Back pain is one of the most common discomforts during pregnancy, ranging from mild aches to severe pain that can disrupt daily life. For many women, it’s a normal part of carrying the extra weight and adapting to changes in posture and body alignment. But when should back pain be a cause for concern, and what can you do to ease it?
To answer these questions, we turned to Dr Terry Teo, Orthopaedic Surgeon and Spine Specialist, and Dr Lim Baoying, Sports Physician. They share their expert insights on the causes of pregnancy-related back pain, when to seek medical attention, and practical tips for relief and prevention.
Understanding Back Pain in Pregnancy
During pregnancy, the body undergoes significant changes to accommodate the growing baby. Hormonal shifts, weight gain, and changes in posture can all contribute to discomfort in the spine, pelvis, and surrounding muscles.
One of the most common types of discomfort is lumbago, or lower back pain (LBP). This is characterised by pain in the lumbar region and can range from a dull ache to more severe pain that interferes with daily activities.
Back pain during pregnancy can also vary in timing. Some women may notice symptoms as early as 8–12 weeks, while for others it develops more commonly between the second trimester (from week 13 onwards) and early third trimester (around the 5th to 7th month). The pain may worsen in the evenings, and in some cases, it can even disrupt sleep.
Women with a history of lower back pain before pregnancy are also more likely to experience symptoms earlier and more intensely. Dr. Terry Teo adds, “Women with previous spinal injuries, spinal instability or malaligned spine are more prone to back pain. Pre-existing conditions like degenerative spine disease, ligamentous laxity conditions, and poor core strength may lead to more back pain.”
The effects of LBP can extend beyond discomfort. It may affect daily activities, make it difficult to maintain a comfortable posture, and impact rest and recovery.
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Causes of Back Pain During Pregnancy
During pregnancy, several factors contribute to the occurrence of back pain. Here are some of them:
Hormonal changes
Hormones play a crucial role in pregnancy, and certain hormones produced during this time can lead to back pain.
Hormones like relaxin cause the ligaments in the pelvic area to loosen and the joints to become more flexible in preparation for childbirth. While this is necessary for the birthing process, it can affect the normal support and stability of the back, leading to discomfort or pain.
Shift in the centre of gravity
As pregnancy progresses and the uterus and baby grow, the centre of gravity shifts forward. This change alters posture and places additional stress on the back, often leading to pain or discomfort. “The centre of gravity shifts with the growing fetus, the spine curves more, and the pelvis tilts to balance the increased load. This places more stress on the spine and the sacroiliac joints,” explains Dr. Baoying.
Weight gain
During pregnancy, weight gain is a normal part of the process as your body provides nourishment for both you and the growing baby. The increase in weight puts extra strain on the back as it needs to support the additional load. This added stress can contribute to back pain, particularly in the lower back region.
Poor posture and physical strain
Maintaining proper posture is essential for good spinal alignment and minimising back pain. However, during pregnancy, the growing belly can alter your posture, leading to increased stress on the back. Poor posture, such as slouching or hunching over, can further exacerbate back pain.
Additionally, activities that require prolonged standing or bending over can strain the back muscles and contribute to discomfort.
Stress
Pregnancy can be a stressful time, and stress can manifest in the body as muscle tension or tightness. The pelvic area undergoes significant changes during pregnancy, and stress can increase muscle tension in this region, leading to back pain. Stressful stages of pregnancy may exacerbate existing back pain or contribute to its occurrence.
Constipation
As the body undergoes significant changes to accommodate the growing fetus, hormonal fluctuations can lead to the relaxation of muscles, including those in the gastrointestinal tract. This relaxation can slow down bowel movements, leading to constipation.
When stool remains in the colon for an extended period, it can cause distension and pressure on surrounding structures, including the lower back. This added pressure can contribute to discomfort and back pain.
Additionally, straining during bowel movements due to constipation can also strain the muscles of the lower back and contribute to pain. Therefore, maintaining regular bowel habits and addressing constipation can play a role in minimising back pain for expectant mums.
It’s important to note that every pregnancy is unique, and the severity and frequency of back pain can vary. If you are experiencing persistent or severe back pain during pregnancy, it is advisable to consult with your healthcare provider for an accurate diagnosis and appropriate management strategies.
How to Relieve Back Pain During Pregnancy
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Maintain good posture
Maintaining proper posture can help reduce strain on your back. Stand up straight, keep your shoulders relaxed, and avoid slouching. When sitting, use a chair with good back support and consider using a cushion or pillow for added comfort.
Exercise regularly
“Core stability exercises improve gluteal, lower back, abdominal and pelvic muscular strength, which in turn reduces the ligamentous laxity around the pelvis, supporting better spinal alignment and reducing back pain,” says Dr. Baoying. Consult with your healthcare provider about suitable exercises during pregnancy, such as prenatal yoga or swimming. These activities can help relieve tension in your back and promote overall well-being.
Practice proper body mechanics
Avoid heavy lifting and instead, ask for assistance when needed. When picking up objects from the ground, bend at the knees and lift with your legs, rather than putting strain on your back.
