Back pain during pregnancy is incredibly common, with between 50-70% of women experiencing it at some point. Managing back pain properly can make a big difference in comfort during this special time. This guide covers the major causes of back pain and the most effective treatment approaches, with lifestyle tips for prevention.
What’s Behind the Aches
Back pain occurs frequently from the weight of the growing baby putting strain on the back and posture changes shifting the body’s center of gravity. But other factors like hormones, muscle separation, and stress play a role too.
Packing on the Pounds
The average woman gains 25-35 pounds during pregnancy. Carrying this extra weight, combined with the baby’s weight, piles strain onto the spine that can lead to achy discomfort. This extra load often causes the most pain in the later months as the baby grows rapidly.
The best prevention is managing weight gain through diet and exercise. Walking, swimming, and stationary cycling are great options for most pregnant women after getting doctor approval. Avoid activities with high risk of falls or abdominal trauma. Easing up on sugary and fatty foods also helps control excess weight.
Posture Adjustments
As the belly expands outward, a woman’s center of gravity shifts forward. To compensate, many pregnant women unconsciously arch their backs more. Others tilt their pelvises or slouch their shoulders without realizing it. These postural habits put strain on the back. A growing baby also flattens the lumbar curve in the lower spine, contributing to muscle soreness.
Making conscious posture adjustments is key. Sit and stand tall, pull the shoulders back, keep the chest lifted, and use a wide stance for stability. Chairs with lumbar support, small back pillows, and pregnancy belts can all help reduce strain.
The Impact of Hormones
The hormone relaxin surges during pregnancy, softening ligaments throughout the pelvis and back to prepare for delivery. This flexibility allows more room for the baby to pass through the birth canal. But it also destabilizes joints and makes them more prone to injury and pain.
There is no direct way to control relaxin but staying active with approved exercises makes muscles better able to support loosening joints. Gentle stretching also helps.
Abdominal Muscle Separation
As the uterus expands outward, the abdominal muscles can start to separate down the middle along the linea alba. This common symptom, called diastasis recti, may worsen back strain as weaker muscles struggle to stabilize the added weight up front.
While concerning, this separation typically heals on its own after pregnancy. In the meantime, exercise focused on core strength can support the back despite muscle divergence. Activities like Pilates and swimming work wonders. A postpartum physiotherapist can also help retrain muscle recruitment after delivery.
The Burden of Stress
Pregnancy comes with worries big and small. Plus challenging life events can pile on more stress during this period. These mental strains often manifest physically as muscle tension concentrated in the back and shoulders.
Relaxation techniques like prenatal yoga, mediation, and massage help calm the mind and release physical tension. Talking through anxieties with a counselor, friend, or support group also works wonders. Light exercise can boost feel-good endorphins. Staying well rested is key as well.
Soothing the Ache
Whether preventing or relieving back pain, the following methods offer the greatest relief without medication risks. Every woman responds differently though, so some trial and error with guidance from a doctor finds the best personal mix.
Exercise as Medicine
Physical activity strengthens core muscles essential for supporting the back, hips, and spine. Exercise also improves flexibility and posture for greater comfort. Options like walking, swimming, stationary cycling, and prenatal yoga classes suit most pregnant women after getting medical approval.
Starting early in pregnancy makes muscles better equipped for the extra third trimester weight but anytime helps. Even 10-15 minutes daily provides tangible benefit. Stretching the lower back gently after activity brings added relief too.
Complementary Therapies
Alternative treatments like massage, acupuncture, and chiropractic adjustment ease back discomfort for many pregnant women. Always consult a doctor before starting to ensure safety.
Therapeutic massage loosens tight muscle knots and reduces inflammation. Acupuncture taps pressure points connected to back nerves to dull pain signals. Chiropractors realign the spine for reduced muscle strain. These methods complement exercise and lifestyle changes well.
Postural Precautions
Simple adjustments in posture, sleeping positions, lifting methods and more can prevent back strains.
Sit straight with lumbar support from pillows or rolls. Stand evenly with feet hip width apart instead of slouched. Sleep on the side with a pillow between knees to align the spine. Lift objects using the legs in a squat while keeping the back straight. Avoid activities with lots of bending and twisting too. Ergonomic guidance tailors workstations for optimal back health as well. Making these changes consciously reduces strain little by little.
Heat and Cold Therapy
Simple hot and cold treatments soothe back discomfort without medication risks. Both heating pads and ice packs calm inflammation. But heat also relaxes tight muscles whereas cold numbs nerve pain better.
Apply hot packs wrapped in a towel for 10-15 minutes up to a few times daily. Use cold packs for 15-20 minutes as needed too. Avoid extreme temperatures and direct contact with skin to prevent burns or frostbite. Rotate treatments week to week as different pain mechanisms flare up.
