The muscles of the back are surprisingly strong but are meant largely to engage in continuous, low-intensity efforts. Requiring them to move quickly or contract strongly, as they must to lift a very heavy weight, can pull them, leading to painful aching and spasms. Most women don't pull their backs during pregnancy, but for those who do, the experience is quite uncomfortable.
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During pregnancy, a woman's body changes tremendously. She generally gains weight, and her weight distribution changes as more of her body weight accumulates at the front of the body. This stresses the back, leading to backaches, which are very common in pregnant women. In their book "What To Expect When You're Expecting," Heidi Murkoff and Sharon Mazel note that many pregnant women experience back pain with no acute injury whatsoever. A pulled back, conversely, is the result of an injury.
Regardless of the cause of back pain--whether it's the result of an injury or of normal body changes--it can be very uncomfortable. Generally, however, the pain of a pulled back is slightly different than that of pregnancy backache. Dr. Raymond Poliakin, in his book "What You Didn't Think To Ask Your Obstetrician," notes that pregnancy backache generally occurs in the lower back and may radiate down the legs. A pulled back, on the other hand, may hurt more on one side than the other and is generally tender to the touch.
Preventing a pulled back during pregnancy involves using good lifting and back care techniques. Dr. Poliakin recommends that a pregnant woman, like a non-pregnant woman, lift with her legs, not with her back. This means she should squat, grasp the object to be lifted, and then stand, as opposed to bending at the waist to lift. Pregnant women should also be careful not to lift objects so heavy that they have to strain or hold their breath to lift, since this can be dangerous.
A non-pregnant woman with a pulled back might take a few Advil, have a glass of wine or soak in a hot bath to alleviate the pain. None of these three options are available to a pregnant woman, however. In their book "You: Having A Baby," Drs. Michael Roizen and Mehmet Oz explain that many over-the-counter drugs should be avoided during pregnancy, alcohol isn't considered safe in any amount, and hot baths can raise a woman's internal temperature too much for safety.
The best way to diagnose and treat a pulled back during pregnancy, explain Drs. Roizen and Oz, is to see a physician. The physician can help a woman determine whether her pain is truly the result of a pulled back or is instead a routine pregnancy symptom. The physician can also help her identify safe and appropriate non-pharmaceutical treatments, like hot or ice packs, and possibly pharmaceutical treatments as well.