Back Pain During Pregnancy
Overview
Back pain in pregnancy is very common, affecting an estimated 50 percent to 80 percent of pregnant women.
It can range from mild pain associated with specific activities to acute pain that becomes chronic.
About 10 percent of the time the pain becomes so severe that it can interfere with the ability to work or carry out normal activities during pregnancy.
Studies show that lower back pain usually occurs between the fifth and seventh months of being pregnant, although in some cases it begins as early as eight to 12 weeks.
Women with pre-existing lower back problems are at higher risk for back pain, and their back pain can occur earlier in their pregnancy.
Symptoms
Lumbar pain during pregnancy is generally located at and above the waist in the center of the back, and it may be concurrent with pain that radiates into the woman's leg or foot.
Posterior pelvic pain (in the back of the pelvis) is four times more prevalent than lumbar pain in pregnancy. It is a deep pain felt below the waistline, on one or both sides or across the tailbone.
Causes and Risk Factors
Increase of hormones — Hormones released during pregnancy allow pelvic-area ligaments to soften and joints to loosen in preparation for the birthing process. This change may affect the support your back normally experiences.
Center of gravity — Your center of gravity will gradually move forward as your uterus and baby grow, which causes your posture to change.
Additional weight — Your developing pregnancy and baby create additional weight that your back must support.
Posture or position — Poor posture, excessive standing and bending over can trigger or escalate back pain.
Stress — Stress usually accumulates in weak areas of the body. Because of the changes in your pelvic area, you may experience an increase in back pain during stressful periods of your pregnancy.
Diagnosis
Diagnosis of back pain during pregnancy is based on a review of the patient’s medical history, a physical examination and possibly an MRI, to rule out a herniated disk. No X-ray or CT scan will be performed because these procedures use radiation.
Treatment
Watch your posture when you are sitting. Lounging in a chair all day puts more strain on your spine than anything else. At home and at work, make sure the chairs you use most provide good support, preferably with a straight back, arms and a firm cushion. Use a footrest to elevate your feet slightly, and don't cross your legs. That can cause your pelvis to tilt forward, exacerbating those strained back muscles.
Take breaks. Walk or stand and stretch at least once an hour. Sitting too long can make your back hurt even more. Try not to stand too long either. If you work on your feet, try to place one foot on a low stool to take some pressure off your lower back.
Avoid lifting heavy loads. If you must, do it slowly. Stabilize yourself by assuming a wide stance; bend at the knees, not at the waist; and lift with your arms and legs, not your back.
Watch your weight.
Wear the right shoes. Extremely high heels are out, as are completely flat ones. Experts recommend a 2-inch heel to keep your body in proper alignment.
No reaching. Use a low, stable step stool to get items from high places and you’ll avoid additional strain.
Think happy thoughts. A calm mind leads to a looser back. You can also try some prenatal yoga, which will relax both your mind and your back.
Physiotherapy, yoga, exercise (walking, biking and swimming) are all considered safe for most pregnant women and can be performed for 20 to 45 minutes, three to five days a week. Pregnant women should take care to exercise at a mild to moderate level, but not to the point of exhaustion.
Strengthen your stomach. Do pelvic tilts to strengthen your abs, which in turn support your back. Or sit on an exercise ball and rock back and forth.
Go hot and cold. Soothe sore muscles by applying cold compresses, then warm compresses in 15-minute intervals.
Take a warm bath. Or turn the showerhead to pulsating to massage your back.
Get a massage. Wait until after the first trimester to get one. Go to a masseuse who knows you’re pregnant and is trained in the art of prenatal massage.
Always Talk to Your OB
Sometimes back pain is a red flag that something serious is going on. Among the most worrisome causes of pregnancy back pain is preterm labor. Women should watch for pain that is new and cyclical — which could be a sign of uterine contractions — along with vaginal bleeding or any change in vaginal discharge that could indicate a placental issue or an early rupture of your waters.
If you experience numbness, tingling or a sharp, shooting pain in your buttocks, legs or feet, call your doctor to make sure there are no serious conditions. Even though the cause of numbness is usually not a more worrisome condition, such as preterm labor, it could signify compression of the sciatic nerve or other nerves that connect your spine to the lower body and pelvic area.
Pregnant women should always consult with their healthcare professional before taking any prescription or over-the-counter medicine. Women taking pain medicines who are considering becoming pregnant should also consult with their healthcare professionals to discuss the risks and benefits of pain medicine. Healthcare professionals should continue to follow the recommendations on the drug labels when prescribing pain medicines to pregnant patients.
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