- Up to 80% of people experience back pain while pregnant, and about a third have severe pain.
- Untreated back pain can get worse, affect sleep, and complicate daily life, even after delivery.
- Gentle physical activity, supportive shoes and clothing, acupuncture, and massage can offer relief.
- Visit Insider's Health Reference library for more advice.
If your back has become a source of pain during pregnancy, you're not alone — anywhere from 50% to 80% of people experience this symptom at some point in pregnancy.
Most pregnancy-related back pain is located in the lower, or lumbar, region and will often radiate to the buttocks, legs, pelvis and other sacroiliac regions. You might also feel pain in your upper back or shoulders, but this is less common, says Apurva Shah, an OB-GYN at Saint Vincent's Hospital and medical advisor for Mira.
For some people, back pain in pregnancy is no more than a minor annoyance. But according to 2019 research, about a third of people experience back pain severe enough to disrupt daily life and routines. Potential complications of pregnancy-related back pain include:
- Needing to modify a job or stop working
- Challenges with daily household tasks
- Trouble sleeping
- Difficulty caring for young children
Back pain in pregnancy is common, and you have plenty of options for relief. Here, you'll learn more about how pregnancy causes back pain and what you can do to manage it.
When does back pain start in pregnancy?
Back pain can set in as early as the first trimester but is more common in the second and third trimesters — between five and seven months of pregnancy.
While anyone can experience back pain in pregnancy at any time, some factors could make it more likely:
- History of back pain. You may be twice as likely to experience back pain during pregnancy if you already have a condition that causes chronic back pain.
- Back pain in a previous pregnancy. About 85% of people who experience back pain in one pregnancy may also have it in a later pregnancy.
- Activity level. Both too much and too little physical activity are linked to higher chances of back pain in pregnancy. Specifically, having a sedentary or physically demanding lifestyle can raise your risk.
- Anxiety. A 2012 study found higher levels of anxiety could make you more likely to develop low back pain during pregnancy.
- Hypermobility. Joint hypermobility, or being "double jointed," was found to be more common in people with pregnancy-related back pain in a 2006 study.
- Body mass index (BMI). A higher BMI could contribute to back pain in pregnancy, but more research is needed to confirm this link.
Activities that put extra stress on your joints, such as lifting heavy objects or lifting in a way that places more strain on your back could also bring on the pain sooner.
Common causes of back pain in pregnancy
It's common knowledge that pregnancy changes a lot about your body, both inside and out. A few of these changes contribute to back pain. Pregnancy hormones play a key role, but so do weight gain and environmental factors related to pregnancy, like stress.
1. Hormones
In early pregnancy, your body starts producing more of the hormone relaxin, which loosens your joints and supports many of the changes your body undergoes during pregnancy. For example, it may act on your ligaments, allowing the body to expand for pregnancy and childbirth.
As relaxin loosens your joints, it can cause misalignment and pressure on the lower back as your spine arches forward with extra weight, says Tracy Shevell, an OB-GYN with Sesame Care.
Slouching or sitting in ways that put uneven stress on your muscles or joints — such as crossing your legs — could worsen this type of pain.
2. Weight gain
It's common to gain 20 to 40 pounds during pregnancy. Weight gain during pregnancy can cause back pain in a few ways:
- Weight gain all over your body could add more stress to your joints, resulting in back pain.
- The increased weight and size of your breasts during pregnancy may put more strain on your upper back and shoulders.
- In the later stages of pregnancy, the extra weight in your abdomen from the infant, amniotic fluid, and placenta can increase the strain on your lower back.
3. Changes in posture
As your uterus grows from the size of a fist to the size of a pumpkin, your center of gravity shifts forward. "To compensate for this forward pull, the back muscles work overtime, which contributes to back pain," says Shah.
As you shift to accommodate this weight, it can negatively impact your posture and cause further pain.
4. Stress
"Stress can lead to muscle spasm and tension and exacerbate already-problem-areas," says Shevell.
A small 2013 study linked higher levels of stress in early pregnancy to higher chances of back pain during pregnancy. Researchers suggest this may be because emotional distress can worsen the physical experience of pain.
In short, you may be more likely to experience back pain during pregnancy if you:
- Have a mental health condition that makes it harder to manage stress.
- Live with environmental stressors like the demands of a fast-paced job or caring for young children.
