This pamphlet explains

the causes of back pain during pregnancy tips for easing back pain when to see your health care provider

Backache is one of the most common discomforts of pregnancy. You can take some steps to reduce back pain, such as bending and lifting correctly and doing exercises to strengthen your muscles.

Causes of Back Pain

Back pain in pregnancy has many possible causes. It usually is caused by strain on the back muscles. In mid-pregnancy, when your uterus becomes heavier, your center of gravity changes. Your posture changes in response. Most women begin to lean backward in the later months of pregnancy, which makes their back muscles work harder.

Weakness of the abdominal muscles also can cause back pain. The abdominal muscles normally support the spine and play an important role in the health of the back. During pregnancy, these muscles become stretched and may weaken, causing some back pain. These changes also make you more prone to injury when you exercise.

Pregnancy hormones may contribute to back pain. To make your baby’s passage through your pelvis easier, a hormone relaxes the ligaments in the strong, weight-bearing joints in the pelvis. This loosening makes the joints more flexible, but it can cause back pain if the joints become too mobile.

What You Can Do

To help prevent or ease back pain, be aware of how you stand, sit, and move. Here are some tips that may help:

• Wear low-heeled (but not flat) shoes with good arch support.
• Ask for help when lifting heavy objects.
• When standing for long periods, place one foot on a stool or box.
• If your bed is too soft, have someone help you place a board between the mattress and box spring.
• Do not bend over from the waist to pick things up—squat down, bend your knees, and keep your back straight.
• Sit in chairs with good back support, or use a small pillow behind the low part of your back.
• Try to sleep on your side with one or two pillows between your legs for support.
• Apply heat or cold to the painful area or massage it.

Exercises for the back can help lessen backache. They strengthen and stretch muscles that support the back and legs and promote good posture—keeping the muscles of the back, abdomen, hips, and upper body strong. These exercises not only will help ease back pain but also will help prepare you for labor and delivery. Staying active during pregnancy can help with back pain. Water exercise and walking are safe to do during pregnancy and are great for the back.

Exercises for a Healthy Back Before doing any of these exercises, see your health care provider to make sure that they are safe for you to do.
Diagonal Curl This exercise strengthens the muscles of your back, hips, and abdomen. If you have not already been exercising regularly, skip this exercise. Sit on the floor with your knees bent, feet on the floor, and hands clasped in front of you. Twist your upper torso to the left until your hands touch the floor. Do the same movement to the right. Repeat on both sides 5 times.	Forward Bend This exercise stretches and strengthens the muscles of your back. Sit in a chair in a comfortable position. Keep your arms relaxed. Bend forward slowly, with your arms in front and hanging down. Stop bending if you feel any discomfort on your abdomen. Hold for 5 seconds, then sit up slowly without arching your back. Repeat 5 times.
Back Press This exercise strengthens the muscles of your back, torso, and upper body and promotes good posture. Stand with your back against a wall with your feet 10–12 inches away from it. Press the lower part of your back against the wall. Hold for 10 seconds, then release. Repeat 10 times.	Upper Body Bends This exercise strengthens the muscles of your back and torso. Stand with your legs apart, knees bent slightly, with your hands on your hips. Bend forward slowly, keeping your upper back straight, until you feel the muscle stretch along your upper thigh. Repeat 10 times.
Backward Stretch This exercise stretches and strengthens the muscles of your back, pelvis, and thighs. Kneel on hands and knees, with your knees 8–10 inches apart and your arms straight (hands under your shoulders). Curl backward slowly, tucking your head toward your knees and keeping your arms extended. Hold for 5 seconds, then return to all fours slowly. Repeat 5 times.	Rocking Back Arch This exercise stretches and strengthens the muscles of your back, hips, and abdomen. Kneel on hands and knees, with your weight distributed evenly and your back straight. Rock back and forth for a count of 5. Return to the original position and curl your back up as far as you can. Repeat 5–10 times.
Leg Lift Crawl This exercise strengthens the muscles of your back and abdomen. Kneel on hands and knees, with your weight distributed evenly and your arms straight (hands under your shoulders). Lift your left knee and bring it toward your elbow. Straighten your leg back. Do not swing your leg back or arch your back. Repeat on both sides 5–10 times.	Trunk Twist This exercise stretches the muscles of your back, spine, and upper torso. Sit on the floor with your legs crossed. Hold your left foot with your left hand using your right hand for support. Switch hands and repeat on the left. Repeat on both sides 5–10 times.

When to Contact Your Health Care Provider

If you have severe pain, or if pain persists for more than 2 weeks, you should contact your health care provider about your back pain. Do not try to treat yourself. Back pain also can be caused by other problems. Back pain is one of the main symptoms of preterm labor. You also should contact your health care provider if you are having fever, burning during urination, or vaginal bleeding.

Once other causes are ruled out, your health care provider may recommend a maternity girdle, special elastic sling, or back brace. These devices help support the weight of your abdomen and ease the tension on your back. In severe cases, mild pain medications, bed rest, or physical therapy may be recommended.

Finally...

Backache is one of the most common discomforts of pregnancy. You can take some steps to reduce back pain, such as bending and lifting correctly and doing exercises to strengthen your muscles. If your pain is severe or lasts longer than 2 weeks, contact your health care provider.

This Patient Education Pamphlet was developed by the American College of Obstetricians and Gynecologists. Designed as an aid to patients, it sets forth current information and opinions on subjects related to women’s health. The average readability level of the series, based on the Fry formula, is grade 6–8. The Suitability Assessment of Materials (SAM) instrument rates the pamphlets as “superior.” To ensure the information is current and accurate, the pamphlets are reviewed every 18 months. The information in this pamphlet does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations, taking into account the needs of the individual patient, resources, and limitations unique to the institution or type of practice, may be appropriate.

Copyright © July 2009 by the American College of Obstetricians and Gynecologists. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.

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