Articles

Key takeaways

• Back pain is common due to softening ligaments and posture changes.
• Good posture, gentle exercise, and proper lifting can help.
• Supportive footwear and side sleeping are beneficial.
• Seek urgent help for severe pain or specific 'red flag' symptoms.

Why back pain is so common in pregnancy

Backache or back pain is very common during pregnancy.

The ligaments in your body naturally become softer and stretch. This prepares your body for labour.

This softening can strain the joints in your lower back and pelvis. This strain can then cause back pain.

Pregnancy also affects your posture. Your natural spinal curve increases to cope with the extra weight of your baby bump. This can also cause pain.

Many people find the pain is worse in the evening. It can also be worse after 28 weeks of pregnancy.

Some people with lower back ache also have pelvic girdle pain (PGP). This is also known as symphysis pubis dysfunction (SPD).

Tips for preventing and managing back pain

Maintaining good posture

The way you stand can make a big difference during pregnancy.

• Try not to stand in the same position for too long.
• Stand tall and keep your bottom gently tucked under.
• Keep your head lifted with your ears in line with your neck.
• Relax your shoulders back and down.
• Try not to slacken your back muscles.

When sitting, try not to slump on the sofa. Use cushions to support your back. Have your feet resting on the floor.

It may be more comfortable to lie on your side if you are watching TV or relaxing. Using a birthing ball may also help.

If you work in an office, set your computer screen just below eye level.

• Your keyboard should be at a comfortable height.
• Your forearms should be flat.
• Get up and move around regularly so you do not get stiff.
• You can ask for an occupational health assessment if you are an employee.

When feeding your baby, ensure you are comfortable and well-supported. Sit with your back well supported and straight. Put a small pillow or cushion behind your waist for lower back support, and make sure your feet can reach the floor.

Safe exercises and stretches

Tummy-strengthening exercises can help ease backache.

To do these exercises:

1. Start on all fours in a box position, with knees under hips and hands under shoulders. Keep your fingers facing forward and engage your abdominal muscles to keep your back straight.
2. Pull in your tummy muscles and raise your back towards the ceiling. Let your head and bottom relax gently forward, moving only as far as comfortable.
3. Hold for a few seconds, then slowly return to the box position. Ensure your back returns to a straight, neutral position without hollowing.
4. Do this slowly 10 times. Move your back carefully.

Pelvic tilt exercises can also help.

To do pelvic tilts:

1. Stand with your shoulders and bottom against a wall. Keep your knees soft.
2. Pull your tummy button towards your spine. This flattens your back against the wall.
3. Hold for 4 seconds, then release. Repeat up to 10 times.

You can also do pelvic tilts while sitting.

1. Sit tall in your chair with your feet flat on the floor.
2. Pull your tummy in towards your spine.
3. Flatten your back against the back of the chair.
4. Hold for 4 seconds, then release gently.
5. Repeat up to 10 times.

Low-impact exercise in pregnancy

Low-impact exercises like pilates and yoga can build muscles to support your back. They can also improve your posture, flexibility, and balance.

If you join a class, tell the teacher how many weeks pregnant you are. Choose a class specifically for pregnant people.

Exercising in water can also be helpful. The water will support your weight.

You could try swimming or an aquanatal class. Contact your local leisure centre to find out what they offer.

Proper lifting techniques

Bend your knees and keep your back straight when you lift or pick something up from the floor.

Try to balance the weight between two bags when carrying shopping.

Kneel or squat to do tasks near the floor, such as picking up toys or bathing your baby. Try to avoid bending your back.

Change a nappy on a raised surface. Never leave your baby unattended on a raised surface.

Keep your back straight when you push your pram or buggy. You can also carry your baby in a well-fitting sling.

Supportive footwear

Wear flat shoes to evenly distribute your weight. They should also have a fastening to keep them firmly on your feet.

Sleep positions

Try to avoid lying flat for long periods of time. It is better for your back and your baby to lie on your side. This is especially important after 28 weeks of pregnancy.

Sleeping on your side is much safer for your baby and helps to reduce the risk of stillbirth.

If you wake up for any reason during the night, check your position. Then go back to sleep on your side. If you nap during the day, pay the same attention to your sleep position.

Using pillows for comfort

You may find it more comfortable to have a pillow under your bump or between your knees. This can support your back and help you sleep better.

If you have pelvic girdle pain (PGP) or symphysis pubis dysfunction (SPD), sleeping on your side can be hard. The important thing is not to lie flat on your back.

You should try and find a way to be comfortable on your side. You can use a pillow behind your back or in a V-shape. You can also use a pillow to support your legs.

Keeping your legs level with a pillow might make it easier to sleep on your side.

Heat therapy

It is safe to use a heating pad or hot water bottle on your back during pregnancy. This can ease lower back pain. Do not use these on your bump.

Use heat packs or hot water bottles for a short amount of time. You may feel warmer than usual during pregnancy due to hormone changes.

Physiotherapy and support belts

Talk to your GP or midwife if your back is very painful. They may be able to refer you to an obstetric physiotherapist.

An obstetric physiotherapist can give you advice and suggest helpful exercises.

Your physiotherapist may recommend a pelvic support belt. These belts can help ease your pain and can be effective if used regularly for short periods.

When to seek help for your back pain

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.
• You also have a fever, bleeding from your vagina, or pain when you pee.
• You have pain in one or both of your sides, under your ribs. This could be a sign of a serious pregnancy condition related to high blood pressure (pre-eclampsia).

Call 999 or go to A&E immediately if you have back pain and:

• You lose feeling in one or both of your legs.
• You lose feeling in your bottom or genitals.