Common Causes of Lower Back Pain While Pregnant

Your lower back aches by mid-afternoon, rolling over in bed sends a jolt through your hips, and lifting your toddler feels harder every week. If you feel like your body is falling apart during pregnancy, there’s a real reason for it. Lower back pain while pregnant is very common, but common doesn’t mean normal, and it doesn’t mean you just have to live with it.

Here are the most common causes of lower back pain during pregnancy, what you can do about each one, the warning signs that need a call to your doctor, and how pelvic health physical therapy helps.

Reason #1: Your Hormones Are Changing

During pregnancy your body produces a hormone called relaxin. It loosens the ligaments that normally hold your bones together tightly, so your pelvis can expand to make room for your baby and for birth.

Relaxin is necessary, but it has a downside. As the ligaments of the pelvis and spine stretch, the joints become less stable, which can lead to lower back pain and sacroiliac (SI) joint pain. If your core muscles can’t pick up the slack, more stress lands on those ligaments and on your spine. The weight of your growing baby adds to it by pulling your center of gravity forward.

Reason #2: Your Posture Is Changing

As your baby grows, your body is pulled forward. Most women start to stick their bottom out with the belly forward, arch the lower back too much, round the head forward and sway backward. Even physical therapists slip into this posture when they aren’t thinking about it.

A few simple cues help:

• Stack your shoulders over your hips: easier said than done as your weight shifts forward, but it also keeps your chest open
• Engage your glutes, don’t clench them: think about “opening up” your hips. Clenching your glutes or your pelvic floor won’t help.

Reason #3: Your Glutes Are Weakening

With your center of gravity changing and your activity level often dropping, your glutes tend to weaken. Weak glutes let you sway forward into an arched lower back, which loads the spine and the SI joints. Keeping your glutes gently engaged, and keeping them strong, helps protect your back.

Reason #4: Your Head Is Shooting Forward

Many women worry about the rounded upper back and “hump” at the base of the neck that can develop during and after pregnancy, and breastfeeding can make it worse. Get ahead of it now. Think about keeping your head back on top of your shoulders, not leaning back, just stacked over them.

Reason #5: Your Activity Level Is Dropping

Women are often told to stop exercising the moment they find out they’re pregnant, or they’re prescribed bed rest for back pain. Bed rest usually makes back pain worse in the long run by making you weaker, and it carries its own risks. Some pregnancies, such as high-risk pregnancies, do need activity limits, so follow your doctor’s guidance. For most women, though, staying active during pregnancy is very beneficial.

Focus on these areas:

• Your glutes: to support your pelvis and lower back
• Your pelvic floor: and not just with Kegels. Your pelvic floor needs to both contract and relax.
• Your deep core: including your breathing muscles

Reason #6: How You Sleep and Lift

Lying on your left side is often recommended from the second trimester on. A pregnancy pillow helps: put it between your knees, under your belly, or under your head and neck, and adjust it in ways a regular pillow can’t.

How you lift matters too, and not just for furniture and boxes. A baby plus a car seat plus a diaper bag adds up fast. Bend at your hips and knees and lift with your legs instead of rounding your back, even if you don’t have pain yet.

A pelvic or abdominal support belt, fitted and recommended by a pelvic health physical therapist, can also help support your growing belly and your posture.

When to Call Your Doctor Right Away

Back pain in pregnancy is usually muscular, but call your OB or midwife promptly if you have:

• Bleeding or fluid leaking: from the vagina
• Regular cramping or tightening: or back pain that comes and goes in a rhythm
• Fever or burning when you urinate: or pain on one side of your back near the ribs
• Sudden, severe pain: or pain after a fall
• Numbness or weakness: in your legs, or a change in bladder or bowel control

How Pelvic Health Physical Therapy Helps

Back pain during pregnancy should be evaluated by a professional, not just fixed on your own. A pelvic health physical therapist is trained in pregnancy care, including back pain. At Back In Motion Physical Therapy & Performance, our prenatal and postnatal physical therapy uses The Gray Method™ to find what is driving your pain and builds a safe plan to:

• Strengthen your glutes, deep core and pelvic floor
• Improve your posture and how you move, lift and sleep
• Recommend and fit a support belt if you need one
• Keep you active through pregnancy and the postpartum months

If your pain is centered low on one side of the back, read more about SI joint pain. After delivery, see when postpartum pelvic floor therapy helps and our answers to the big questions about diastasis recti. Have more questions? Download our free pelvic floor guide.

Enjoy Your Pregnancy With Less Back Pain

The months before and after your baby arrives should be celebrated, not spent working around pain. Our pregnancy back pain treatment in Fort Myers starts with The Gray Method™, one-on-one with a Doctor of Physical Therapy at our clinics in Fort Myers, Cape Coral and Estero.

Start with our Fixing the Cause & Not Just the Symptoms Assessment, or Inquire About an Appointment →

Call our office at (239) 223-0484 to schedule your appointment.