Spinal pain in pregnancy
Back pain in pregnancy - NHS
It is very common to get backache or back pain during pregnancy, especially in the early stages.
During pregnancy, the ligaments in your body naturally become softer and stretch to prepare you for labour. This can put a strain on the joints of your lower back and pelvis, which can cause back pain.
Avoiding and easing back pain in pregnancy
Try these tips:
- bend your knees and keep your back straight when you lift or pick something up from the floor
- avoid lifting heavy objects
- move your feet when you turn to avoid twisting your spine
- wear flat shoes to evenly distribute your weight
- try to balance the weight between 2 bags when carrying shopping
- keep your back straight and well supported when sitting – look for maternity support pillows
- get enough rest, particularly later in pregnancy
- have a massage or a warm bath
- use a mattress that supports you properly – you can put a piece of hardboard under a soft mattress to make it firmer, if necessary
- go to a group or individual back care class
You can take paracetamol to ease back pain while you are pregnant, unless your GP or midwife says not to. Always follow the instructions on the packet.
When to get help for back pain in pregnancy
If your backache is very painful, talk to your GP or midwife. They may be able to refer you to an obstetric physiotherapist at your hospital, who can give you advice and may suggest some helpful exercises.
Non-urgent advice: Contact your GP or midwife urgently if:
You have back pain and you:
- are in your second or third trimester – this could be a sign of early labour
- also have a fever, bleeding from your vagina or pain when you pee
- have pain in one or more of your sides (under your ribs)
Immediate action required: Call 999 or go to A&E if:
You have back pain and:
- you lose feeling in one or both of your legs, your bum, or your genitals
Exercises to ease back pain in pregnancy
This gentle exercise helps to strengthen stomach (abdominal) muscles, which can ease back pain in pregnancy:
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1) Start on all fours with knees under hips, hands under shoulders, fingers facing forwards and stomach muscles lifted to keep your back straight.
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2) Pull in your stomach muscles and raise your back up towards the ceiling, letting your head and bum relax downwards gently – do not let your elbows lock and only move your back as far as you comfortably can.
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3) Hold for a few seconds then slowly return to the box position – take care not to hollow your back, it should always return to a straight, neutral position.
4) Do this slowly and rhythmically 10 times, making your muscles work hard and moving your back carefully.
Doing prenatal yoga or aquanatal classes (gentle exercise classes in water) with a qualified instructor can also help build your muscles to better support your back. Ask at your local leisure centre.
Page last reviewed: 15 March 2021
Next review due: 15 March 2024
Back Pain During Pregnancy | ACOG
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Backache is one of the most common pregnancy problems, especially in the later months. The pain usually goes away after the baby is born. But for many women, back pain lingers for months after giving birth.
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You can blame your growing uterus for your aching back.
Your expanding uterus shifts your center of gravity and stretches out and weakens your abdominal muscles. This changes your posture and puts a strain on your back. Plus, the extra weight you’re carrying means more work for your muscles and increased stress on your joints. This is why your back may feel worse at the end of the day. -
The abdominal muscles support the spine and play an important role in the health of the back. During pregnancy, these muscles stretch and weaken. These changes also can increase your risk of hurting your back during exercise.
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Yes, pregnancy hormones can contribute to back pain. To prepare for the passage of the baby through the birth canal, a hormone relaxes the ligaments in the joints of your pelvis to make them more flexible. Back pain can occur if the joints become too flexible.
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There are several things you can do to prevent or ease back pain. For example, wear supportive clothing and shoes. Pay attention to your position when sitting, sleeping, and lifting things. If you need to stand for a long time, rest one foot on a stool or a box to take the strain off your back. You also can use heat or cold to soothe sore muscles.
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Look for an abdominal support garment (for sale in maternity stores and catalogs). It looks like a girdle and helps take the weight of your belly off your back muscles. Also, some maternity pants come with a wide elastic band that fits under the curve of your belly to help support its weight.
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Wear low-heeled (but not flat) shoes with good arch support, such as walking shoes or athletic shoes.
Avoid high heels—they tilt your body forward and strain your lower back muscles. -
Sit in chairs with good back support or tuck a small pillow behind your lower back. Lumbar supports, special devices that support the lower back, are sold at office supply and medical supply stores.
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If you must lift something, squat down, bend your knees, and keep your back straight. Do not bend at the waist to pick up things.
