What causes back pain in pregnancy

Backache is extremely common in the middle to late stages of pregnancy. It’s caused by many factors but is largely due to strain on the ligaments and muscles of your back. Indeed, the extra weight of the baby in your womb shifts your center of gravity forwards meaning that the way you stand/walk and your posture are affected. Pregnancy hormones also soften the ligaments around your back and pelvis to create room for the growing baby and in preparation for labour, leaving your back less supported.

Much like pelvic girdle pain in pregnancy, there are a few tips that may help relieve the pain. However, until you have delivered your baby, there is very little that can be done to relieve the pain completely. That said, the following may help:

• Keep active by a brisk walk or doing light exercises such as yoga
• Avoid sitting in the same position for prolonged periods
• Avoid lifting heavy loads (including toddlers)
• When sitting, use a cushion or a rolled-up towel to support your lower back
• Take warm baths
• Wear flat and well-cushioned shoes as these allow your weight to be evenly distributed
• Work at a surface high enough to prevent you stooping
• Use a firm mattress as this can help prevent or relieve backache

If your backache continues and is severe, seek advice from your midwife or GP. They may discuss taking simple painkillers with you (e.g. paracetamol) and may also refer you to a physiotherapist for assessment.

NICE (The National Institute for Health and Care Excellence) advises that exercising in water, massage therapy, and group or individual back care classes might help with symptoms of backache.

Some local swimming pools provide aquanatal classes with qualified instructors. You could enquire at your local swimming pool. Exercising in the water will support your weight, thus allowing you to move more freely.

Exercises to ease backache in pregnancy

NHS Choices recommends the exercises below to help to strengthen abdominal muscles and thus ease backache in pregnancy:

• Start in a box position (on all fours) with knees under hips, hands under shoulders, and fingers facing forwards and abdominals lifted to keep your back straight
• Pull in your stomach muscles and raise your back up towards the ceiling, curling your trunk and allowing your head to relax gently forward – don’t let your elbows lock
• 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
• Do this slowly and rhythmically 10 times, making your muscles work hard and moving your back carefully
• Only move your back as far as is comfortable

Main points

• Backache in pregnancy is very common.
• Pregnancy backache has many causes but is largely caused by the extra weight of the baby together with softening of your ligaments caused by pregnancy hormones.
• Backache is likely to persist throughout pregnancy no matter what you do. However, some steps can be taken to lessen the severity of pain.
• Keep active, don’t lift heavy loads, wear sensible shoes, and sleep on a firm mattress to potentially reduce the severity of backache.
• See your GP or midwife for cases of severe or persistent backache.
• NICE (The National Institute for Health and Care Excellence) advises aqua exercise, massage therapy, and group or individual back care classes to help ease the symptoms of backache.
• Strengthen abdominal muscles to reduce the scope for backache.

References

Liddle SD, Pennick V; Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database Syst Rev. 2015 Sep 30 9:CD001139. doi: 10.1002/14651858.CD001139.pub4.
WHO recommendations on antenatal care for a positive pregnancy experience; World Health Organization, 2016