How Do I Relieve Back Pain During Pregnancy?

Is back pain during pregnancy common?

A study published in 2023 found that 40.5% of pregnant women experience back pain.  28.3% in the first trimester, 36.8% in the second trimester, and 47.8% in the third trimester¹. A study looking at Indian women specifically, found that 80% of pregnant women reported back pain⁵. Although back pain during pregnancy occurs often, it doesn’t need to be normalised. Studies show that movement and exercise can significantly decrease back pain during pregnancy²³⁴. It’s important to note that various types of pain surrounding the back are common during pregnancy. Pregnancy related back pain involves pain that starts at the low back and can travel all the way down to the foot. Pelvic girdle pain starts in the joints of the pelvis, travels down but stops at the knee. It’s possible to have both or confuse one with the other! Make sure your pelvic floor physiotherapist is asking all the right questions to understand the specific region you’re experiencing pain, because treatment can differ. 

 

Why do pregnant women experience back pain?

Pregnant women experience back pain for a variety of reasons, here are some: 

1. Hormonal changes - The hormone relaxin increases how loose your ligaments are, which can cause pain. However, relaxin levels are at their highest during the first trimester, which is often the time when women experience the least amount of pain. Hormonal changes actually tend to affect how sensitive women’s bodies are to pain, increasing the likelihood that they feel and are limited by pain. 
2. Stress - Anxiety and stress during pregnancy is extremely common, as women experience changes in bodies, thoughts about motherhood, worry about the baby, the list can go on. Stress is known to increase pain and inflammation in the body!
3. Changes in posture - As the baby grows, it changes the pressure on the spine, pelvic floor, and legs. This can create muscle imbalances, causing pain and discomfort. That’s why seeing a pelvic floor physiotherapist can help significantly, because they can help you strengthen and stretch in areas to decrease pain and offset the new changes. 
4. Discontent at work and the belief that the pain won’t get better - These factors might seem surprising, but research shows they’re actually major factors in why women experience pain! It’s essential to find a practitioner who won’t brush off your pain and instead help you try to improve it. 
5. Lack of sleep - Fatigue and not getting enough sleep can play a huge role in how a woman’s body experiences pain. It’s important to optimise sleep and focus on quality sleep. Our pelvic floor physiotherapists take this into consideration and can help you find strategies on how to improve your sleep to decrease your pain. 

What’s the solution?

For women experiencing pregnancy related back pain, there is hope! Various methods can help decrease the pain, so that the chance of experiencing similar pain during postpartum comes down. 

1. Exercise - any type of consistent exercise focused on movement, rotations, and strengthening is shown to decrease back pain. Swimming or walking in the pool can be extremely beneficial as well! It is completely safe to exercise during your pregnancy - unless specified by your doctor. Working with a pelvic floor physiotherapist can be extremely beneficial for anyone nervous about exercising or new to it. 
2. Manual Therapy - soft, gentle massage and release of tension points can be beneficial in relieving pain (although this is not a permanent solution). It’s important to work with a pelvic floor therapist who focuses on active movement in conjuction with tension release. 
3. Support belts - These can be extremely helpful, especially in the third trimester. Support belts help to relieve some of the pressure the baby’s weight is putting on your low back and pelvis. 
4. Mental health therapy - As we mentioned above, stress and anxiety can contribute to the pain a woman experiences during pregnancy. Addressing these feelings helps to relieve the mental pain someone might be going through, which then relieves the physical pain. Our mental health therapists are experienced in treating both pregnant and postpartum women. 
5. Relaxation strategies - Tension in your body leads to increased pain. It’s important that your pelvic floor physiotherapist is giving you tools you can reach towards to relax your body and decrease your pain. 
   
    

Conclusion: 

Although back pain during pregnancy is common, there is a non-medicinal way to help treat it and decrease the likelihood of it returning during postpartum. It’s important for women to know they don’t have to suffer in pain. The sooner you get treated for back pain, the higher chance you have of a better quality of life. At Proactive for Her, we have expert pelvic floor physiotherapists who treat women as a whole person, looking at all aspects of their lives in order to decrease pain in the most holistic way possible. If you or someone you know is suffering from pregnancy related back pain, make sure to reach out to one of our experts!

1. Salari N, Mohammadi A, Hemmati M, et al. The global prevalence of low back pain in pregnancy: a comprehensive systematic review and meta-analysis. BMC Pregnancy Childbirth. 2023;23(1):830. Published 2023 Dec 2. doi:10.1186/s12884-023-06151-x
2. Richards E, van Kessel G, Virgara R, Harris P. Does antenatal physical therapy for pregnant women with low back pain or pelvic pain improve functional outcomes? A systematic review. Acta Obstet Gynecol Scand. 2012 Sep;91(9):1038-45. doi: 10.1111/j.1600-0412.2012.01462.x. Epub 2012 Jul 2. PMID: 22583125.
3. Davenport MH, Marchand AA, Mottola MF, Poitras VJ, Gray CE, Jaramillo Garcia A, Barrowman N, Sobierajski F, James M, Meah VL, Skow RJ, Riske L, Nuspl M, Nagpal TS, Courbalay A, Slater LG, Adamo KB, Davies GA, Barakat R, Ruchat SM. Exercise for the prevention and treatment of low back, pelvic girdle and lumbopelvic pain during pregnancy: a systematic review and meta-analysis. Br J Sports Med. 2019 Jan;53(2):90-98. doi: 10.1136/bjsports-2018-099400. Epub 2018 Oct 18. PMID: 30337344.
4. Lingxiao Chen, Manuela L Ferreira, Paula R Beckenkamp, Eduardo L Caputo, Shiqing Feng, Paulo H Ferreira, Comparative Efficacy and Safety of Conservative Care for Pregnancy-Related Low Back Pain: A Systematic Review and Network Meta-analysis, Physical Therapy, Volume 101, Issue 2, February 2021, pzaa200, https://doi.org/10.1093/ptj/pzaa200
5. Saxena AK, Chilkoti GT, Singh A, Yadav G. Pregnancy-induced Low Back Pain in Indian Women: Prevalence, Risk Factors, and Correlation with Serum Calcium Levels. Anesth Essays Res. 2019;13(2):395-402. doi:10.4103/aer.AER_196_18