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Sleeping on your side is best later in pregnancy. Keep one or both knees bent. It also may help to place a pillow between your knees and another under your belly. You also can try a full-length body pillow.
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You can use a heating pad or warm water bottle for painful back muscles.
Heating pads should be set at the lowest possible temperature setting. Wrap your heating pad or warm water bottle in a towel to help prevent burns. Cold compresses also can help ease pain. Limit the time you use heat or cold. -
If you have severe back pain, or if the pain goes on for more than two weeks, call your obstetrician–gynecologist (ob-gyn) or other obstetric care provider. He or she will want to rule out other causes of the pain.
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Back pain can be a sign of some pregnancy complications. For example, back pain can be a symptom of preterm labor. Pain also can be a sign of a urinary tract infection (UTI). Contact your ob-gyn or other obstetric care provider if, in addition to back pain, you:
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Once other causes for your pain are ruled out, your ob-gyn or other obstetric care provider may recommend that you see a rehabilitation specialist or a physical therapist.
He or she also may recommend a maternity girdle or brace if you aren’t already using one. -
Yes, exercises for the back can:
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Strengthen and stretch the muscles that support your back and legs
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Promote good posture
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Keep the muscles of the back, abdomen, hips, and upper body strong
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Help ease back pain
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Help prepare you for labor and childbirth
Before doing any exercises, talk with your ob-gyn or other obstetric care provider to make sure they are safe for you. Exercising should not cause pain. If you have pain, stop doing the exercise. See Exercise During Pregnancy for more exercise tips.
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Yes. Walking generally is safe during pregnancy and is great for the back.
Wear walking shoes or tennis shoes that fit well and give good support, flexibility, and cushioning. -
Water exercise can be especially helpful for back pain. The water supports your weight so you avoid injury and muscle strain. Many women swim right up to the end of their pregnancies.
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If you have no complications that prevent you from doing so, staying active during pregnancy reduces back pain and increases your ability to go about your daily activities. Always talk with your ob-gyn or other obstetric care provider before starting or changing an exercise program during pregnancy.
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Complications: Diseases or conditions that happen as a result of another disease or condition.
An example is pneumonia that occurs as a result of the flu. A complication also can occur as a result of a condition, such as pregnancy. An example of a pregnancy complication is preterm labor.Hormones: Substances made in the body by cells or organs that control the function of cells or organs. An example is estrogen, which controls the function of female reproductive organs.
Ligaments: Bands of tissue that connect bones or support large internal organs.
Obstetric Care Provider: A health care professional who cares for a woman during pregnancy, labor, and delivery. These professionals include obstetrician–gynecologists (ob-gyns), certified nurse–midwives (CNMs), maternal–fetal medicine specialists (MFMs), and family practice doctors with experience in maternal care.
Obstetrician–Gynecologist (Ob-Gyn): A doctor with special training and education in women’s health.
Preterm: Less than 37 weeks of pregnancy.
Urinary Tract Infection (UTI): An infection in any part of the urinary system, including the kidneys, bladder, or urethra.
Uterus: A muscular organ located in the female pelvis that contains and nourishes the developing fetus during pregnancy.
Don't have an ob-gyn? Search for doctors near you.
FAQ115
Published: May 2020
Last reviewed: December 2021
Topics:
Pregnancy During Pregnancy Pregnancy Discomforts and Other Concerns
Copyright 2022 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information.
This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care.
It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.
5 Exercises for Back Pain During Pregnancy - Academic Medical Center (AMC)
During the second half of pregnancy, most women suffer from nagging lower back pain. Most often, it is caused by physiological changes in the body and disappears with a change in body position and the selection of a comfortable posture. Back pain can also be provoked by inflammatory and infectious diseases and exacerbations of chronic pathologies. To determine the cause of discomfort, be sure to consult a doctor. If no diseases have been identified, and aching pain is the result of an increase in the load on the back muscles, then special physical exercises will help to loosen it. nine0004
5 exercises to relax the back
Back twists
Sit on the floor or sofa with your legs crossed. Take your right hand forward and begin to slowly wind it behind your back and turn after it with your whole body.
Move until you feel a slight stretch in your muscles. After that, return to the starting position and turn to the other side. When performing the exercise, make sure that your back remains straight.
Child posture
This exercise helps to relax the back muscles. Get on your knees, put your feet shoulder-width apart and rest your palms on the floor. Keeping your palms pressed to the floor, lower your buttocks onto your heels. The stomach should lie between the knees, and the back muscles should stretch.
