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50% of people who experience back pain in pregnancy receive little or no treatment from their healthcare provider
What is it?
While your body goes through many visible physical changes during pregnancy, you might not realize that your skeleton also undergoes a major transition during those nine months as well.
- A surge in relaxin, a hormone that helps the body prepare for labor by helping ligaments loosen to widen your pelvis, can also cause aches, pains, and changes to your spine. This can cause lower back pain and pelvic pain, which are common issues during pregnancy.
- You may notice that your posture changes as your body adjusts to the weight of your growing baby, which can also cause pain in the lower back.
How common is it?
Very common. It’s estimated that 66% of people experience lower back pain, and 20% experience pelvic joint pain at some point during pregnancy. These issues can occur separately or together, typically increasing in intensity as your pregnancy progresses and the weight on your pelvis increases.
- Research suggests that 50% of people who experience this type of pain in pregnancy receive little or no guidance from their healthcare providers on interventions to manage pain and discomfort.
Pelvic joint pain can continue into the postpartum period, with 20% of people in one study experiencing residual symptoms for up to 18 months after giving birth. Lower back pain can also persist after birth as you carry your baby around. Breastfeeding can also cause lower back pain if the positioning isn’t optimized to support your body alignment during feedings.
What can I do about it?
Early detection to identify where you are having pain can help guide interventions to reduce discomfort and gain muscle strength and flexibility.
Be mindful of how you lift and move
One study found that everyday motions during pregnancy – like standing up from a chair, tossing and turning, lying down, and sitting up – could cause lower back pain.
- If you must lift something, bend at your knees instead of bending at the waist, and keep your back straight. Avoid any sudden movements that jerk your body and could potentially aggravate your back.
- Keep your knees together when stepping out of the car or getting up from a chair to help reduce pelvic strain and discomfort by aligning the pelvis
- Support your lower back when sitting with a lumbar pillow, especially if you spend much time at a desk.
- Be mindful of your posture by sitting upright and avoiding rounding your shoulders to help prevent strain on your spine.
- Back pain tends to worsen the longer you sit or stand, and with repetitive motions or lifting. Take time to adjust your position, add a pillow, prop your feet up, or whatever else you find helpful.
Exercise to decrease pain and improve strength and flexibility
Physical activity effectively reduces discomfort and improves muscle strength and flexibility for some people, but research is limited regarding a one-size-fits-all approach.
- Core stability exercises that are safe for pregnancy have been shown to be particularly effective at decreasing pain and improving physical functioning for the lower back.
- Studies have found that a sedentary lifestyle increases your risk of back pain compared to those who engage in more physical activity. Discuss which physical activities are safe during pregnancy with your healthcare provider.
Modify your sleeping positions
Help maintain alignment in your hips and pelvis by keeping both knees bent, placing a pillow between your knees and another under your belly, or using a full-length body pillow.
Cold or hot compresses
Experiment with trying hot or cold compresses on your back to see if either provides relief.
Pelvic support belts
Support belts wrap around your midsection to provide abdominal, pelvic, and back support, which can take some pressure off your back and stabilize your pelvis.
- Pelvic support belts that are made of flexible materials are more effective at reducing pain than those made of rigid materials.
- Don’t wear support belts or bands for prolonged periods of time. If possible, work with a healthcare provider or physical therapist to be properly fitted and choose the correct size, as well as learn how and when to use it.
Over-the-counter pain medications
As with any medicine, whether over-the-counter or prescription, the risks and benefits should be discussed with your healthcare provider.
- Acetaminophen (Tylenol) is typically the first medication recommended for minor back pain because of its safety profile in pregnancy.
- Ask about non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, which may be safe in the second trimester for short-term use but are not recommended in the first or third trimesters when pain is typically severe.
Physical therapy, chiropractic care, and massage
A chiropractor manipulates the body's joints, particularly the spine, to restore or enhance joint function. Ask your healthcare provider for a referral and find a chiropractor who is experienced in treating pregnant patients.
- One study found that most pregnant patients undergoing chiropractic treatment reported clinically significant improvement.
Acupuncture for pain relief
One study showed that acupuncture significantly reduced pelvic pain experienced in the evening more effectively than exercise. Acupuncture is thought to trigger the body's ability to respond to pain more effectively.
Transcutaneous electrical nerve stimulation (TENS)
A study published in 2012 found that the use of a transcutaneous electrical nerve stimulation machine (TENS), which sends a low-voltage electrical current through the body to relieve pain, is an effective and safe treatment modality for pregnancy-related lower back pain. This method can also be used for pain relief during labor.
When should I be worried?
You should contact your healthcare provider if:
- Your back or pelvic pain interferes with your quality of life
- It’s not helped with simple adjustments
- It’s severe or increasing in intensity
- Prolonged bed rest is not recommended and can worsen pain.
- It’s important to note that the quick onset of back pain could be a sign of preterm labor, and a fever accompanied by back pain can signal other issues that should be addressed immediately with medical attention.
This article has been crafted collaboratively, drawing insights from a team of dedicated writers, editors, and contributors, including The Pregnancy Podcast. Their collective expertise has contributed to the informative and diverse content presented here.
