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How do I get rid of pain in my lower back and thigh?

Q: I am a 28 years old female with two kids aged four and two years respectively. I got married six years back and had my first baby after two years of marriage. After my first delivery, I started having pain in lower back, which still persists. I consulted an orthopaedic surgeon who stressed on reducing weight and intake of non vegetarian foods. Now, I have started having severe pain in my right thigh and I cannot walk straight after getting up from the bed. There is no swelling in my thigh. How do I treat my lower back and thigh pain? I am 5.2 inches tall and weigh 62 kg.

A:Pain in the lower back is quite common before and after delivery. There are several reasons for this but by and large most of these settle within 3 to 6 months of confinement. One of the most common causes is increased curvature of the back (called lordosis) due to the increasing size of the foetus. This leads excessive strain on the ligaments of the back and an ache / tiredness especially after walking. This usually settles soon after delivery. This does not need anything special other than muscle toning exercises for the abdomen and back. Relaxation of ligaments of the pelvis is part of normal pregnancy to accommodate for the increasing size of the foetus and to prepare the pelvis for delivery. This in some patients may be excessive causing a strain on the ligaments (usually the sacroiliac ligaments at the back of pelvis) causing pain again on movement and activity. This also can be of varying intensity and may last longer. Occasionally this may be worse in the first few steps that you take after resting and gradually reduce. It may get worse during the next pregnancy and this may last longer. This also does not need anything special other than exercises. Radiation to the front of thigh is not a feature of this pain. Compression of a nerve that supplies the front and side of the thigh may be seen in some women during pregnancy and may persist. This condition called meralgia parasthetica usually causes a burning / tingling type of pain. Not associated with back pain but the sacroiliac pain and this kind of a pain may co exist. But this pain is not affected by your walking. Some patients may have a pre-existing intervertebral disc problem, which may get aggravated during pregnancy, which persists after delivery. This is usually a radiating pain to either the back of thigh or the leg may or may not be associated with numbness or tingling. Pain is worse on sitting for long but is not typically relieved by walking. The physical signs are usually very clear and the diagnosis is apparent on examination. Some patients who breast-feed their babies without sufficient intake of milk / calcium for themselves end up having calcium deficiency with osteomalacia. This presents by fourth to fifth month of delivery and is associated with aches and pains and a pain in the back, which is usually not low back but somewhere in the middle of the back. Occasionally may be also low back pain. Some patients with severe problem may have pain in the hip but usually not a radiating pain. These pains may be worse on activity. There are several other conditions that can present with backache but this is the most common list. Your pain seems more like a persistent sacroiliac joint pain but I think before I can advise you any treatment you need to be carefully examined in the light of the above. Any way I do not think you need to be particularly worried as these pains have nuisance value but are not truly ominous.

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