Cat back
Get on your knees and place your palms on the floor. Gently lift your back up, arching it in a semicircle. Hold this position for 5 seconds, then relax and repeat all over again. nine0004
Reverse cat back
Kneel down and place your palms on the floor. Raise your head up and bend your back down. Hold this position for 5 seconds.
Bird Flight
Stand sideways against a wall or back of a sofa so that you can hold on with one hand.
Holding on with your left hand, lift your right leg to a horizontal position. Hold this position for 5-10 seconds, then repeat the exercise with the other leg. This exercise strengthens the back muscles, making them stronger. nine0004
How to do the exercises?
Before you decide to do exercises to relieve back pain, be sure to consult your doctor. He will assess your condition and determine the acceptable load level. All exercises must be performed smoothly, avoiding sudden movements and strictly following the execution technique.
Contraindications for gymnastics
Not in all cases, pregnant women are allowed to exercise. They are prohibited with the threat of miscarriage or premature birth, after pregnancy loss, with increased uterine tone, with severe toxicosis, changes in blood pressure, diseases of the spine and cardiovascular system. nine0004
How to prevent back pain?
During pregnancy, back pain is the result of increased strain on the back muscles and spine.
To reduce stress and prevent pain, wear low heel shoes or shoes with less than 3 cm heels, support your lower back with a pillow when you sit, and sleep on your side, with a pillow under your belly if necessary.
Which symptoms require immediate medical attention? nine0007
Lower back pain in the second half of pregnancy appears due to the shift of the center of gravity, weakening of the ligamentous apparatus, preparation of the body for childbirth. However, back pain can also be a symptom of dangerous diseases or complications.
Seek medical attention:
- if you experience pain in the upper back and neck, accompanied by high blood pressure, headache or dizziness;
- with a decrease in the mobility of the shoulder joints and numbness of the fingers; nine0004
- in case of pain in the thoracic spine, which is accompanied by pain in the ribs and heart;
- for back pain accompanied by leg numbness;
- with aching pain that does not go away and does not weaken with a change in body position;
- for pain accompanied by fever, edema, pain during urination;
- with sharp, intense, cramping pains.
During pregnancy, you feel not only great joy in expecting a baby, but also a great responsibility for his health. One of the main conditions for a favorable course of pregnancy and the birth of a healthy baby is observation by a highly professional obstetrician-gynecologist. Unfortunately, the number of pregnant women at high risk to both mother and child is on the rise. nine0004
It is therefore important to see a doctor as soon as possible. In the early stages of pregnancy, an obstetrician-gynecologist must determine the health status of the expectant mother and conduct screening studies of the fetus on time. We offer comprehensive pregnancy support packages for you.
Pregnancy management at the Academic Medical Center is based on the provisions of the MOH pregnancy management protocol and 25 years of successful medical experience. Our comprehensive packages include a full range of necessary consultative and diagnostic measures from the moment of registration to delivery.
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More pregnancy management packages.
Lower back pain and pregnancy
As a result, there are changes in the spine, in the muscles of the abdomen and back and the shape of the lumbar curve of the spine (hyperlordosis), and all this becomes relaxed. Poor posture and poor muscle tone can also affect spinal mechanics.
The lumbar curve of the spine begins to slowly increase as the pelvis begins to move back. This posture begins to affect the weakened muscles and leads to the accumulation of fatigue in the muscles of the lower back. A woman may experience moderately painful muscle spasms at first, which may be the first sign of the possibility of persistent low back pain as the pregnancy progresses. The growing uterus shifts the center of gravity and weakens the abdominal muscles, changes posture and puts excessive stress on the back. If the uterus affects the nerves, then this can lead to pain. In addition, being overweight during pregnancy puts more stress on the muscles and joints, and therefore, by the end of the day, a pregnant woman may feel discomfort.
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Experts describe the two most common patterns of low back pain during pregnancy: low back pain that occurs in the area of the lumbar vertebrae in the lower back, and posterior pelvic pain, which is felt in the back of the pelvis. Some women have symptoms of both types of low back pain.
Lower back pain is similar to the pain that a woman experienced before pregnancy. Pain is felt in the lower back and around the spine, approximately at waist level. Women may also experience pain that radiates to the legs. Prolonged sitting or standing can aggravate the pain and, as a rule, the pain tends to increase towards the end of the day. Many more women experience back pelvic pain, which is felt less than lower back pain. The pain may be deep inside the buttocks, on one or both buttocks, or in the back of the thighs. Pain can be triggered by activities such as walking, climbing stairs, getting in and out of the bathroom on a low cabinet, turning in bed, or twisting and lifting heavy objects.
