Back Pain After Pregnancy
Persistent or newly developed pain in the lower back after pregnancy, also known as postpartum back pain, usually lasts for 6 months but may continue up to a decade.1,2 Postpartum back pain mostly occurs while performing activities that involve body movements,3 such as walking, lifting, bending, and/or carrying the new baby, and may be relieved with rest, exercise, and home treatments. The type and severity of pain depend on the underlying cause.
This page discusses the various causes and types of postpartum back pain and when medical attention may be warranted.
What Are Some Causes Of Back Pain During Pregnancy
There are several reasons why you may experience back pain during pregnancy. Sone of the most common causes include:
- Weight gain: As you gain weight during pregnancy, the spine has to support that added weight. That change causes lower back pain. The weight of the growing baby and uterus can also put pressure on the blood vessels and nerves in the pelvis and back, causing pain.
- Changes in hormones: During pregnancy, your body releases a hormone called relaxin that allows ligaments in the pelvic area to relax and joints to loosen in preparation for giving birth. The hormone can cause ligaments that support the spine to loosen as well. This, along with the shifting of joints, can lead to instability and pain.
- Changes in posture: Poor posture, excessive standing or sitting, and bending over can trigger or increase your back pain. In addition, while youre pregnant, your center of gravity shifts forward as your uterus and baby grow, causing your posture and the way you move to change. This can result in strain and pain.
- Stress: Stress can cause muscle tension in the back, resulting in back pain or back spasms. You may experience an increase in back pain during stressful periods of your pregnancy.
- Chronic back pain prior to pregnancy.
Find The Proper Shoes
You may be a fashion maven who receives regular compliments on your maternity style, but if you’re wearing high-fashion shoes, you’re not doing your back any favors. “High heels increase the curvature of your back and create pressure” that drives the weight of your pregnancy directly into your lower spine and hip joints, Dr. Rosser says. You may also lose your balance and heels cause you to be less stable.
But walking in flats isn’t the answer either, because they leave your feet, which tend to spread during pregnancy because of hormonal changes, unsupported. Poor foot position can manifest itself as imbalance and pain all the way up your legs and back. To get the best support-and to relieve the most pressure-Dr. Rosser advises a low-heeled shoe that is comfortable with either a built-in arch support or an orthotic insertion. The slight rise of the low heel will help distribute the weight that’s on your legs in a more stable and back-supportive way.
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You Have Vaginal Bleeding Or Uterine Tightening
Sometimes back pain is a red flag that something serious is going on. Among the most worrisome causes of pregnancy back pain is preterm labor. Dr. Rosser advises watching for pain that is “new” and “cyclical,” which could be a sign of uterine contractions, along with vaginal bleeding or any change in vaginal discharge that could indicate a placental issue or an early rupture of your waters.
Damla Karsan Dryden, M.D., an OB-GYN at Texas Children’s Pavilion for Women in Houston, tells patients to watch for an abdominal sensation that might be described as a “tightening uterus,” which could be painless or feel like mild, period-like cramping. If this sensation is accompanied by back pain that comes and goes at regular intervals, uterine contractions could be happening this could possibly signify preterm labor.
Although a person in this situation can take the recommended dose of acetaminophen and rest on their side for a bit, if the back pain is severe and is not relieved with rest and pain medicine, they should contact their health care provider, advises Dr. Dryden.
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When To See A Doctor
Back pain that does not subside with rest or home treatments, such as a massage, heat therapy, or gentle stretching and exercise, and/or pain that progresses over time may require medical attention. As a general rule, troubling symptoms, such as newly occurring numbness or weakness in the leg or worsening of previous leg pain and numbness symptoms, must be reported to a doctor.
See Management of Back Pain in Pregnancy
A doctor can accurately diagnose the underlying cause of the pain and formulate a treatment plan. For breastfeeding mothers, it is advisable to consult a doctor before taking any pain-relieving medication. The type and dosage of pain-relieving medications vary, and not all over-the-counter medications are safe while breastfeeding.
Postpartum back pain may be a continuing symptom of pregnancy or develop as a new symptom after labor and delivery.9 Failure to adequately treat the symptoms may lead to chronic pain, affect daily functioning, and reduce the overall quality of life. Women are encouraged to seek medical attention to relieve the symptoms and address the underlying problem. Having a pain-free back after labor and delivery will help new mothers care for their newborn more effectively and enjoy the early phases of motherhood.
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Back Pain During Early Pregnancy
Back pain during early pregnancy is, unfortunately, extremely common. The joy of carrying a baby can often be marred by it, even during the first trimester before the baby bump starts to show. Why is this, and what can be done to alleviate the pain?
