Congratulations on your pregnancy! While carrying a baby is both exciting and wonderful, it also doesn’t come without at least the occasional worry or stress. With all the emotional and physical changes happening, it’s no wonder why you might feel back pain during pregnancy.
Back pain, often lower back pain, is one of the most common discomforts pregnant women face. In fact, it’s estimated that 50 to 70 percent of soon-to-be moms have some level of back pain during pregnancy. So if you’re expecting and find yourself clutching your lower back from time to time, you’re far from alone.
The good news is, this type of pain is normal in the majority of cases. What’s more, the pain can usually be alleviated by adopting some simple strategies. Before we get into what you can do for relief, let’s review the causes and types of back pain in pregnancy.
Why You Get Back Pain When You’re Pregnant
The main reason pregnant mothers feel achy is because their bodies are producing more of a hormone called relaxin. Relaxin helps keep ligaments in your body loose, so the baby is able to more easily pass through your pelvis. The surge of relaxin starts shortly after conception, peaks in the second trimester (when most moms begin to suffer from back pain) and remains steady until a few days after delivery. Other reasons that make pregnant women more prone to back pain include:
Women will normally gain between 25 and 35 pounds during a healthy pregnancy. This means the spine has to support that additional weight. A growing baby and uterus also place added pressure on blood vessels and nerves in the pelvis and back.
Shifts in posture
Your center of gravity shifts due to pregnancy. As a result, you may adjust your posture and movement, which can lead to back pain.
When the uterus expands, the rectal abdominis muscles (two parallel sheets of muscles that run from the rib cage to the pubic bone) may separate along the center seam. This separation can aggravate back pain.
Yes, even emotional strain can create muscle tension in your back. This may be felt as back pain or spasms.
The Lowdown on Low Back Pain and Pregnancy
Studies have shown that lower back pain usually happens between the fifth and seventh month of pregnancy. Sometimes, this pain can begin as early as eight to 12 weeks. Women who had low back pain before pregnancy (or had low back pain in a previous pregnancy) are at higher risk for this type of pain. Their back pain can also happen earlier during pregnancy.
There are two main types of back pain in pregnancy: lumbar or lower back pain and posterior pelvic pain.
Lower back (lumbar) pain
This type of pain is usually felt at and above the waist in the center of the back. It may or may not include pain that radiates into the legs or feet. Pain that spreads into the legs or feet is known as sciatica pain. If you have sciatica, your leg pain will generally be more severe than your back pain. You’ll probably feel it below the knee and it may also radiate to your foot and toes. True sciatica (which can be the result of a herniated disc in the lower part of the spine) affects only about 1 percent of moms-to-be. Lumbar pain in pregnancy is similar to lower back pain experienced by women who aren’t pregnant. The pain often increases with prolonged standing, sitting or repetitive lifting.
Pain in the back of the pelvis (posterior pelvic pain) is four times more common than lumbar pain during pregnancy. It is a deep pain felt below and to the side of the waistline and/or below the waistline on either side across the tailbone. Pelvic pain like this can run down into the buttocks and upper portion of the back of the thighs. This type of pain does not resolve quickly with rest and may cause morning stiffness. The pain can be made worse or triggered by rolling in bed, climbing stairs, sitting and then getting up from a seated position, lifting, twisting and bending forward, and running and walking.
How to Ease Your Back Pain During Pregnancy
Now that we’ve identified the causes and types of back pain during pregnancy, we’ll give you a little advice on what you can do to relieve that nagging ache. Treatment for back pain during pregnancy is pretty straightforward, and that’s even better news for you. After all, you deserve to feel your best and should be focusing as much of your energy as possible on bringing a healthy new life into the world.
Here are 10 simple strategies for easing your pain and preventing future occurrences:
Choose the right footwear
When it comes to shoes, skip the stilettos and wear low-heeled (not flat) shoes with good arch support.
Treat yourself to a massage
Prenatal massage by a trained therapist is great for boosting circulation and easing muscle pain, so go ahead, pamper yourself.
Practice the principles of good posture
This means: stand up straight and tall, hold your chest high, keep your shoulders back and relaxed, and don’t lock your knees. Use a wide stance for the best support when you stand, and if you have to remain upright for long periods of time, rest one foot on a low stepstool. Take breaks whenever possible.