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Positions that involve leaning forward, such as sitting, in a chair, and working at a desk while leaning forward, can exacerbate posterior pelvic pain. Women with posterior pelvic pain are also more likely to experience pain over the pubic bone.
When low back pain radiates to the buttocks and thighs, sciatica is often suspected - although sciatica is not very common in pregnant women. True sciatica, which can be caused by a herniated disc or the presence of a disc protrusion in the lumbar spine, occurs in only 1 percent of pregnant women. nine0004
If there is compression and inflammation of the sciatic nerve (herniated disc), then the pain in the legs is more severe than with normal low back pain. Pain can be felt not only in the thigh, but also below the knee or even radiate to the foot. It is also possible the presence of sensory disturbances, such as numbness or tingling sensations.
With severe sciatica, there may be numbness in the groin area, as well as in the genital area.
You may also have trouble urinating or defecation. If a pregnant woman has suspicions of sciatica, then she must definitely contact her doctor. If symptoms such as impaired sensation in the legs and weakness in one or both legs or loss of sensation in the groin and impaired urination or defecation appear, then you need to see a doctor urgently! Such symptoms may be evidence of the development of the "cauda equina" syndrome in the presence of a herniated disc in a pregnant woman, and in such cases an emergency operation is necessary. nine0004
Risk factors for low back pain
It is not surprising that, most likely, low back pain in pregnant women is most likely if there were already pains before pregnancy or there were degenerative changes in the lumbar spine (protrusions, herniated discs). Also at higher risk are pregnant women who led an inactive lifestyle before pregnancy, as a result of which their back muscles are weak, as well as the abdominal muscles. Pregnancy with multiple fetuses (twins) significantly increases the risk of lower back pain.
Obesity may also be a risk factor for developing low back pain during pregnancy. nine0108 Diagnosis of low back pain.
Examinations such as CT (MSCT) are rarely used to diagnose the causes of low back pain in pregnant women due to possible teratogenic effects on the fetus. MRI is also not recommended, especially in the first trimester of pregnancy. But, if there are clinical indications, then MRI can be performed. Therefore, as a rule, the diagnosis of low back pain in pregnant women is mainly based on physical examination data, symptoms and medical history (for example, the presence of a disc herniation before pregnancy). nine0004
Treatment
The use of any medication during pregnancy is very risky, as all medication will also be passed on to the fetus. Therefore, the usual prescription of painkillers, muscle relaxants, or steroids (NSAIDs) for back pain is contraindicated in pregnant women. In addition, the use of acupuncture physiotherapy is also not recommended.
It is possible to use light massage and very gentle manual therapy techniques.
At the forefront of the treatment of back pain in pregnant women comes exercise therapy (gymnastics) and certain recommendations for daily activities. Gymnastics can be specialized, such as prenatal yoga. Good effect gives swimming and walking. nine0004
Swimming is an excellent exercise choice for pregnant women because it strengthens the abdominal and lower back muscles, and being in the water relieves stress on joints and ligaments.
Need to maintain proper biomechanics during pregnancy:
- Stand up straight. This becomes more and more difficult to do as the shape of the body changes, but one must try to keep the back straight and the shoulders back. Pregnant women tend to drop their shoulders and arch their back as their belly grows, which puts more stress on the spine. nine0128
- If it is necessary to sit during the day, then one should sit straight. Leg support (bedside table) can help prevent lower back pain, and you can also put a special pillow under the lower back.
Take frequent breaks from sitting. You need to get up and walk for several minutes, at least once an hour. - It is equally important not to stand too long. If you need to stand all day, then it is advisable to rest while lying on your side during a break, supporting your upper leg and stomach with pillows. nine0128
- Avoid movements that increase pain. If there is posterior pelvic pain, then one should try to limit activities such as climbing stairs. It is also advisable to avoid any activity that requires extreme movement of the hips or spine.
- It is important to wear comfortable shoes and avoid high heels. As the abdomen grows, the center of gravity shifts and when wearing shoes with heels, the risk of falls increases. nine0128
- Always bend your knees and pick things up from your haunches to minimize stress on your back. Spinal twisting should be avoided and activities such as vacuuming or mopping should be avoided.
- Divide the weight of the items to be carried.
