Back and pelvic pain during pregnancy

How common is back pain during pregnancy?

More than half of the pregnant people we meet say that at some point during pregnancy, they’ve had problems with lumbar spine pain and pelvic pain. Some only have minor issues, while others have severe pain and significant problems, which is why we are here. Studies show that lumbar spine and pelvic pain are the primary reasons for going on sick leave during pregnancy. Pain in the tailbone and across the glutes is also common.

What’s happening in the body?

Physiologically, during pregnancy, the ligaments in the pelvis are loosening up due to the rise in hormones, including oestrogen, progesterone and relaxin. The pelvis and ligaments have to adjust, first to the pregnancy and then to childbirth, when the baby needs to be able to rotate downward and come out. Basically, the pelvis needs to be able to pass a baby, and this loosening process occurs in all pregnancies, even though it isn’t painful for everyone.

Is it possible to prevent back pain during pregnancy?

To best prevent, alleviate and treat different kinds of back pain, it is very important for the pregnant person to have information about the anatomical changes that unavoidably occur in the back and elsewhere in the body. If you had issues during a previous pregnancy, it’s a good idea to pay attention to symptoms and be sure to get help from a physiotherapist early on. Activity and exercise are known to be beneficial for the pregnant body and for the changes that take place during pregnancy. All pregnant people should get about 30 minutes of exercise and physical activity per day to support the body and reduce the risk of complications.

When looking at underlying risk factors for developing back pain during pregnancy, there is a notable increase among people whose work involves a significant physical workload. The risk is also higher among people who have had lower back or pelvic pain before, and if you’ve had back pain during pregnancy, we know this affects your risk of developing pain in a subsequent pregnancy. Prior trauma, being pregnant with multiples, poor ergonomics and people who were less physically healthy before pregnancy are also at greater risk of developing issues.

Why does pelvic pain happen?

All pregnant people undergo the process of the pelvis becoming softer and more mobile as it opens up to be able to let one or more babies through. Sometimes, this can cause pain. It’s tough to say why some people have pain and others don’t, because researchers are uncertain of the underlying cause behind the pain. But a combination of hormonal and physical causes is likely. So the loosening of the pelvis, in addition to a tired body, hyper-mobile joints, weight gain and pressure from the growing baby, all play a role in pelvic pain.

What does pelvic pain feel like?

It’s highly individual, but pelvic pain – which is felt in the pubic bone and the rest of the pelvis – tends to be most severe when walking quickly, taking long strides, using stairs, rolling over in bed, or getting up from a seat. Other signs are pain when moving a leg sideways, walking with a limp or waddle, and difficulty carrying anything heavy or lifting in general. Most people experience this pain in the evening, after being active all day. So pelvic pain can impact daily life and the ability to work in several ways.

How early might you develop pelvic pain?

Most people who develop pelvic pain start feeling it around mid-pregnancy, but it can begin sooner. Others won’t have pain until they go into labour. For most people who have had pain, the pelvis will return to normal about 4 to 12 weeks after childbirth, but some people might be dealing with this issue for up to 6 months after the baby’s arrival.

Do you have any tips for combating pelvic pain?

• Try to avoid bearing weight on one side, for example, standing with your weight on one leg or walking on stairs. Take the lift or escalator instead, if possible.
• It’s fine to go on walks with pelvic pain, but listen to your body: don’t go too far, shorten your stride, slow down and avoid uneven surfaces. Try using walking poles or crutches if needed, and shoes with plenty of give.
• Sit down to put on your socks and shoes.
• Change your work position often and be sure to take breaks.
• Avoid unnecessary carrying and lifting.
• Stand up and sit down with your legs together. Try to do this when getting in and out of a car as well.
• If it’s hard to roll over in bed, it might help to wear slippery pyjamas and to have slippery sheets.
• When seated, placing something behind your lower back for support might feel nice.
• When lying on your side, for example in bed or on the couch, it can provide some relief to place a pillow between your knees or calves.
• Aim to correct your posture by shifting your weight slightly towards your forefoot when standing still.
• Wear a pelvic support belt for pain relief. Your midwife can help with this; it’s important for the belt to be the right size for the best support.
• Another pain relief option you can try is TENS.

