The most prevalent problem in women after giving birth to a child is backache. The aim of this article is to decide the occurrence of back pain 1-2 months postpartum and to indicate the aspects including epidural anesthesia for pregnancy and delivery that may incline to it. This study was planned to approach the widespread postpartum back ache with and without epidural analgesia among pregnant women. In the recent era, families are not known about different delivery methods and their merits and de-merits and there was no way to discuss them on the subject.

1. MOTHERS OFTEN GET BACK
PAIN/BACKACHE AFTER
GIVING BIRTH TO A CHILD

2. Introduction
 The most prevalent problem in women after giving birth to a
child is backache. The aim of this article is to decide the
occurrence of back pain 1-2 months postpartum and to indicate
the aspects including epidural anesthesia for pregnancy and
delivery that may incline to it. This study was planned to
approach the widespread postpartum back ache with and
without epidural analgesia among pregnant women. In the
recent era, families are not known about different delivery
methods and their merits and de-merits and there was no way to
discuss them on the subject.

3. Objective
 The aim of this article is to measure the commonness of back
pain and its effect on quality of life after normal vaginal
delivery and cesarean reaction. This article reviews the
gestational back pain during pregnancy and of new onset
postpartum back pain.
 By searching different databases PubMed database, Medline,
Medline In-process and Embase and low back pain , pelvic
girdle pain investigating the treatment. Low back pain could
sense as either a pelvic girdle pain between the posterior iliac
crest and the gluteal fold or as lumbar pain over and around
the lumbar spine. The point of pain should be examined and
recognized early. The proper treatment purposes to decrease
the uneasiness and the effect on the pregnant women’s quality
of life. This article disclose the most common risk factors with
treatment methods which can help to lighten the pain.

4. Conclusion
 Low back pain is one of the most common musculoskeletal
complaints of pregnant women. Low back pain during
pregnancy may be the result of mechanic, hormonal and other
factors associated with changes of the body. Literature clearly
indicates that low back pain may be disabiling, limiting every
day activities, impacting productivity and should not be
ignored and left untreated.
 Treatment option include exercising, physiotherapy,
stabilization belts nerve, stimulation, pharmacological
treatment , massage, relaxation and yoga depending on the
case.
 Given the high incidence of low back pain during
pregnancy, larger studies are needed, in order to test
prevention and treatment options in broader populations and
contribute to improving woman’s health.

5. Prevalence
 80% of women suffering from Low Back Pain claim that it
affects their daily routine and 10 % of them report that they are
unable to work rates range from 25 % - 90%, will most studies
estimating that 50% of pregnant women will suffer estimating
that 50% of pregnant women will suffer from LBP. 1/3 of them
will suffer from severe pain, which will reduce their quality of
life. The majority of womens are affected in their first pregnancy.

6. Reasons
 This topic has been discussed in various populations. However, the
subject remains controversial and the etiology is poorly understood.
 One of the most frequent mechanism suggested, is associated with
the mechanical factors, due to weight gaining during pregnancy, to
the increase of the abdominal sagittal diameter of the consequent
shifting of the body gravity center anteriorly, increasing the stress
on lower back.
 Studies suggest that on interior shift is associated with public
syphilis problems.
 A negative active straight leg raise test (ASLR) is a positive PPPT
may be interpreted has an increased activity of the pelvic floor
muscles in order to compensate for the impaired pelvic stability.
 According to some initial pilot data, weakness of gluteal medius in
strongly related to the presence of Low Back Pain during pregnancy.

7.  Another theory suggests that LBP during pregnancy, which
worsens at night, may be the consequence of the expanding
uterus putting pressure on the vana cava causing venous
condestion in the pelvis is the lumbar spine.
 Sciatica is a rater rare clinical entity of LBP during pregnancy,
appering in only 1% women.
 Sciatica may be the result of herniation or dulging of an
intervertebral disc, causing nerve compression.
 Rare causes of sciatica should also be deemed when there is no
evidence of disc disease.
 In a small group of women the persistent pain dureing
posipartum period may be secondry to osteitis condensars .

8. Diagnostics
 The diagnosis of LBP during pregnancy is the differentiation
between Lp and PGP is usually based on symtomps due to the few
existing diagnostic tests. The subjectivity of the pain is the disability
caused by back pain makes the evaluation more difficulty.
 Due to some present diagnostic lests the diagnosis of LBP, LP and
PGP during pregnancy can be differensiate depending upon thir
symptoms. Evaluation become more difficult due to the pain
subjectivity and backpain ailment Sabino Jelall LP and PGP can
distinquish by phusical analysis because these entities exist
difference in the site of pain and arusing test.yoults. Pstqaard et al.
 Proposed a PPPT performed with patient lying in the horizontally
with the face and toso facing up as opposed to the prone partiion
and hip at right angle of flexion. Pelvis is and peg at opposite of
antherier ilian spine (ASIS) qluteal ache opposite to the
contraiateral arouse the positive value of PPPT is 0.091.

9.  Ostqaard HC et al. PPPT is positive for PGP. PGP can also be eiat
by Patrick-Febere test. Many other test are used to differensiate
LP from PGP. A clinical test ASLR perfomed in the supine
position patient extend their knee while raising one leg proves
that the parson suffering from LBC show lwss. Force as
comparison to healthy one while using more activity.
 De grout M. Van de Pol et al. developed PMI to estimate the
potential of doing normal routine work. PMI applied on pregnant
women it is varifed self report three scale questionarie to estimate
quality of life and petency in relation to LBP/PGP Van de Pol G et
al. Quebec back pain scale is oftenly used to measured the
diability coused be LBP or PGP. Expending of pelvic ring
normally occure during pregnancy Lead beater RE et al.
 Unfortunately during pregnancy some times pelvic instability is
caused when forcibly explsion it used. Petnotomy or
synchandrotomy is the last treatment for the labour dystocia and
shoulder clystocia. Baxely F.G. et als to avoid major comlications
during and after symphisitany few priticipate litce vertical incirin
through crtilage must be insured, Chaldis B et al.

10. Reference
 Bastiaanssea JM, de Bie RA, Bastiaenen CH, Essed GG, van den
Brandt PA. A historical perspective on pregnancy related low
back is for pelvic girdle pain. Eur J. obstet Gyneclol Teprod Biol.
2005; 120: 3-14 {Pub Med} {Google scholar}.