By Alison Heyerdahl

Pregnancy and lower back pain are almost synonymous.   It is common to experience stiffness and aching that sometimes refers down into the buttocks, hips, and legs.  Back pain usually starts in the second trimester of pregnancy and sometimes only remits once your baby is born. 

According to studies, approximately 10% of women reported that back pain during pregnancy prevented them from working, and more than 80% said it affected their ability to perform daily tasks.

What causes lower back pain during pregnancy?

There are many possible causes of lower back pain during pregnancy. 

• During pregnancy, your body releases a hormone called relaxin.  Relaxin causes the ligaments in your pelvis to loosen up to allow the easy passage of your baby during delivery.  It also causes the ligaments that support the spine to become lax, leading to instability and pain.

• Weight gain during pregnancy can also lead to back pain.  Women typically put on between 25 and 35 pounds, which creates extra pressure on the spine. 

• Postural changes during pregnancy can also lead to lower back pain.  As you gain weight, and your belly grows, it becomes difficult to maintain your posture.  The curvature in your spine becomes accentuated, putting pressure on the joints in your spine. 

• As your uterus expands, the two sheets of muscle that run from your rib cage to your pubic bone (your abs) separate to accommodate your growing baby. This separation can cause instability in your pelvis, resulting in lower back pain.

• Subsequently, preterm labor can sometimes also be felt or described as back pain. This pain may come and go, or may present as a more constant pain. Often with preterm labor, you may also experience cramping similar to menstrual cramps. 

Treatment for lower back pain during pregnancy

There are many steps you can take to do to ease your lower back pain.  These include:

• Avoiding gaining too much weight during pregnancy.  In addition to the obvious benefits of eating a healthy diet, some foods have been linked to reducing spinal inflammation.  These include tomatoes, olive oil, green leafy vegetables, nuts like almonds and walnuts, fatty fish such as salmon, and fruits like strawberries, blueberries, and cherries. 

• Maintaining the correct posture.  As our bellies get heavier, our backs tend to arch, putting strain on our joints.  As much as possible try to flatten your lower back and tuck your bottom in.  This will also strengthen the muscles of your lower back. 

• Exercising to strengthen your core and back muscles.  While too much exercise can increase your back pain, too little can also contribute to the weakening of your muscles.

• Wearing the correct shoes.  Wearing the correct footwear can go a long way to reducing back pain.  High heels and flip-flops should be avoided.  You should also consider purchasing new footwear if your shoe size changes during pregnancy. 

• Taking some time out for self-care.  Finding ways to manage your stress during pregnancy has physical and emotional benefits.  A prenatal massage, relaxing with a heating pad, and getting plenty of rest are good ways to manage stress while helping your spine.

If you are experiencing frequent back aches that do not subside with hydration, rest, and position changes, or if you are noticing these frequent with menstrual cramps, seek medical care, especially if you are preterm.