There’s no doubt that the experience of a longed-for pregnancy can be one of the most rewarding times of your life. But the transition from early pregnancy to new parenthood can be beset by problems. Some of these are relatively minor, though irritating, such as indigestion or heartburn, tiredness and the need for frequent trips to the loo. Some can even add to the fun, such as the quest for a new wardrobe or strange and unexpected food likes and dislikes. But one of the most commonly occurring minor problems is back pain in pregnancy and it is one which a great many mothers-to-be have experienced.

In this article we are focusing not on serious complications that could harm the long-term health of mother and/or baby, but on the phenomenon of pregnancy-associated back pain which, while not life-threatening, can easily have something of a dampening effect on the whole experience. Let’s take a closer look at the causes of back pain in pregnancy, how to guard against it, and what the best remedies are when it does occur.

What are the causes of back pain in pregnancy?

There are several different factors that influence the tendency to feel back pain during pregnancy. Here are the most common causes:

• Hormonal changes. Of the many changes which can have a physical effect in pregnancy is the release of the hormone relaxin. It is produced by the ovaries and placenta and its effect is to relax the ligaments in the pelvis in preparation for childbirth. Unfortunately it can also relax the ligaments around the spinal column, leading to instability and back pain.
• Changes in posture. As the pregnancy progresses, your changing centre of balance can cause you to stand and move differently even though you may not be aware that you are doing so. The resulting strain on the muscles can cause back pain. Emotional stress can have a similar effect and of course, since the pain is in itself stressful, this can become a vicious circle.
• Weight gain: naturally weight gain occurs during a healthy pregnancy, typically between 10 and 16 kilos. This extra weight has to be supported by the spine and musculature, which can cause lower back pain. In addition, the weight of the uterus and the growing baby can put pressure on blood vessels and nerves in the back and pelvic area.
• Your age. This can make a difference, since the older you are, the less flexible and adaptable your muscles will likely be. Muscle mass also gradually declines as the years pass. However, this should be no obstacle to pregnancy at any age. If this is your particular concern, you may like to have a look at some more information on getting pregnant in your forties in our website article.

Prevention: guarding against back pain in pregnancy

However, before you start to wonder whether back pain in pregnancy is inevitable, the good news is that there are measures you can take to avoid the problem altogether, or failing that, to mitigate its severity. Many of these are common-sense lifestyle tips:

• Wear comfortable flat shoes in order to help with even distribution of weight and avoid any extra strain on the muscles that can be caused by wearing high heels.
• Avoid lifting heavy objects, and when lifting anything from a low position, bend your knees and keep your back straight rather than bending from the waist.
• If you need to carry shopping, try to distribute the weight evenly on both sides.
• When sitting, at home or in the workplace, make sure your posture is good and avoid slouching. Using a cushion or maternity support pillow can help.
• Prioritise getting enough rest, particularly in the later stages of pregnancy, and make sure your bed is firm enough for good support. If necessary you can increase the firmness by inserting a sheet of hardboard underneath the mattress.

In addition to these measures, keeping up a gentle exercise regime can help your muscles to stay strong, increase their flexibility and adapt to the new pressures weighing on them. Participating in prenatal yoga or aqua-natal classes, as long as these are under the supervision of a qualified instructor, can also help to maintain and strengthen your back muscles. Whichever exercise regime you choose, it’s important to keep up the exercises that your body is used to, rather than taking up a completely new form of exertion. However, if your normal fitness regime includes strenuous activity, it’s important to tone down the intensity and if in any doubt, talk to your doctor.

Other safe exercises for most pregnant women include walking, swimming and stationary cycling.

• Walking is a really essential exercise throughout pregnancy. Not only does walking help to keep your muscles strong and your posture good, but because it is low impact and aerobic, it can help to prevent circulation problems and prevent swelling of your legs and feet.
• Swimming is beneficial to avoid back pain in pregnancy, because the support of the water reduces any joint strain while allowing all the benefits of muscular strengthening and stretching. You can keep it simple by swimming a few laps, or go for the added benefits of a social group by joining a synchronised swimming or water aerobics classes.
• Stationary cycling also strengthens the back muscles and helps avoid circulation problems.

If you would like to get more in-depth information on the wider benefits of exercise during pregnancy for your general wellbeing and on its role in helping to avoid back pain, have a look at our blog article on exercise during pregnancy.

Remedies for back pain in pregnancy

Preventative measures aside, if you do experience back pain in pregnancy, what can you do to relieve it? First and foremost, it’s essential to talk to your doctor or midwife before taking any sort of medication, or if you have any concerns that the pain could be a sign of something wrong. If you suspect that your back pain is signalling a problem, contact your doctor or midwife. This applies particularly during the second or third trimester, when it could be a sign of early labour. Other circumstances in which you should seek help immediately include having a fever in addition to the pain, or bleeding, or if you have any numbness in your bottom or pubic area, or have pain in your side, under your ribs.

If there’s nothing wrong as such and your back pain is quite severe, the doctor or midwife may be able to refer you to an obstetric physiotherapist, who can offer you advice and may suggest a personalised exercise programme.

Usually it is considered safe to take paracetamol during pregnancy as long as the instructions on the packet are followed, and unless you have been advised against this by your doctor or midwife. Other solutions which work well for some include hot or cold compresses, a massage and working on improving posture.

• A massage or a warm bath can be helpful in encouraging stressed muscles to relax.
• Many people find that applying heat and cold to the painful parts of the back helps. You can make a cold compress with ice or frozen vegetables wrapped inside a towel and applied to the location of the pain for about 20 minutes. Alternate on different days with heat, for example with a hot water bottle applied to the back. However, you should be careful not to apply heat to the belly area during pregnancy.
• Focus on improving posture and avoiding strain by keeping a good supply of pillows, cushions and rolled-up towels to help you keep an upright and strain-free position when sitting or lying in bed. When sitting, elevating your feet slightly with a low stool or a stack of books can help to alleviate any strain on the back.

With the help of these tips and tricks, and with a focus on maintaining your overall good health with the right nutrition and exercise regime while pregnant, we hope that back pain does not impinge on what is a joyous time for you and your partner. If you have any concerns about fertility and how IVI, as the world’s largest assisted reproduction group, may be able to help, do get in touch. You can check the facts and figures about who we are and our record of success on our website, or get in touch by using the IVI contact form.