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Most pregnant women experience back pain, usually starting in the second half of pregnancy. During the second trimester, around the 20th week, the growing uterus and the weight gain associated with pregnancy can put pressure on the lower back and pelvis (area of the body below the abdomen located between the hip bones), leading to discomfort and pain.

Around 50-80% of pregnant women experience some degree of lower back pain. It is one of the most common pregnancy problems, especially in the later months. The pain usually goes away after the baby is born, but for some women the back pain can linger for months after giving birth.

There are various reasons why a lower back pain could start for you:

  • Weight gain – During a healthy pregnancy, women typically gain between 12-15 Kgs. The spine has to support that weight. That can cause lower back pain. The weight of the growing baby and uterus also puts pressure on the blood vessels and nerves in the pelvis and back.
  • Posture changes – Pregnancy shifts your centre of gravity. As a result, you may gradually — even without noticing — begin to adjust your posture and the way you move. This may result in back pain or strain. Your expanding uterus shifts your centre of gravity and stretches out and weakens your abdominal muscles. This changes your posture and puts a strain on your back.
  • Hormone changes -During pregnancy, your body makes a reproductive hormone called relaxin that allows ligaments in the pelvic area to relax and the joints to become looser in preparation for the birth process. The same hormone can cause ligaments that support the spine to loosen, leading to instability and pain.
  • Muscle separation – As the uterus expands, two parallel sheets of muscles (the rectus abdominis muscles), which run from the rib cage to the pubic bone, may separate along the centre seam. This separation may worsen back pain.
  • Stress – Stress and tension also has an effect on lower back pain. Because of the increase in stress hormones the muscles do not have a chance to relax and recover and can be permanently in a state of tightness. Over time this creates muscle fatigue and further tension.

Tips to reduce Low Back Pain

Fortunately, there are various strategies that pregnant women can use to alleviate back pain during the second trimester. These include maintaining good posture, using supportive shoes, engaging in regular exercise, practicing relaxation techniques, and using heat or cold therapy.

  • Exercise – Regular exercise strengthens muscles and boosts flexibility. That can ease the stress on your spine. Safe exercises for most pregnant women include walking, swimming, and stationary cycling. Your doctor or physical therapist can recommend exercises to strengthen your back and abdomen.
  • Heat and cold compress – Applying heat and cold compress to your back may help. If your doctor says yes, start by putting cold compresses (such as a bag of ice) on the painful area for up to 20 minutes several times a day. After two or three days, switch to heat — put a heating pad or hot water bottle on the painful area. Be careful not to apply heat to your abdomen during pregnancy.
  • Improve your posture – Slouching strains your spine. So using proper posture when working, sitting, or sleeping is a good move. For example, sleeping on your side with a pillow between the knees will take stress off your back. When sitting at a desk, place a cushion behind your back for support; rest your feet on a stool and sit up straight, with your shoulders back. When standing, pull your hips forward and your shoulders back.
  • Use supportive shoes – Wearing shoes that provide adequate support and cushioning can help reduce pressure on the feet, legs, and lower back.
  • Practice relaxation techniques: Techniques such as deep breathing, meditation, and massage can help reduce stress and tension in the muscles, relieving back pain.
  • Counselling – If back pain is related to stress, talking to your doctor may be helpful.

If back pain is severe or accompanied by other symptoms, such as vaginal bleeding or cramping, it is essential to seek medical attention as these may be signs of a more serious condition.

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