Multidisciplinary Obstetric Medicine Service (MOMS)
Back Pain During Pregnancy
Most pregnant women experience back pain, typically starting in the second half of pregnancy. Most women feel pain in their lower back, in the posterior pelvic region or lower lumbar region.
Posterior pelvic pain is the more common of the two and is a deep pain felt below and at the sides of the waistline, on one or both sides of your buttocks or at the back of your thighs. It can be experienced on one or both sides of your body.
Lumbar pain occurs in the area of the lumbar vertebrae in your lower back, at and above the waist in the center of the back. The pain may radiate to your leg. Lumbar pain during pregnancy feels similar to lower back pain you may have experienced before you were pregnant.
Back pain during pregnancy can range from mild pain caused by specific activities to acute back pain that can become chronic back pain over time. Women with pre-existing lower back problems or chronic pain are at a higher risk for back pain, and their back pain can occur earlier in pregnancy.
How Often Does Back Pain During Pregnancy Happen?
Back pain during pregnancy is extremely common. It is estimated between 50 and 70 percent of pregnant women experience back pain.
What Are Some Symptoms of Back Pain During Pregnancy?
The symptoms of back pain during pregnancy are very similar to the symptoms of back pain prior to pregnancy. Some of the symptoms include:
- Pain in the center of your back
- Pain above or at the sides of the waistline
- Pain over the pubic bone
- Pain in the buttocks or thighs
- Pain that can radiate to the legs
- Stiffness or discomfort after sitting or standing for long period of time
What Are Some Causes of Back Pain During Pregnancy?
There are several reasons why you may experience back pain during pregnancy. Sone of the most common causes include:
- Weight gain: As you gain weight during pregnancy, the spine has to support that added weight. That change causes lower back pain. The weight of the growing baby and uterus can also put pressure on the blood vessels and nerves in the pelvis and back, causing pain.
- Changes in hormones: During pregnancy, your body releases a hormone called relaxin that allows ligaments in the pelvic area to relax and joints to loosen in preparation for giving birth. The hormone can cause ligaments that support the spine to loosen as well. This, along with the shifting of joints, can lead to instability and pain.
- Changes in posture: Poor posture, excessive standing or sitting, and bending over can trigger or increase your back pain. In addition, while you’re pregnant, your center of gravity shifts forward as your uterus and baby grow, causing your posture and the way you move to change. This can result in strain and pain.
- Stress: Stress can cause muscle tension in the back, resulting in back pain or back spasms. You may experience an increase in back pain during stressful periods of your pregnancy.
- Chronic back pain prior to pregnancy.
How Can Back Pain During Pregnancy Be Treated?
Back pain is very common in pregnancy and is usually not serious. While it may not be completely preventable, there are some changes you can make to reduce the severity or frequency of your back pain. Some treatments for back pain include:
- Exercise: Regular exercise strengthens muscles and boosts flexibility, easing the stress on your spine. Good exercises for reducing back pain include walking, swimming, and stationary cycling. Your doctor can recommend exercises to focus on strengthening your back and abdomen.
- Heat and cold: Applying heat and cold to your back may help reduce the pain. Start by putting cold compresses on the painful area for up to 20 minutes as needed. After two or three days, use heat, with a heating pad or hot water bottle on the painful area. Be careful not to apply heat to your abdomen during pregnancy.
- Improve your posture: Poor posture can strain your spine, so try to use correct posture when working, sitting, or sleeping. Sleeping on your side with a pillow between your knees can take stress off your back. When sitting, place a pillow behind your back for support, elevate your feet, and sit up straight, with your shoulders back. Wearing a support belt or brace may also help.
- Counseling: If your back pain is caused by or worsened by stress, counseling may help. You will discuss your thoughts and feelings with a counselor or therapist, who will help you understand your feelings and cope with your stress. Ask your doctor for more information or a referral for counseling.
- Medication: If your back pain is severe or persistent, your doctor may recommend you take medication to treat inflammation and relieve your symptoms. Acetaminophen is safe for most women to take during pregnancy; however, aspirin and other nonsteroidal anti-inflammatory medications usually are not recommended. In some cases, your doctor may recommend other pain medicines or muscle relaxants. Your doctor will prescribe the safest medication for you at the most appropriate dosage. Always speak with your doctor before taking any pain medication.
- See a professional: If your back pain is severe or interferes with your day-to-day activities, you may want to make an appointment with a physical therapist, chiropractor or massage therapist. Chiropractic manipulation of the spine can be safe during pregnancy, but speak with your doctor first to ensure that it is safe for you and your individual condition.
While these treatments can help reduce symptoms of back pain, some small changes in your habits can also help prevent triggering or worsening back pain. Some changes are:
- If you need to pick something up from the ground, squat down instead of bending over.
- Avoid wearing high heels or other shoes that do not provide adequate support.
- Avoid sleeping on your back.
- Elevate your feet often, especially when sitting for a prolonged period of time.
- Wear a support belt or support hose, if needed.
Unless you experienced chronic back pain prior to pregnancy, your pain will most likely ease gradually before you give birth.
When Should I See My Doctor for Back Pain During Pregnancy?
Even if you experience only mild back pain, it is important to inform your doctor. He or she can recommend the best methods for you to manage those symptoms and can then monitor you throughout your pregnancy for worsening symptoms.
If your symptoms are severe, become severe, and are persistent or prolonged, call your doctor right away.
You should call your doctor and seek immediate medical care if your back pain is accompanied by:
- Numbness or weakness: Severe pain, numbness or weakness in the legs may be a sign of a condition called sciatica. While sciatica is not common, its symptoms can be similar to normal back pain. However, sciatica can cause leg pain that is more severe than your back pain. You will likely feel it below the knee and in your foot and toes, along with a tingling sensation, numbness or weakness. Call your doctor immediately if you feel weakness in one or both legs, or lose sensation in your legs, groin, bladder, or anus.
- Fever and dull ache: A fever accompanied by a dull ache across your lower back or along the sides of your back could be a sign of a kidney or bladder infection, or urinary tract issues. This would require immediate attention and treatment with antibiotics. Call your doctor immediately if you feel back pain accompanied by painful urination, blood in the urine, chills, or fever.