What causes lower back pain when you’re pregnant?

Lower back pain is very common when you’re pregnant, and while it certainly isn’t fun, it may be nice to know that lower back pain is not dangerous. Pain in your back later in pregnancy could be linked to the fact that your growing belly is getting bigger and heavier, which puts pressure on your lumbar spine. Between 50 to 70 percent of people report having had lower back pain during pregnancy. What causes lower back pain? Several factors, the most common of which are hormones, bearing weight unevenly, and changed movement patterns. Like we said, your hormones soften your joints and ligaments, which can change your posture; you might become hyper-mobile and load your body incorrectly. Your weight and centre of gravity will unavoidably change and the later into pregnancy you are, the further forward your centre of gravity will shift. This will also impact your posture. Higher weight and a bigger and bigger belly will change how you use your body and it can be easy to forget to vary your activities and change your seating and resting positions throughout the day.

What tips do you have for an achy lower back?

• Correct your posture and try to shift your weight slightly towards your forefoot.
• Support at your lower back while sitting might feel nice.
• Change your position while you work often and try to remember to take breaks.
• Avoid unnecessary carrying and lifting.
• When lying on your side, try placing pillows between your knees/calves to relieve the pressure.
• If you spend a lot of time standing, you can rest your back by leaning against a wall or on the back support of a chair.
• Try TENS for pain relief.

Why do many people experience tailbone pain while pregnant?

It might sound strange, but pregnancy can actually affect the position of the tailbone, which can cause pain. The cause once again is hormones, which lead to increased mobility in the joints and pelvic muscles. It isn’t exactly easy to differentiate between pelvic pain and tailbone pain, which often produce the same symptoms.

Can anything be done about an achy tailbone?

Pelvic exercises are a good choice, but the best tip is to get relief by sitting on a soft surface. A soft memory foam pillow or a seat cushion with a hole in the middle that won’t put pressure on your tailbone will be best of all. These can often be found at drugstores. If you have a tender tailbone, you can also seek out massage, osteopathy and specific exercises aiming to soothe the nervous system around the tailbone, and the joints of the pelvis and lumbar spine that affect it. Don’t try to figure this out yourself; if you’re having issues, then ask your midwife or doctor for help. They can help you find a physical therapist who will design a treatment plan just for you.

What do we know about the risk of issues in the future, after having back pain during pregnancy?

We think it’s important to know that the pain declines for most people already in those first few weeks after giving birth, but some people might have lingering issues. If the issue doesn’t let up, then your doctor or midwife can refer you to a physical therapist.

Is there anything in particular to pay attention to regarding back pain during pregnancy?

Back pain isn’t dangerous for you or for your baby, but it is important to get the help and tools you need to manage and ease the situation. Talking with your doctor or midwife and getting professional help is important. Some people need to go on sick leave; others can keep working, but might need to modify or reallocate their tasks.

It’s also important to remember that back pain can pop up when labour begins, and it’s good to have a sense of the difference between labour pain and ordinary back pain. Labour pain is intense and comes in waves, but when it first begins, it might just feel like back pain, similar to menstrual pain, in your lumbar spine. So when you first go into labour, you might feel back pain that transitions into something like throbbing menstrual cramps. But like we said, the biggest difference is that this pain comes in waves and you can feel the uterus contracting.

We really want to emphasise the importance of getting help if you’re having problems. If you’re suffering from pelvic and back pain, then you need help and support to handle your day-to-day tasks. Being in pain all the time can be mentally exhausting and when you’re pregnant, you already have enough on your plate with creating a new life. So don’t make light of your pain; talk to your doctor or midwife and get help!

Please note that all information above is based on Swedish recommendations.