of your thighs. It may be triggered by activities such as walking, climbing stairs, getting in and out of a tub or a low chair, rolling over in bed, or twisting and lifting.

Positions in which you're bent at the waist – such as sitting in a chair and leaning forward while working at a desk – may make posterior pelvic pain worse. Women with posterior pelvic pain are also more likely to have pain over their pubic bone.

Medical Massage is good medicine, not merely relaxation

If doctors knew the true causes of health and healing, they'd be prescribing massage therapy to most of their patients rather than prescription drugs. Massage therapy is good medicine, and it's a far more potent healing therapy than most people realize. In fact, I believe that every person, healthy or otherwise, should receive a massage therapy treatment at least once a month.

Why is massage therapy such good medicine?

Because it helps move lymph, blood and oxygen to the various organs and tissues in ways that normally don't happen in the bodies of most people. This is especially true for those who don't exercise: for them, massage therapy is critical for maintaining any degree of health.

There's also the "touch factor" of massage therapy that I believe to be remarkably healing. There's something almost magical about the human touch, and its qualities can't be measured with scientific instruments (yet), but researchers know very well that it has powerful physiological effects: touch calms people. It reduces blood pressure, it boost immune system function, and it makes people feel loved. These are very important for those seeking health and healing. (And if you don't believe me, just volunteer at a nursing home some time and offer free hand massages to the patients. I've done this, and you'd be amazed to see the different it makes in the people you're touching.)

The human touch is powerful medicine, which is why I find it so bizarre that doctors seem so afraid of touching their patients. But you don't need a doctor for this kind of healing: find yourself a good massage therapist and get some healing on a monthly basis.

New Monroe pain clinic can help you live a comfortable life

You may have lived with chronic pain such as migraine headache, back pain or fibromyalgia for years.
By mid-summer, you could be feeling a lot better.

At Integrative Pain Management, Monroe's new pain clinic, Dr. Jacob Khesin brings decades of study and experience and a history of success to the treatment of pain.
Many people suffering from pain now are going through a challenging time because of stricter regulations on prescribed pain medications.

"What I do is a good alternative and compliment to traditional health care," said Khesin last week in the newly-remodeled clinic in the former Planned Parenthood office on Woods Creek Road near U.S. Highway 2. "It's strictly medical."

Integrative Pain Management is located at
15228 Woods Creek Rd. SE, Monroe, WA 98272
for more information, call 360-545-3061 or visit
www.IntegrPM.com.

Jacob Khesin, who has studied in China and Russia as well as in the United States, uses a variety of physical techniques to treat pain both acute and chronic.

Among the many conditions with which he has success is pain related to bulging or herniated disks, migraine, pain related to multiple sclerosis, carpal tunnel syndrome, arthritis, pain from old injuries and post-operative pain.

Khesin treats many pain conditions with pain management massage. Such massage, he explained, is nothing like the kind of relaxation massage that many places offer.

Much pain, especially neurological pain, is caused by pressure and inflammation of nerves. Medical massage is a useful approach to address that pressure or inflammation.

"What I do is far from a regular massage," he said."It’s specific manual therapy."

Medical massage restores the function of the soft tissues of the body, he said. But often, the cause of the pain isn't found in the soft tissue.

"This work is often not related to muscles," said Khesin. "Most of the trouble is related to connecting tissue, ligaments and tendons."

It's those areas that Khesin may target.

"I do specific work to relieve pressure on specific body parts," he said.

Medical massage has also been found to be useful in the treatment of migraine and headaches said Khesin, who is a member of the Washington Academy of Pain Management and who works at Northwest Hospital in Seattle with a team of other doctors including neurosurgeons, neurologists, pain doctors, sports and rehab specialists.

Between 80 and 85 percent of people who come for migraine treatment experience relief with medical massage, said Khesin. The same holds true for most of the other conditions he treats.

Sometimes the response is nearly miraculous.

One recent patient had disk-replacement surgery several years ago. The recovery for that surgery, said Khesin is "absolutely horrible." For years, the patient took a lot of pain medication. Unable to move much, he gained weight and more health problems.

After several months of working with Khesin, his condition improved enormously, allowing him to cut back significantly on pain medication.

"His mind is clear, he feels much better, and he lost 20 pounds," said Oksana, Dr. Khesin's partner, an architect who redesigned the clinic for its current use.

For another patient pain management massage delayed rotator-cuff surgery for two years.

Typically, it takes several treatments to experience optimal results. Most people respond quite well with two treatments a week for about a month.

Integrative Pain Management has an array of comfortable, attractive treatment rooms, and soon practitioners will join the practice to offer acupuncture, chiropractic and naturopathic care as well.

Khesin, who also has offices in Bellevue and Seattle, has had his own practice since 1997, and is also skilled in many other modalities, including Chinese manual orthopedics, applied kinesiology, cranio-sacral therapy, low intensity laser therapy, myofascial release, deep tissue, reflexology, and manual lymph drainage.

With his extensive education and years of experience, as well as his compassion and intuition, Dr. Khesin is confidant that he can offer help to the people of the Sky Valley who suffer from pain.

"What I do really works," he said, “Maybe it’s time to rethink your pain management strategy.”

Integrative Pain Management is located at
15228 Woods Creek Rd. SE, Monroe, WA 98272 for more information,
call 360-545-3061 or visit www.IntegrPM.com.

Massage Therapy Research

The therapeutic benefits of massage continue to be researched and studied. Recent research has shown the effectiveness of massage for the following conditions:

• Cancer-related fatigue.
• Low back pain.
• Osteoarthritis of the knee.
• Reducing post-operative pain.
  
• Boosting the body’s immune system functioning.
• Decreasing the symptoms of carpal tunnel syndrome.
• Lowering blood pressure.
• Reducing headache frequency.
• Easing alcohol withdrawal symptoms.
• Decreasing pain in cancer patients.

From American Massage Therapy Association

Can You Rub Out High Blood Pressure?

Finally. An indulgence that may actually be good for you. What is it, you ask? A long, deep massage.

When people with sore muscles received a deep-tissue massage, both their systolic and diastolic blood pressure (BP) numbers dropped several points. Nice.

More Points for Pressure
There's still more research needed in order to figure out if regular massage could reduce high blood pressure long-term. But in this study, people averaged a short-term drop from about 125/76 down to 115/70 -- after just 45 to 60 minutes of deep-tissue work from a licensed bodyworker. Not too shabby. The massage sessions also induced a relaxing 10-point drop in heart rate. Ahhh.

Massage can relief symptoms of Carpal Tunnel

Carpal tunnel syndrome is a disease of the hand characterized by numbness, tingling, pain, and weakness. The disease typically affects the thumb, index, and middle fingers and is often particularly troublesome at night. A major nerve, specifically the median nerve, travels down the arm and enters the hand through the carpal tunnel, which is located in the central part of the wrist. In people with carpal tunnel syndrome, pressure in the carpal tunnel is higher than in unaffected people, and median nerve irritation occurs.

Many conditions can cause increased pressure within the carpal tunnel and lead to carpal tunnel syndrome. Carpal tunnel syndrome was first described with broken wrists. A broken wrist can cause bleeding and swelling within the carpal tunnel leading to increased pressure within the carpal tunnel. Most people with carpal tunnel syndrome have no identifiable cause. It affects almost 5% of the population and is most common in middle-aged women. Carpal tunnel syndrome is diagnosed based on the complaints of the individual combined with physical tests and often electrical studies. No single test is definitive for diagnosis of carpal tunnel syndrome. Instead, the person's complaints and test findings together lead to its diagnosis.