Mr Bob Chatterjee, an expert Consultant Spinal Surgeon, tells us that the typical back pain during pregnancy comes in later months, when the baby bump shifts your posture a bit further forward. As you might expect, this would put pressure on the muscles of your back. However, many women do unfortunately experience back pain in early pregnancy as well, before any visible sign of a bump appears.
Unfortunately weve also noticed that avoiding chocolate may help to avoid back pain during early pregnancy.
Back pain often accompanies pregnancy and, as Bob says this isnt always easy to treat. Its fair to say that you should expect some degree of back pain during pregnancy, and one saving grace is the bodys natural painkillers the endorphins will kick in and help to relieve it to a degree.
Tips For Back Pain Relief At Home
There are plenty of ways you may be able to ease your pregnancy back pain without medical intervention. Heres where to start:
Pay attention to your posture. When you stand up, make sure with your shoulders held back. If you have to remain standing for an extended period, elevate one foot on a box or stool to relieve the pressure on your back. Try to avoid standing for too long, however, and remember to take regular breaks to get off your feet.
Speaking ofmaintain good posture when youre sitting down, too. Find ergonomic chairs both at home and at work that will support your back. You may want to purchase a small cushion or pillow to place behind your lower back, along with a stool or footrest for elevating your feet.
Dont lift anything too heavy, either, and avoid bending at the waist to hoist items up off the floor. Instead, you should squat, bend your knees, and lift with your legsand never with your back.
Exercise. may help prevent and ease back pain, in addition to all its other benefits. The best time to start is prior to conception. Simple exercises before you get pregnant to improve core strength will help a lot, as will being as close to a healthy weight as possible before pregnancy, which has the additional benefit of reducing pregnancy risks and cesarean delivery risk, Dr. Meyer says.
Yoga can be a safe, helpful form of exercise when you’re pregnant.
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Path To Improved Well Being
There are several causes of back pain during pregnancy. These are due to changes that occur in your body.
Pressure on back muscles
As your baby grows, your uterus expands and becomes heavier. This puts added weight on your back muscles. You may find yourself leaning backward or arching your low back. The pressure can lead to back pain or stiffness.
Weakness in stomach muscles
Your growing baby also puts pressure on your stomach muscles. This can cause them to stretch and weaken. Your stomach and back muscles are connected. Your back muscles have to work harder to offset your belly.
Pregnancy can alter your center of gravity. The way you move, sit, and stand can cause pain to your back and other parts of your body. A compressed nerve due to poor posture also can cause pain.
Many hormones change when you are pregnant for different reasons. Later in your pregnancy, hormones increase to relax the muscles and ligaments in your pelvis. This prepares your body for labor. If your muscles and ligaments become too loose, it can lead to back pain.
Anxiety and built-up tension can make your back muscles tight or stiff.
To help prevent back pain, be mindful of how you sit, stand, sleep, and move.
If you have back pain, these tips can help relieve soreness and stiffness.
Get A Prenatal Massage
A certified prenatal massage therapist can bring quick relief when back pain is acute, especially when it’s the result of muscular clenching that irritates nerves and sends pain signals to the brain. Research has shown that in addition to relieving pain, regular prenatal massage can help alleviate depression and anxiety in pregnancy.
Swedish massage is the most common and advisable method of prenatal massage because it is gentle and soothing, and it uses long, smooth strokes that won’t aggravate the joints or push fluid through the body in an unhealthy way. Women should first consult with their doctors to make sure prenatal massage is safe and then make sure the prenatal massage therapist is certified. To be comfortable on the massage table, a side-lying position is usually best.
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Treatments For Back Pain In Pregnancy
More good news: Unless you had chronic backaches before you got pregnant, your pain will likely ease gradually before you give birth.
Meanwhile, there are many things you can do to treat low back pain or make it rarer and milder:
- If you need to pick something up from the ground, use your legs to squat rather than bend over.
- Don’t wear high-heeled shoes. Choose low-heeled shoes with good arch support. Remember, as hormones loosen joints, you may need to buy a larger shoe size.
- Don’t sleep on your back.
- Wear support hose.
If your back pain persists, you may want to consult your doctor to see what else you might try. Be sure to consult your doctor before taking pain medications. Acetaminophen is safe for most women to take during pregnancy. Aspirin and other nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen are not advised. In some cases, your doctor may recommend other pain medicines or muscle relaxants that are safe during pregnancy.
How To Prevent Back Pain During Pregnancy
Carrying around extra weight for nine months can put extra strain on the spine, and chemicals released during pregnancy can also contribute to back pain. Back pain is a very common ailment for pregnant women, which can prevent healthy sleep and regular movement, which is important for both mother and baby.
The ligaments in the pelvis and lower back naturally stretch during pregnancy, to prepare the body for birth. This can put pressure on the joints which then becomes backache, and some expectant mothers also suffer from pain in the pelvic area. See below for some highly recommended ways to safely relieve back pain during pregnancy.