According to Dr. Baoying, “During pregnancy, the shift in the body’s centre of gravity, weakened core muscles, ligament laxity from hormones, and weight gain all contribute to extra strain on the spine.” So, be mindful of your body mechanics when performing daily tasks.
She also said that ‘the best posture is the next position’. Hence, “avoid sitting or standing in one spot for too long, and move frequently. Practice body awareness by visualising lifting the belly slightly in and up to engage the core. Distribute the load evenly, such as using a backpack for groceries instead of carrying bags on one side. An ergonomic desk and chair set-up can also make a difference. Supportive footwear also matters. Choose low heel height, stable medial foot arch support, stable heel counter and good outsole grip.”
Use heat or cold therapy
Applying heat or cold to your back can provide temporary relief from pain. Consider using a warm compress or taking a warm bath to relax tense muscles. Alternatively, you can apply a cold pack or ice wrapped in a cloth to reduce inflammation and numb the area.
Opt for supportive footwear
Wearing supportive footwear, such as shoes with cushioned soles, can help improve your posture and provide better support for your back. Avoid high heels or shoes that lack adequate support, as they can exacerbate back pain.
Utilise pregnancy pillows
Invest in quality pregnancy pillows for additional support. It can help relieve pressure on your back while sleeping and maintain proper spinal alignment. Experiment with different positions and pillow placements to find what works best for you.
Can you get a back massage while pregnant?
Pregnancy massage, also known as rental massage, is designed to provide relief from soreness, back pain, and leg cramps that often accompany pregnancy. It involves techniques that help ease muscle tension, promote relaxation, and improve blood circulation.
However, you need to ensure that the massage therapist is experienced in providing prenatal massages and is aware of the sensitive areas to avoid, such as the breasts and abdomen. If you’re considering prenatal massage, it’s recommended to consult your healthcare provider before starting any new treatment during pregnancy.
Can Belly Bands Help Relieve Back Pain?
Belly bands, also known as maternity belts or pregnancy support belts, are designed to provide support to the lower back and abdomen during pregnancy. These elastic bands wrap around the belly and offer gentle compression, helping to redistribute the weight of the baby and alleviate pressure on the lower back.
While there is anecdotal evidence suggesting that belly bands can provide some relief from back pain during pregnancy, the effectiveness may vary from woman to woman. Some expectant mothers find that wearing a belly band offers additional support and stability, reducing discomfort in the lower back.
However, it’s important to note that belly bands should be used under the guidance of a healthcare provider. They are not a substitute for proper posture, exercise, or other treatments for back pain during pregnancy. If you’re considering using a belly band, it’s advisable to consult with your healthcare provider to ensure it is appropriate for your specific situation.
Exercises to Relieve Pregnancy Back Pain
Strengthening exercises to prevent back pain when pregnant
1. Pelvic Tilts
Lay on your back with your knees bent and your feet flat on the floor to learn the pelvic tilt. You’ll probably notice a gap between your back and the floor if you place your palm on the small of your back.
Now strive to firmly press the lower half of your spine against the floor, leaving no space between your back and the ground. The buttocks should be relaxed to isolate the abdominals. The pelvic tilt can be performed while lying down, standing, sitting, or kneeling.
2. Arm and leg raises
Kneel on your hands and knees with a straight spine. To maintain your pelvis stable, lift your right arm and left leg to establish a straight line with your spine, then conduct a pelvic tilt.
After pausing in this position, slowly drop your arm and leg. Alternate lifting the opposing arm and leg. Split the workout into two pieces and complete the leg or arm rises separately if you’re having problems maintaining balance in this stance.
3. Wall Squats
Place your head, shoulders, and back against a wall, with your feet about 1 to 2 feet away. Squat with your knees at a 90-degree angle and your lower back on the wall, as if you were about to sit down. Carefully return to the wall, keeping your back and buttocks in touch.
Stretching exercises to prevent back pain when pregnant
Photo by Pavel Danilyuk from Pexels
1. Back stretch
Start on your hands and knees, legs wide apart and hands slightly forward of your head. Place a small pillow under you if necessary to provide abdominal support during this back workout. Sit back on your knees and stretch your arms forward to feel a stretch along your spine.
2. Hamstring stretch
Place one foot on a chair and point both hips and feet forward. Keep your back straight and bend forward from your hips to feel a stretch in the back of your thigh. If you can’t stand tall or your knees bend, try a lower step.
3. Chest stretch
Stand with your back straight and your head upright. Clasp your hands behind your back and gradually stretch your arms up and back without bending forward to feel a stretch at the front of your shoulders and arms.
4. Neck stretch
While sitting or standing, tilt your head forward and to one side. Pull lightly from behind your head with the hand on the same side as your tipped head. You can isolate the neck muscles that need stretching by moving your head while pulling.
Pilates exercises to prevent back pain when pregnant
Pilates is a non-impact workout that is safe to practice during pregnancy. It increases flexibility, tones and strengthens the muscles and improves posture to alleviate backaches, and ultimately helps with labour and delivery. Healthline has compiled a few pilates exercises for early pregnancy back pain.
