Soothing winter aches and pains the pregnancy-safe way

Growing a baby inside you comes with great excitement but also some discomfort, as it causes your organs to shift to accommodate it, changes your centre of gravity, and puts pressure on your skeleton, muscles and joints.

Back pain is the most widely reported body ache – a 2023 review of 28 studies found low back pain affects 40.5% of women. This tends to peak in the third trimester. Abdominal and pelvic pain is most common in the second trimester, with cramps and sharp pains in the belly and groin known as ‘round ligament pain’. Some women also develop soft tissue pain as their circulatory system comes under stress and they retain fluid, and nerve pain such as sciatica, as nerves are compressed by the pressure of the uterus and by weight gain. 

In all, a quarter of pregnant women experience at least temporarily disabling symptoms during pregnancy, according to a 2018 study.

Cold winter weather can exacerbate these aches and pains, stiffening joints and muscles. It also increases your risk of colds and flu, which can cause further aches, pains and fatigue. At the same time, you may have lowered resistance, because pregnancy affects your immune system as it adjusts to supporting another life (source).

Treating any ailment becomes more complicated when you are pregnant, as whatever you take or do can affect not just you, but your baby. 

Prioritise safety

“Don’t take over-the-counter medication without first checking with your healthcare provide – some may not be suitable during pregnancy,” says Durban specialist gynaecologist and obstetrician Dr Sunkaran Pillay.

It’s best to avoid all medication for the first 12 weeks, a critical period for the development of your baby’s vital organs. After that, some medications are considered safe, including paracetamol for aches and pains. Medications to avoid while pregnant (unless recommended by your healthcare provider) as they raise the risk of problems, are codeine and nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen.

“Always consult with your doctor or pharmacist before taking any medication when pregnant,” says Clicks pharmacist Waheed Abdurahman. 

For flu: If you get flu, tell your healthcare provider. You will generally be advised to rest and have plenty of fluids to keep hydrated. 

To avoid it: Flu vaccine is safe at any stage of pregnancy and is recommended by the World Health Organization. The vaccine is not 100% effective but significantly reduce your risk of severe illness and complications. 

For backache: Massage may ease muscle tension, improve relaxation, and reduce pain. Choose a qualified professional, preferably a physiotherapist trained in women’s health or pelvic health. Massage is generally considered safe after the first trimester, but if you are at risk for preterm labour, preeclampsia, gestational diabetes or other complications, your healthcare provider may advise against it. “Ease discomfort by being aware of your posture and ensure you are well supported when sitting and sleeping,” says Lulu Becker, a Durban-based physiotherapist with a special interest in pelvic health. Try a maternity support pillow, and use a mattress that supports you properly – if necessary, put a piece of hardboard under a soft mattress to make it firmer. 

To avoid it: Aim to maintain a healthy weight with a balanced diet and keep fit. It’s recommended that pregnant women aim for at least 150 minutes a week of moderate intensity physical activity (anything that gets your heart beating faster), and two sessions a week of muscle-strengthening training, says Becker. “Walking, yoga, dance, Pilates, swimming and aqua aerobics are all popular with pregnant women I treat. It’s generally safe to continue with the exercise you were doing pre pregnancy (with consent from your doctor), but avoid contact sports and anything where you could fall or get hit in your belly. Also avoid exercises where you lie flat on your back after the first trimester, as this can affect blood flow, and anything that makes your tummy muscles ‘cone’ down the midline, is painful, or makes you leak urine or experience pressure in your pelvis.” As your belly grows, your tummy muscles widen and separate down the midline, and you need to avoid exacerbating this, she says. “Avoid sit-up type movements, but you can still work on core stability strengthening by doing exercises on all fours, doing other exercises on a Pilates ball, and in the full body movements done in pregnancy Pilates and yoga classes.”

For sore muscles and joints: Prenatal massage by a physiotherapist or pregnancy-trained massage therapist may help improve circulation and relieve muscle aches, Becker says. Apply a warm compress to soothe pain and relax muscles, or a cold pack to reduce inflammation and numb painful areas. It’s also generally considered safe to have a warm Epsom salt bath (two cups in a bathtub) when pregnant but take care not to ingest any Epsom salt or let your body overheat. 

To avoid it: Stay fit with safe exercise and gentle stretches.

For pregnancy-related pelvic girdle pain: This results from your growing belly affecting the biomechanics of your lower back and pelvis, causing stiffness in your pelvic joints, or by the joints moving unevenly, says Becker. A physiotherapist can assess your posture, balance, and muscle strength, and provide manual therapy, activity modification advice, and home exercise programmes. “Dry needling and taping may help too,” she says. Round ligament pain may also be helped by wearing a maternity belt or girdle for support. Constipation, common in pregnancy, can worsen pelvic pain, Becker adds. “Be mindful of your water and fibre intake, and use a foot rest so your knees are higher than your hips. Ask your doctor about taking a stool softener.”

To avoid it: “Watch your posture,” she says. “Sit in a chair with firm back support rather than a soft low lounge chair, stand with your weight evenly distributed between both feet, and your ribcage stacked over your pelvis, and take small steps to reduce pelvic forces. Wear comfortable flat shoes.”

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