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Lower Back Pain During Pregnancy: Causes and Treatments


Posted by Dr. Scott Wilson | 15-Sep-2022

  • Lower back pain during pregnancy is not uncommon given the physical changes taking place in your body and the resulting strain placed on the joints of your lower back and pelvis.
  • Untreated back pain can often lead to permanent disabilities and chronic pain that could affect other parts of your body.
  • By knowing the causes and the different options for treating lower back pain, you can without relying on medications that might adversely affect your pregnancy. 

Experiencing lower back pain during pregnancy is common for many women, especially during their second and third trimesters. Weight gain, hormone changes, increased joint stress, and reduced overall movement are all factors that contribute to lower back pain during pregnancy. It’s a sensation that can be constant, deliberating and may get worse with activity. It can also significantly interfere with your sleep. 

Most pregnant women rely on medication, but growing evidence shows that not all medications are safe for consumption during pregnancy. Some even have the potential to interfere with fetal development. 

Therefore, it’s important to better understand both the causes and best treatment options for relieving lower back pain during pregnancy. This can help to reduce discomfort, your lower back pain from turning into a chronic disorder and it can also improve your quality of life. 

Key Causes of Lower Back Pain During Pregnancy

  • Weight Gain
  • Increase in Uterus Size
  • Relaxin Hormone
  • Widening of the Pelvis
  • Changes in Posture
  • Emotional Stress 

1. Weight Gain

As you gain weight during pregnancy, more stress is put on your spine due to the weight of the growing baby. This weight also tilts your center of gravity forward, increasing the curve in the lower back. These changes can lead to lower back pain along with throbbing, swollen feet due to excess fluid buildup, known as edema. 

2. Relaxin Hormone

During pregnancy, your body releases the Relaxin hormone. This hormone relaxes the ligaments in the pelvic area and loosen the joints in preparation for childbirth. The relaxin hormone also affects other ligaments that support the joints in the lower back, hips, knees, and ankles, causing them to loosen as well. This, combined with the shifting of joints, can lead to instability and lower back pain during pregnancy.

3. Widening of the Pelvis

Estrogen, along with relaxin, is also released during pregnancy. These two hormones cause the pelvis to widen. This widening results in severe pelvic pain that typically intensifies in the later stages of pregnancy. It can also progress rapidly and can affect the muscles and soft tissues in the lower back and thighs, resulting in lower back pain. 

4. Changes in Posture

The growth of the baby and uterus shifts your center of gravity forward. Performing daily activities in a slouched position can result in strain and pain on the neck and lower back. Another common cause of lower back pain is sacroiliac joint dysfunction. This dysfunction is similarly the result of increased body weight and changes in posture. 

5. Increase in Uterus Size

During pregnancy, the lining of your uterus thickens and the blood vessels enlarge to provide nourishment to the fetus. This affects the shape of your spine, making the lower back more curved than usual. Also, the muscles that stabilize your pelvis are shortened during pregnancy, which increases the curvature of your lower back and causes lower back pain.

6. Emotional Stress

Emotional stress during pregnancy can cause physical symptoms, such as fatigue, headaches, stiffness, muscle tension, and muscle pain. Stress increases tightness and back spasms, particularly in areas of weakness, and may worsen an existing condition.

Best Options for Treating Lower Back Pain During Pregnancy 

  • Exercise
  • Hot or Cold Therapy
  • Posture Improvement
  • Acupuncture 
  • Chiropractic
  • Physiotherapy

1. Exercise

By including exercises in each trimester, you can strengthen your muscles and relieve lower back and pelvic pain commonly experienced during pregnancy. Strengthening exercises only be performed at a mild to moderate level, not to the point of exhaustion. You should also only do simple stretches and strengthening exercises, such as:

  • Pelvic Tilts
  • Arm and Leg Raises
  • Kegels (for pelvic floor muscles)
  • Wall Squats 

2. Hot or Cold Therapy

Applying heat and cold to an aching back is a great way to relieve pain during pregnancy. But always make sure that you use heating pads for only 10 minutes or less. Do not use it overnight or while sleeping. Hot or cold therapy helps in increasing blood circulation in the affected area, reduces painful muscle spasms, and improves mobility in stiff muscles. However, it’s just a temporary solution during pregnancy.