1. TheraBand arm pull
- When standing or sitting, keep a TheraBand shoulder distance apart in front of your chest.
- As you exhale, pull the band apart with your arms straight, maintaining arm height and pressing your shoulder blades together.
- Return the band to its original position.
- Reps should be 10–15.
2. Arm Rows
- Standing or seated, bring both arms up to 90 degrees from your sides, fists pointing forward.
- Exhale and thrust both arms forward, keeping your shoulder blades together, as if you’re moving through water or opposing it.
- As you inhale, pull your arms back to their starting position, maintaining a tight squeeze through your arms, upper back, and shoulders.
- Reps should be 10–15.
3. Pointer
- Standing or seated, bring both arms up to 90 degrees from your sides, fists pointing forward.
- As if you’re going through or against water, exhale and press both arms forward, shoulder blades together.
- As you inhale, return your arms to their beginning position, retaining a firm grasp on your arms, upper back, and shoulders.
- It’s best to do 10–15 reps.
4. Glute Stretch
- To begin, take a seat in a chair or on the floor.
- Stretch your buttocks and hips by crossing one leg over the other and gently pressing your knee out to the side.
- Keep both sit bones at the same level.
- Hold for 20 seconds on each side.
5. Lower back stretch
- Sit on the floor with your legs straight out in front of you. (If your tummy is getting bigger toward the end of the third trimester, separate your legs into a “V” but not too wide.)
- Take a deep breath and extend your arms forward.
- Exhale and reach forward from your hips until your lower back and legs are stretched.
- Avoid slouching by keeping your knees on the floor.
- For 20 seconds, stay in this position.
6. Clams
- Lay on your side, if required, with a pillow to support your tummy.
- Place your hand or a pillow beneath your head.
- Maintain an open chest while bending your knees to align your heels with your hips.
- Press your heels together and open your top knee away from your bottom knee while inhaling and exhaling.
- You should be able to feel the contraction of your hip and glute muscles. Maintain as much flexibility in your thighs as possible.
- Only go halfway up if your lower back hurts.
- On each side, do 10–20 reps.
7. Leg Raises
- Place hands under shoulders and knees under hips while on all fours.
- While inhaling, stretch one leg back along the floor.
- Exhale and lift your stretched leg off the floor slowly, squeezing your butt muscle and pointing your foot.
- Lift and lower your leg without letting it touch the floor, working your buttocks each time.
- Maintain torso and hip stability.
- If your lower back or pelvis hurts, only move a short distance up and down.
- Rep 15 times on each leg.
Remember, mums-to-be, before starting any exercise routine, heed the advice of your doctor first. Also, if you are suffering from severe back pain during pregnancy, stop any form of exercise and consult with your OB-Gynaecologist.
When to Seek Help for Pregnancy Back Pain
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Back pain is common during pregnancy, but there are times when it may signal something more serious. According to Dr. Terry Teo, back pain could be more than just pregnancy-related changes if “the pain is persistent or worsening with rest or treatment.” You should also watch for “associated symptoms like weakness or sensory changes in the legs, or loss of bowel or bladder control, which may suggest nerve compression.”
Here are some key signs to seek medical attention promptly:
- Severe or persistent pain: If your back pain is debilitating, disrupts sleep, or continues despite rest, consult your doctor for further evaluation.
- Radiating pain or numbness: Pain that spreads down the legs or is accompanied by tingling, numbness, or weakness could indicate sciatica or nerve compression.
- Bladder or bowel dysfunction: Difficulty controlling your bladder or bowels, such as urinary incontinence or constipation, may signal nerve involvement.
- Fever or systemic symptoms: Back pain with fever, chills, or other systemic signs could suggest an infection or another underlying condition.
- Pregnancy complications: Back pain with vaginal bleeding, cramping, decreased fetal movement, high blood pressure, or sudden swelling requires immediate medical attention.
If you experience these symptoms, your doctor will usually start by reviewing your medical history and performing a physical examination. In some cases, an MRI may be recommended to rule out conditions such as a herniated disk. X-rays and CT scans are avoided during pregnancy as they involve radiation.
How to Prevent Back Pain During Pregnancy
Backaches are a common occurrence in pregnancy, especially during the third trimester when the growing belly leads to a shift in the centre of gravity. While it’s almost impossible to prevent back pain when pregnant (unless you belong to the lucky ones who barely experience any unwanted symptoms), there are some things you can try to minimise the aching:
- Strengthen your back muscles through the stretching exercises mentioned above (with your doctor’s approval).
- Maintain a healthy and steady pregnancy weight.
- Avoid wearing high heels and wear supportive footwear.
- Avoid standing for long periods of time.
- Avoid activities that involve heavy lifting. When you need to lift something, make sure you squat down and put more pressure on your legs instead of the back.
- Use a belly band to support your growing tummy.
- Practice good posture when walking, sitting or standing.
- Avoid sleeping on your tummy. Practice sleeping on your side, with a pillow to support your back.
If you are experiencing severe back pain when pregnant, do not hesitate to consult your doctor.
Republished with permission from theAsianparent Philippines.
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