How to get relief
Persistent back pain during pregnancy can make daily life tougher, but these expert-approved tips could help you manage it.
1. Try some support gear
Some of the following support devices could help you reduce pregnancy-induced back pain, says Shevell:
- Belly bands to support your growing uterus
- Lumbar back support pillows to manage back strain
- Pregnancy pillows to help you sleep with less discomfort
- Blocks to support your feet while sitting
- Back-supporting garments to improve posture
- A correctly fitting bra to take some of the extra burden off your back and reduce pressure on your lower spine
Shoes are another clothing item to consider when it comes to managing back pain. While wearing comfortable shoes can always help support your back, "high-heeled shoes are considered anti-supportive and should be moved to the back of your closet for a while," says Shevell.
While a small 2015 study does suggest support belts could help reduce low back pain and make movement less uncomfortable during pregnancy, more research is necessary to confirm this.
2. Practice good posture
Good posture is an important part of preventing and alleviating back pain during pregnancy, says Shah.
When standing, Shah says it can help to:
- Plant your feet in a wide stance for good balance
- Avoid locking your knees
- Keep your chest high
- Relax and pull your shoulders back
- Maintain straight and tall posture
"If you plan on standing for prolonged periods of time, rest one foot on a stool and alternate regularly to change weight distribution," he says.
When sitting, Shah says it's wise to:
- Use a chair with good lumbar support
- Keep a pillow behind your neck (or where you need some extra support)
- Make sure your knees stay lower than your hips, adjusting the height of your chair if necessary
A 2017 study tracked how different movements impacted participants' low back pain through their pregnancies. Participants linked three movements in particular — sitting, getting up from a chair, and tossing and turning in bed — to their low back pain.
Study authors emphasized that uneven posture plays a key role in pregnancy-induced back pain, so taking a mindful approach to your posture, such as using intentional movements when standing up or sitting down, could make a difference.
3. Exercise
Research emphasizes the importance of exercise in supporting a healthy pregnancy and reducing the back pain it can cause.
"Though it may seem counterintuitive, exercise can often loosen up muscles and strengthen problem areas," says Shevell.
Shevell says some of the best forms of exercise during pregnancy are low-impact activities including:
- Swimming and water therapy. These could help relieve low back pain during pregnancy, according to a 2009 study.
- Yoga. This activity could reduce the intensity of back pain in pregnancy.
- Cycling. A small 2007 study found that pregnant participants who stuck to a cycling exercise routine didn't experience an increase in their back pain over the second half of their pregnancies. Those who didn't exercise did notice an increase in pain.
- Stretching. Practicing a variety of pregnancy-safe stretches could help relieve back pain.
4. Consider alternative medicine
Shah says the following forms of alternative medicine could be a good option to aid relaxation and help you get some relief from back pain:
- Chiropractic care. You can ask your doctor or midwife to refer you to a chiropractor who specializes in helping people with pregnancy-related concerns, says Shah. In a small 2014 study, most pregnant participants reported chiropractic care made their back pain easier to manage.
- Acupuncture. A small 2018 study found acupuncture — which uses small needles to potentially soothe back pain and other ailments — provided significant relief to pregnant participants with back pain. But make sure to choose a certified facility that uses sterile needles, Shah says.
- Prenatal massage. Massage therapy can help relax your back. A small 2016 study found that 10- to 20-minute sessions of massage therapy, twice weekly for five weeks, helped pregnant participants manage and relieve pain safely. Just be sure to choose a therapist with experience providing care to people during pregnancy, says Shah
As with any form of alternative care, it's a good idea to check in with your primary care team before jumping in.
5. Work with a physical therapist
While research provides mixed results when it comes to physical therapy's effectiveness for reducing back pain in pregnancy, many people find this often-recommended approach helps them manage pain.
"Physical therapists will be able to guide you with specific exercises and therapy individualized to your specific need," says Shah.
Shah also says physical therapy could help you manage back pain in the fourth trimester, or the three months following delivery.
Insider's takeaway
The sooner you start experimenting with ways to mitigate your back pain, the better chances you may have of decreasing its severity or preventing it in the long run.
Also, remember that back pain may not magically disappear after giving birth. Up to 40% of people may still experience low back pain six months after delivery. So, seek treatment sooner than later to reduce your risk of many discomforting months.