3. Postural Improvement

The increased frontal weight during pregnancy tends to curve the back and results in a hunchback-like posture. This slouching position can stiffen the back muscles and cause the abdominal muscles to lose strength. This leads to lower back pain. Therefore, always maintain a proper posture while working, sitting, or sleeping. Some ways to improve your posture include:

  • When standing: Push your hips forward and hold your shoulders back. You may also wear a support belt for better posture and stability.
  • When sitting: Place a pillow or rolled-up towel behind your back for support. You should also sit up straight and rest your feet on a stool with your shoulders back. 
  • While sleeping: Make sure to sleep on your side with a pillow between your knees. This position can take the stress off your back. 

4. Acupuncture 

Acupuncture is considered a safe and effective lower back pain treatment method during the second and third trimesters of pregnancy. The procedure involves inserting thin needles at certain points on the body. Stimulating these points can correct imbalances and improve the flow of energy. The benefit of acupuncture is that in addition to providing back pain relief, patients report feeling calm, rested, and a sense of well-being after the treatments.

5. Chiropractic

Chiropractors can help relieve nerve compression caused by the added weight of pregnancy resulting in lower back pain. Several prenatal health programs include chiropractic care along with pelvic exercises to give your lower back the support it needs as well as the required adjustments to prevent muscle tightness.

6. Physiotherapy

Physiotherapy is one of the most effective back pain treatment methods during pregnancy. It can reduce symptoms of lower back pain and can strengthen your back to reduce the risk of long-term complications and chronic disorders. Relieving lower back pain through physiotherapy is also the most trusted treatment option because it includes everything from education and exercise to manual therapy and bracing, or a combination of all these treatments.

Physiotherapist Answers To Frequently Asked Questions:

Q1: What causes lower back pain in the second and third trimesters?

Answer: During the second and third trimesters, the growing fetus is in its final stages and puts increased demand on the body, resulting in pain and discomfort. Hormonal and postural changes are some of the major contributors to lower back pain during these trimesters. The weight of the baby, the growing uterus, and the widening of the pelvis are some of the other reasons for increased back pain during this period.

Q2: What can I take for lower back pain while pregnant?

Answer: For severe and persistent back pain, you should consult your doctor before taking any medication. Doctors usually recommend Acetaminophen, such as Tylenol and other muscle relaxants. But make sure to avoid ibuprofen and other NSAIDs.

Q3: What part of your back hurts when pregnant?

Answer: Back pain that is localized to the lower back is common during pregnancy. This pain may radiate into the buttock, thigh, and legs, resulting in pain similar to sciatica. The lumbar spine and pelvis are other parts of the back that hurt when pregnant. 

Concluding Thoughts on Lower Back Pain During Pregnancy

Even though back pain is common during pregnancy, ignoring it can lead to musculoskeletal disorders or a chronic back condition. It’s best to focus on low-impact exercises, stretching, physiotherapy and other treatments during pregnancy rather than relying on medications. These treatment options can strengthen your back muscles and prevent injury in the later stages of pregnancy.

If you’re struggling with lower back pain during pregnancy and need help, contact us today and let us show you why, at Physiomed, Healthier Starts Here.

Dr. Scott Wilson

Dr. Scott Wilson is the Founder & Chairman of Physiomed; one of Canada’s largest franchised networks of inter-disciplinary healthcare clinics. A graduate of Canadian Memorial Chiropractic College, Dr. Wilson founded Physiomed in 1994 and has since grown Physiomed to over 30 clinics in Southern Ontario and British Columbia. With hundreds of practitioners from over a dozen disciplines, Dr. Wilson and Physiomed have helped over 100,000 Canadians with physiotherapy, chiropractic, massage therapy, orthotic therapy, compression therapy and clinical conditioning as part of a program of rehabilitation and health optimization. In addition to helping patients improve their physical and mental well-being, Dr. Wilson has also mentored hundreds of practitioners to provide better care while enjoying more fulfilling careers. He is also a keynote speaker on many health related topics including how physiotherapy, chiropractic and health & wellness treatment can help with stress, weight loss, and unlocking the true potential within to achieve lasting physical well-being.

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