Pregnancy Back Pain: When to Worry

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Note: The Pregistry website includes expert reports on more than 2000 medications, 300 diseases, and 150 common exposures during pregnancy and lactation. For the topic Pain, go here. These expert reports are free of charge and can be saved and shared.

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When I was pregnant, it wasn’t until my second trimester that I began to experience back pain. It was a mild ache in my middle back, on the left side that persisted throughout (and beyond) my pregnancy. I did my very best, under the advice of my physician, to maintain my exercise regimen of stretching, yoga, and pilates, modifying the exercises to accommodate my growing belly. But still, the changes in my body caused me pain. This is not an uncommon occurrence for pregnant women.

It goes without saying that during pregnancy your body goes through tremendous changes. As such, you are pretty much guaranteed to have some pain here and there. Back pain is probably the most common pain complaint during pregnancy. But how do you know what’s normal and what’s not?

First Trimester

Very early in pregnancy, even before you start showing, your body prepares for what’s to come by releasing hormones like progesterone and relaxin. These hormones work to make your joints more flexible to accommodate for a growing fetus and eventually the birthing process, during which the joints of your pelvis need to stretch to allow the baby passage through the birth canal.

Unfortunately, the extra flexibility in your joints can also make it more easy for you to injure your back. Because of this, it is very important to continue strengthening the core muscles in your abdomen and back. Strong core muscles can give your joints more stability. With your doctor’s OK, core strengthening exercises can be performed at any stage of pregnancy. Some great ones include pelvic tilts while lying on your back, the prone plank (on your hands or elbows), and the side plank (on your hand or elbow, with or without the support of your bottom knee).

Second and Third Trimesters

As you move from the first trimester to the second and third, your body will change in more noticeable ways. You’ll feel your clothes getting tighter and you may feel more uncomfortable just sitting or lying in bed. This is because your uterus is expanding to accommodate a rapidly developing fetus. Your center of gravity begins to shift forward and your back will sway more in the opposite direction to provide a counterbalance to your quickly rounding stomach. Having a strong core will help you maintain a healthy posture and protect against back pain.

How to Prevent Back Pain in Pregnancy

In addition to keeping your core muscles strong, there are several more ways to prevent back pain during pregnancy. First, avoid heavy lifting, especially repetitive heavy lifting. If you must lift something heavy, remember to bend at your knees instead of bending over at the waist. Second, avoid standing for long periods of time. This puts a strain on your core muscles and makes it more difficult to maintain proper posture. If you do have to stand for a prolonged period, make sure you are wearing comfortable shoes. Third, when sleeping on your side, try placing a pillow between your legs and a pillow behind your back for extra support. Fourth, you may consider trying a pregnancy support belt. You may find this especially useful in the later stages of pregnancy when your belly is a its largest and when you are at your most exhausted. It is very important to remember NOT to take any pain relief medication without the permission of your doctor.

Ways to prevent back pain in pregnancy:

  • Strengthen core muscles by exercising regularly (with your doctor’s permission)
  • Avoid heavy lifting, especially repetitive heavy lifting
  • Avoid standing for long periods of time
  • Avoid wearing high heels
  • Sleep with a pillow between your knees
  • Sleep with a pillow supporting your back
  • Try a pregnancy support belt in the later stages of pregnancy
  • Do NOT take any pain relief medication without your doctor’s permission

You can check out some more strategies for preventing back pain here.

When to Worry

According to the American College of Obstetricians and Gynecologists, you should contact your doctor if you are experiencing back pain for more than two weeks during your pregnancy. Back pain could be a sign of a urinary tract infection, which can be easily managed with proper medications. Additionally, back pain in the third trimester could be associated with preterm labor. If you think this may be the cause of your back pain, contact your physician right away.

For more information about pain in pregnancy, visit the expert report here.

Janette DeFelice
Dr. Janette DeFelice is a writer currently focusing on how the changing environment affects our health. She holds a Doctor of Medicine degree from Chicago Medical School where she taught clinical and diagnostic skills to beginning medical students, and a Master’s degree in Humanities from the University of Chicago. She also has a Bachelor’s degree in Political Science. Her writing can be seen online at BeTheChangeMom, ChicagoNow, and Medium, and she’s very excited to have published her first novel, Delia Rising: A Ballet in Three Acts. She lives in Chicago’s west suburbs with her school-age twins, her husband, and a family cat named Clara Barton.

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