Dear Doctor,

I gave birth seven months ago and I had no problem until recently when I started experiencing back pain. I didn’t it take serious at first, but for the past two weeks, the pain has been intense. I have taken painkillers and even gone for massage sessions but nothing seems to work. I was told it could last forever. Is this possible? I need help.

Patricia, 29

Dear Patricia

Backache can occur immediately after delivery due to multiple causes. Increase in abdominal girth due to pregnancy alters the posture of a woman and puts strain on her back.

Increased weight means more stress on joints and back, thus resulting in backache and joint pain. Requirement of calcium increases during pregnancy and subsequent breast feeding.

Failure to meet this requirement results in the softening of bones and occurrence of back pain.

Back muscles are put to strain during normal labour and there can be subsequent pain. If one receives spinal anesthesia during delivery, it can injure some nerve causing chronic backache later on. Backache can also occur due to urinary tract and pelvic infections, both during pregnancy and later after delivery.

Stooping forwards while nursing a baby strains the back muscles. One may have pain due to one or more of these causes either during pregnancy or after delivering the baby. Usually the pain subsides a few months after, but it may persist if the underlying cause persists. Sometimes as in your case, there may not be any pain immediately after delivery, as everything may be okay.

But subsequently, either due to bad posture, calcium deficiency, pelvic or urinary tract infections, other heavy work done, intervertebral disc protrusion, etcetera, one or more of these causes can cause backache. Physical and or mental stress also contributes to backache.

All these conditions are manageable and there is no fear of having a lifelong problem.

The diet should be nutritious and rich in calcium. Green leafy vegetables, milk and milk products, beans, among others, are good natural sources of calcium. They also provide vitamin D3, magnesium and potassium, elements that can help in assimilation of calcium in the body.

Relaxation is also useful.

One should avoid bending the back while feeding a baby or doing any domestic chore. It is better to sit straight on the knees, instead of bending if anything has to be done on the floor.

For sitting it is advised to have a hard cushion to support the back. Hard straight back chairs are good in this regard as compared to the sofa chairs where the back is slumped.

Use of a hard bed is better for sleeping than the soft, thick mattress where alignment of back is disturbed causing backache.

Infections, if present, are easily diagnosed by microscopic examination of mid-morning sample of urine or vaginal discharge and are curable by suitable antibiotics. Pain killers help to relieve pain. Subsequent physiotherapy and back strengthening exercises are useful to prevent pain in the long run.

If the pain is sudden, severe and disabling or has associated abnormal sensations like tingling and numbness in the hips or legs, it is better to consult an orthopedic surgeon.

Dr. Rachna is a specialist in internal medicine at Ruhengeri Hospital.