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Back Pain During Pregnancy

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There’s no shortage of new body changes, strange symptoms, and temporary discomforts during pregnancy — and back pain is chief among them. Most people experience back pain at some point in their pregnancy, usually in the second and third trimester. But although back pain is common, you don’t have to just deal with it.

What causes back pain in pregnancy? How can you prevent and manage it? Let’s take a closer look.

Why Does My Back Hurt?

There’s a lot going on in your body as your baby grows. Many issues can affect back pain, including:

Hormonal changes. Pregnancy hormones loosen supportive ligaments in your low back and pelvis (the sacroiliac joints) in preparation for labor and delivery. This is normal and healthy, but it can strain the muscles and joints in your back and cause pain.

Shifting center of gravity. As your baby grows, your center of gravity shifts forward to compensate. Resulting changes in your posture can increase the stress on joints, nerves, and muscles in your back.

Weaker abdominal muscles. Your expanding uterus causes abdominal muscles to separate (called diastasis recti). This reduces support for your pelvis and spine and causes back pain.

Stress. The normal stress of pregnancy and daily life can make your back muscles tense, leading to pain and muscle spasms.

Pre-existing back pain. If you had back pain before pregnancy you might be at higher risk of experiencing it during pregnancy. It’s more likely to happen earlier in your pregnancy.

What Can I Do to Manage Back Pain During Pregnancy?

Pregnancy-related back pain is very common, but there are many things you can do to ease your pain:

Get or stay active. Exercise is not only safe, but highly recommended because of its many health benefits for you and your baby (including decreasing back pain). Your Hinge Health exercises are a great starting point. Activities such as walking, swimming and water aerobics, yoga, and using light weights or your body weight for resistance training are also recommended during pregnancy. Ask your doctor for activity suggestions and exercise considerations for each trimester.

Watch how you move and sit. Minor adjustments to your posture can help prevent back pain. When you stand, use a wider two-footed stance or rest one foot on a low stool. Choose chairs that support your back or use a lumbar support pillow. Try to keep objects close to your body when lifting and don’t lift objects that are too heavy for you.

Skip the high heels (and certain flats). Shoes with a low heel and good arch support are better for pregnancy-related back pain than flat shoes with no support (like many flip-flops or ballet slippers) or high heels.

Take breaks. It’s best not to stay in any position too long (pregnant or not). Sitting or standing too long can make your back pain worse. Aim to stretch and change your position once an hour or so to give your body a break.

Aim for a good night’s sleep. When you get quality sleep, you tend to have less pain. And when you have less pain, it helps you sleep. Although many factors can mess with your sleep — especially during pregnancy — try these tips:

  • Make sure your sleeping surface provides good support.

  • Try not to sleep on your back after 20 weeks. This can compress major blood vessels and make back pain worse.

  • Not a natural side sleeper? Place pillows under your belly and between your knees to help you snooze more comfortably.

Try massage, a heating pad, or ice packs to turn down the volume on your pain. Place a towel between your skin and the heating pad or ice pack to protect your skin.

Stressed? Incorporate relaxation techniques like meditation and breathing exercises into your day. A warm bath or shower can calm your mind and muscles, and reduce your pain.

Ask your provider about pain medications. Acetaminophen can be a safe choice for pain relief in pregnancy, but always consult your doctor before taking any medications during pregnancy. It’s best to avoid NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen as some research shows increased risks with these drugs during pregnancy.

Consider alternative therapies like acupuncture and acupressure. These may also help reduce back pain in pregnancy. Some acupuncture and acupressure points might stimulate labor. Be sure your practitioner knows about your pregnancy and avoids these areas.

When Is Back Pain a Red Flag?

Although back pain is common in pregnancy and usually related to musculoskeletal (MSK) issues, it can sometimes be a warning sign of complications, such as preterm labor or a urinary tract infection. Watch for back pain that occurs with vaginal bleeding or a change in vaginal discharge, fever, contractions, or pain that feels new and cyclical. If you have any of these, contact your doctor.

Remember: You don’t have to accept weeks or months of back pain simply because you are pregnant. You can take steps today to ease your pain and get back to thinking about the exciting journey ahead with your new baby.

Many exercises can help relieve pregnancy-related back pain. Reach out to your Hinge Health coach or physical therapist for advice on which are best for you and whether you would benefit from any care plan modifications.

Key Takeaways

  1. Many normal and healthy changes in your body that occur during pregnancy can contribute to back pain.

  2. Back pain during pregnancy is not usually a sign of a serious problem.

  3. Exercise and many other small lifestyle modifications can help ease pregnancy-related back pain and get you back to thinking about your exciting journey ahead.

References

  1. Back pain during pregnancy: 7 tips for relief. (2019). Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy/art-20046080

  2. Back pain in pregnancy. (2020, December 3). Nhs.uk. https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/back-pain/

  3. Davenport, M. H., Marchand, A.-A., Mottola, M. F., Poitras, V. J., Gray, C. E., Jaramillo Garcia, A., Barrowman, N., Sobierajski, F., James, M., Meah, V. L., Skow, R. J., Riske, L., Nuspl, M., Nagpal, T. S., Courbalay, A., Slater, L. G., Adamo, K. B., Davies, G. A., Barakat, R., & Ruchat, S.-M. (2019). Exercise for the prevention and treatment of low back, pelvic girdle and lumbopelvic pain during pregnancy: a systematic review and meta-analysis. British Journal of Sports Medicine, 53(2), 90–98. doi: 10.1136/bjsports-2018-099400

  4. Finan, P. H., Goodin, B. R., & Smith, M. T. (2013). The Association of Sleep and Pain: An Update and a Path Forward. The Journal of Pain, 14(12), 1539–1552. doi: 10.1016/j.jpain.2013.08.007

  5. I’m Pregnant: What Pain Meds Can I Take? (n.d.). WebMD. Retrieved May 13, 2022, from https://www.webmd.com/baby/pain-relievers-that-are-safe-during-pregnancy#2