Medication Considerations
Over-the-counter acetaminophen (Tylenol) offers relief for many women after checking with their provider first. Extended use should still be minimized, especially in the last trimester. If back strains become extreme, a doctor may prescribe muscle relaxants or painkillers suitable for pregnancy.
Other anti-inflammatories like ibuprofen (Advil, Motrin) require caution as they may impact fetal development and decrease amniotic fluid if taken in later pregnancy. Due to risks, reserve medications only for moderate to severe back strains under medical guidance. Also avoid any chiropractic or massage treatments focused on pressure points on feet or ankles during pregnancy.
Adjusting Your Lifestyle
Making a few daily lifestyle tweaks reduces repetitive back strains that can add up over nine months. Supporting the belly both sleeping and upright prevents muscle overexertion. How you pick up items, wear shoes, and sit at a desk all impact pain levels too.
Sleeping Strategically
The third trimester brings pronounced back pain, especially at night. Sleeping mainly on the left side aligns the spine neutrally plus enhances circulation. Placing pillows under the knees, abdomen, and lower back minimize nighttime muscle strain. If hip soreness flares up, a memory foam mattress topper helps cushion pressure points.
Getting in and out of bed smartly reduces the need to twist the back also. Roll up sideways moving the shoulders and hips together, letting the feet gently drop to the floor before using the arms to lift the torso. Reverse the process slowly getting back into bed.
Choose Supportive Footwear
Wearing unsupportive shoes or high heels throws off the body’s foundation all day. Low heeled shoes with strong arch reinforcement better distribute weight to minimize spinal loads. Many women need to go up a shoe size too as feet swell during pregnancy. If plantar fasciitis flares up, try shoe inserts for cushioning relief. Ditch fashion for function for fewer back and foot woes.
Lift the Right Way
Lifting from the legs instead of bending forward prevents pesky pulls in the back muscles. When grabbing items off the ground, squat down keeping the back straight and engaging the leg muscles to avoid strain. If an object proves overly heavy or awkward, do not stubbornly power through! Ask someone nearby for assistance instead. Save the solo heavy lifting for after delivery and recovery.
Sit and Stand with Intention
Choosing supportive furniture and reminding joints to align properly when standing up makes good posture habitual. Set computer screens at eye level to discourage slouching. Stabilize the pelvis while standing by squeezing the glutes gently and keeping the tailbone tucked slightly under. These mental tips over time spare the spine excess curvature.
Knowing When to Ask for Help
Most back discomfort naturally resolves or improves greatly in the weeks after childbirth. If pain becomes severe or persists over two weeks without relief however, see a doctor to assess for complications. Contact a doctor immediately if experiencing rhythmic cramping, pins and needles or numbness in the legs, fever, vaginal bleeding or painful urination along with the backache.
In rare cases, severe symptoms may indicate a kidney infection, pelvic issues, vertebral conditions or pregnancy-associated osteoporosis. Catching complications early vastly improves outcomes for both mother and baby. Do not endure any intense, worsening or spreading back pain silently out of pride or avoidance. Communicate concerns promptly to receive optimal care during this sensitive time.
In Conclusion
Back pain remains an expected nuisance during pregnancy thanks to good old hormones, extra weight and other issues. But with knowledge of the underlying causes and proactive treatment methods, most women escape major suffering beyond moderate muscle strains. Without a known spinal condition or nerve impingement already, patients can have confidence that the nuisance will fade in time.
Written by Dr. Tony Mork
Orthopedic Spine Surgeon
I’m Dr. Tony Mork, MD, a Minimally Invasive Orthopedic Spine Surgery Specialist in Newport Beach, California. With over 40 years of experience, I’m dedicated to providing information for all topics that involve neck and back pain.
January 31, 2024
Contact a Spine Specialist Near You!
Related Articles
Lower Back Pain | An Overview
Lower back pain is an exceedingly common affliction that affects up to 80% of adults at some point in their lives. Understanding the underlying causes of lower back pain is key to finding the appropriate treatment and relief. Anatomy of the Lower Back The lower back,...
Degenerative Disc Disease | Causes and Risk Factors
Degenerative disc disease describes age-related wear and tear to the rubbery spinal discs cushioning the vertebrae that can lead to chronic back or neck pain. While partly genetic, there are also lifestyle factors and injuries that accelerate disc degeneration over...
Upper (Thoracic) Back Pain | What is Causing My Pain?
Upper back pain is a surprisingly common affliction, affecting up to one-quarter of the adult population at some point. While not as prevalent as lower back pain, discomfort in the thoracic region still accounts for a substantial slice of musculoskeletal complaints...