Backache is a common experience during pregnancy, often localized in the lower back or pelvic region. This discomfort can range from a dull ache to more intense pain. While common, its onset and severity vary considerably.
When Back Pain Typically Begins
Some individuals experience back pain early in pregnancy, even in the first trimester (8 to 12 weeks), as the body adapts to hormonal changes. This early onset is less common. For many, back pain becomes more noticeable as pregnancy progresses into the second and third trimesters. The increasing weight of the growing uterus and baby places more strain on the back and pelvis. Most pregnant individuals will experience some form of back discomfort by the late second or third trimester.
Factors Contributing to Pregnancy Backache
Hormonal Changes
The release of relaxin, a hormone that loosens ligaments and joints throughout the body, particularly in the pelvic area, is a primary factor. While this aids childbirth, it can also lead to instability in the lower back and pelvic joints, causing pain.
Weight and Postural Shifts
The increasing weight of the growing fetus and uterus strains the muscles and ligaments of the back. This additional weight pulls the center of gravity forward, leading to compensatory changes in posture. As the abdomen expands, pregnant individuals often unconsciously lean backward, increasing the arch in their lower back.
This altered posture, known as lordosis, further stresses the lumbar spine and surrounding muscles. The abdominal muscles, which typically support the spine, become stretched and less effective during pregnancy. This combination of ligamentous laxity, increased weight, and postural adjustments places significant demand on the back.
Managing Discomfort
Maintaining good posture; standing tall with shoulders back and avoiding excessive arching of the lower back can reduce strain. When sitting, using a small pillow or rolled towel behind the lower back can provide additional support and encourage proper spinal alignment.
Regular, gentle exercise tailored for pregnancy can strengthen core muscles and improve flexibility. Activities like prenatal yoga, swimming, or walking can help maintain muscle tone and reduce stiffness without putting undue stress on joints. Specific stretches for the back and hips can also offer relief by improving circulation and flexibility.
Applying heat or cold therapy to the affected area can soothe sore muscles. A warm bath or a heating pad set to a low temperature can relax tense muscles, while a cold pack might help reduce inflammation. Using supportive maternity pillows, especially when sleeping, can also make a difference by providing proper alignment for the hips and spine. Wearing supportive, low-heeled shoes can distribute weight more evenly and reduce pressure on the back. Considering ergonomic adjustments at work or home, such as using a supportive chair or adjusting desk height, can also minimize prolonged strain.
Signs to Discuss with Your Doctor
While backache is common in pregnancy, certain symptoms warrant immediate discussion with a healthcare provider. Severe back pain that is sudden in onset or incapacitating should be evaluated promptly. Pain accompanied by fever, chills, or a burning sensation during urination could indicate an infection, such as a urinary tract or kidney infection.
Any back pain associated with vaginal bleeding, abdominal cramping, or regular contractions, particularly before 37 weeks, should be reported immediately. These symptoms could be signs of preterm labor or other complications. Numbness, tingling, or weakness in the legs, or pain radiating down one or both legs, may suggest nerve compression and requires medical assessment.