Support your back
Practicing good posture also means paying attention to how you sit. Pick a chair that supports your back. You can also place a small pillow behind your lower back, and prop your feet on a low stool.
Wear a support belt
Although there hasn’t been much research confirming the effectiveness of maternity support belts, some women do find the additional reinforcement beneficial.
Try hot and cold
If your healthcare provider okays it, place a cold compress (e.g., bag of ice or frozen veggies wrapped in a towel) on the affected area for up to 20 minutes several times each day. After two or three days, put a heating pad or hot water bottle on the painful area. Do not apply heat to your abdomen during pregnancy.
Consider complementary treatments
Studies have shown that acupuncture can be helpful in relieving low back pain in pregnancy. When performed correctly, chiropractic manipulation of the spine can also be safe during pregnancy, but if you’re considering either of these complementary approaches, check with your doctor first.
Lift with care
If you have to lift a small object, squat down and lift with your legs instead of bending at the waist or lifting with your back. Know your limits when lifting and do not hesitate to ask for help if you need it.
It’s best for pregnant women to sleep on their sides versus their backs. Keep one or both of your knees bent. Place a pregnancy or a support pillow between your bent knees, as well as beneath your abdomen and behind your back.
While you might feel like just curling up on the couch, exercising could be a better choice. Bed rest is usually not helpful in the long run for low back pain. Below are some exercises you may want to consider. (Note: Always check with your healthcare provider before beginning any new exercise regimen. For safety reasons, pregnancy may require you to change up your previous exercise routine.)
To help the muscles that support the back and legs become more flexible, perform stretching exercises. Stretch gently, as stretching too quickly or too much can put too much strain on your joints. Join a prenatal yoga class, as these classes are ideal for staying limber, as well as enhancing balance.
Swimming is the perfect exercise for pregnant women because it strengthens the abdominal and lower back muscles. The buoyancy of the water takes the strain off your joints and ligaments, too. Find a prenatal water exercise class in your community and sign up if you can.
Walking is another good option to try. It’s low impact, easy to work into your daily schedule, and best of all, it doesn’t have to cost you a penny.
For lower back pain, try pelvic tilts, which can help ease pain and strengthen muscles at the same time. To do a pelvic tilt, rest on your hands and knees with your head in line with your back. Do not lock your elbows, but keep your arms straight. Pull in your stomach, rounding your back slightly. Hold for several seconds, then relax your stomach and back, keeping your back as flat as you can. Gradually work yourself up to 10 repetitions. Sometimes, kneeling on hands and knees can be uncomfortable for pregnant women. If this is the case for you, you may want to try standing. Stand straight with your back to the wall (relax your spine). As you breathe in deeply, press the small of your back against the wall. Exhale and repeat.
When to See a Doctor
When you go into labor, it will not feel the same as back pain. Labor pain is similar to strong menstrual cramping. The pain is constant, grows in intensity and frequency over a short time period, and is not brought on by activity (like back pain).
Call your doctor if you are concerned about your back pain or have the following symptoms:
- Back pain is severe, constant or getting progressively worse
- Back pain is caused by trauma, fall or accompanied by a fever
- Loss of feeling in one or both legs
- Sudden weakness or loss of coordination
- Loss of sensation in the buttocks, groin, genital area, bladder or anus
- Difficulty urinating or having a bowl movement, or incontinence
- Low back pain in the late second or third trimester, particularly if you haven’t had back pain before that point (could be a sign of preterm labor)
- If you have a fever, nausea or blood in your urine, and/or pain in your lower back or in your side under your ribs on one or both sides (possible sign of kidney infection)
You should also consult your health care provider to see if there’s anything else you can try if you’re not getting sufficient pain relief from self-care. Be sure to talk to your doctor before taking any pain medications. Tylenol (acetaminophen) is generally safe for most women to take during pregnancy. Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) like Motrin, Advil or Aleve are not advised. In certain circumstances, your doctor may recommend other pain medications or muscle relaxers that are safe for pregnant women.
Your provider may also refer you to see a physical therapist if your pain is debilitating, and you can’t work, perform everyday tasks or walk. Physical therapy may help solve your problem with only a few sessions.