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When To Worry About Pregnancy Back Pain
Low back pain that’s worse when you’re standing but eases once you sit or lie down is considered normal during pregnancy. But talk to your doctor if the pain starts to radiate down your legs into your calves or feet interferes with daily activities or causes fever, chills,weight loss, weakness, or sensory issues.
When To Call Your Healthcare Provider
While some low back pain and discomfort are normal during pregnancy, there will be instances where you should reach out to your obstetrician or another healthcare professional.
Contact your healthcare professional for the following low back symptoms:
- Any severe pain in your back
- Low back pain that lasts more than two weeks
- Low back pain accompanied by abdominal cramping that gets gradually worse
- Pain or other difficulties with urinating
- Numbness or tingling in the legs
- Vaginal bleeding
- Any abnormal vaginal discharge
- Fever and/chills
These symptoms are concerning and require immediate medical attention. Back pain in pregnancy might be a sign of preterm labor or a urinary tract infection. If back pain is accompanied by vaginal bleeding, fever, or burning with urination, you should reach out to your healthcare provider right away.
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How To Reduce Back Pain
You can prevent back pain or reduce it by:
- wearing comfortable, supportive, low-heeled shoes
- not standing for long periods of time
- sitting with your bottom against the back of a chair and sitting up tall – put a small cushion at your lower back if needed
- tucking your hands under your bump for support if standing for long periods
- not lifting heavy objects – if you need to lift anything, bend your knees and keep a straight back
- staying active with gentle exercises and stretching
- being aware of your posture
Back Pain During Pregnancy
Back pain or discomfort is common during pregnancy and should be expected to some degree by most women. Back pain may be experienced during any point of your pregnancy however, it most commonly occurs later in pregnancy as baby grows.Back pain can disrupt your daily routine or interfere with a good night of sleep. The good news is there are steps you can take to manage the back pain that you experience.
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Is Pregnancy Back Pain The Same As Sciatica
It can be. If youre feeling sharp, shooting pain that starts in your back or buttocks and radiates down your legs, you may be experiencing sciatica.
The good news about back pain during pregnancy is that it’s usually as resolvable as it is common. Plus, there are many ways to relieve it so if one solution doesnt work, another probably will.
Book A Physical Therapy Appointment
Physical therapists, in addition to treating acute injuries, help pregnant women work through back pain by manipulating joints, muscles, and nerve pressure points and providing exercises that expectant moms can continue at home. Rick Olderman, M.S.P.T., a Denver-based physical therapist and the author of Fixing You: Back Pain During Pregnancy, says that one of his goals is to educate patients by “teaching them how to walk, sit, stand, bend forward, lie down, and exercise” in a healthy, back-supporting way.
One thing he does is placing tape on the backs of pregnant women’s knees to “remind them to unlock their knees,” a habit that can put pressure on the large muscles of the legs and hip joints and the back, he says. Because women’s joints become lax as a result of hormonal changes, Olderman also helps show women the importance of limiting their joints’ ranges of motion to about 75 percent. “It may feel good to stretch, but the tissue stress becomes greater,” he says, and can actually exacerbate pain. Some health insurance plans cover physical therapy, which is not always the case with other complementary therapies.
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Strap On A Maternity Belt
If you have pelvic girdle pain around your middle lower back and hips, a maternity belt may relieve your pain. This support garment does the work of the ligaments, muscles and fascia of the girdle area, explains Richter. But, she cautions, it should not be worn all of the time, because those muscles will stop working and will need to be retrained after you have your baby. I usually recommend that clients wear them during more taxing activitiessuch as activities with lots of bending, lifting, walking or standingjust so theyre not in discomfort, she explains. And then I give them exercises to try and resolve the issue.
Mickeler warns against wearing the belts too tightly, which can contribute to pelvic organ prolapse. Because of this, its best to have a practitioner guide you on how to use one.
Focus On Your Posture
As your uterus expands, the way you stand and walk may change. Your body is naturally accommodating for the shift in your center of gravity and the laxity of your ligaments. At night, you may be most comfortable sleeping on your side with a pillow between your legs. Also, your lower back might curve more inward while your pelvis tips forward. To straighten up, work on regularly strengthening your pelvic floor and core muscles.
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Ergonomically Supported Sleep Positions Reduce Mechanical Strain In The Lower Back
A side-sleeping posture with the use of appropriate supportive pillows is recommended in pregnancy.
- Using a pillow between the knees and ankles while sleeping brings the top of the knee at the same level as the hip, reducing strain on the lower back.1
- Placing a vertical pillow near the abdomen and upper body can help support the top arm and chest area.1
The head and neck may be supported by a small rolled-up towel placed under the neck inside the pillowcase.
See Best Pillows for Different Sleeping Positions