What Is Lower Back Pain in Pregnancy?

Updated on November 01, 2022

Medically reviewed by Monique Rainford, MD

Many pregnant people experience pain in the low back that radiates into the buttocks and legs. This pain usually strikes in the second trimester, but can start sooner, and it often occurs when you're trying to sleep. It may be constant or worsen with activity and often affects a person's quality of life.

While you may not be able to completely get rid of this symptom, physical therapy, stress reduction, and changing your sleeping position may help ease it or prevent it from worsening.

Learn more about lower back pain during pregnancy, including signs and symptoms, causes, and treatment.

pregnant woman holding lower back and in pain — LumiNola / Getty Images

Frequency and When It Presents

Research shows that around 50% of people who are pregnant will experience low back pain during pregnancy or in the postpartum period. Low back pain during pregnancy can be mild or associated with specific activities. For some people, it can be chronic—that is, pain is persistent and lasts more than three months.

One-third of pregnant people will suffer from severe low back pain that reduces their quality of life, while 10% report that low back pain affects their daily routine and ability to work. For most people, low back pain starts between the fifth and seventh months of pregnancy, but for some, low back pain may occur earlier.

Symptoms

You may experience lower back pain at any time during your pregnancy. For most people, symptoms will resolve after the birth of their child. Unfortunately, some may experience chronic pain that remains after childbirth.

Back and related pain during pregnancy might manifest as:

A dull or sharp ache or burning pain in the lower back.
Pain on one side of the lower back.
Foot drop: This is the inability to lift the front part of the foot while walking.
Pain similar to sciatic nerve pain radiating into the thigh and leg: These symptoms are more common if there is lower lumbar nerve impingement due to any number of conditions, including a herniated disc, muscle strains, or muscle spasms.
Lower back pain with lying down and sleeping: Lower back pain that gets worse at night is related to an expanding uterus putting pressure on the vena cava—a major blood vessel—and blood vessel congestion in the pelvis and low back.

Back pain during pregnancy may mimic sciatica—pain that radiates along the sciatic nerve that stretches from the low back through the hips and buttocks down the leg. Sciatic nerve pain usually affects only one side of the body, however.

Causes

The causes of lower back pain in pregnancy are considered multifactorial. This means that different things are affecting various body structures in the lower part of the body leading to lower back pain.

Many of the causes are recognized and naturally occurring changes during pregnancy, including those related to posture, blood circulation, anatomy, and hormones. Lower back pain during pregnancy is rarely serious or life-threatening.

One theory about lower back pain in pregnancy relates to mechanical instability of the low back in the lumbar spine and pelvis. During pregnancy, the lumbar spine goes through a compensatory process called lordosis, where the spine adjusts to the center of gravity from the increasing pregnancy weight and abdominal enlargement.

This process adds excess strain on the lumbar joints, discs, ligaments, and muscles. The psoas muscle of the hip becomes shortened from the compensatory lordosis, further adding to low back pain.

Psoas Muscle

The psoas muscle connects the upper body to the lower body. It is responsible for flexing the hip joint and lifting the upper leg towards the body. One of its most common movements is walking.

People with a history of low back pain or other preexisting back problems seem to have a higher risk for developing lower back pain during pregnancy.

In addition to changes in the body and history of risk, some daily activities during pregnancy can cause unbalanced movements in the spine, pelvis, and hips resulting from naturally occurring changes of pregnancy.

These might include:

Walking or running
Rolling over when in bed
Bending and twisting the spine
Lifting
Climbing steps

While rare, some obstetrical conditions, such as miscarriage, ovarian cysts, or uterine fibroids, may cause lower back pain in pregnancy. Lower back pain is also a symptom of urinary tract infection or preterm labor.

Treatment

Treatment of lower back pain in pregnancy will depend on the stage of pregnancy, what has caused the back pain, any aggravating factors, underlying medical conditions, such as diabetes or high blood pressure, and the severity of symptoms, along with the effect on the quality of life.

In determining treatment options, your clinician may evaluate your posture, range of motion, gait (walking) patterns, joint pain, tendon reflexes, and curvature degree in the lower spine.

Treatment goals will include maintaining function levels and reducing discomfort during pregnancy. Treatment often involves physical therapy and exercise, hot and cold therapy, postural correction, making adjustments to make sleep more comfortable, regular stretching, chiropractic care, acupuncture, and stress reduction with meditation.

Physical Therapy and Exercise

Your healthcare provider or a physical therapist can recommend exercises to strengthen your low back and reduce pain. Regular exercise can strengthen the muscles of your low back, boost flexibility, and reduce the stress on the spine.

Safe exercises during pregnancy include walking, swimming, cycling, and low-impact aerobic exercises (i.e., elliptical trainer or stationary bicycling).

Hot and Cold Therapy

Applying heat and cold to your back might help reduce pain and stiffness in your back. Use cold compresses (such as a bag of ice or cold pack) in the painful area for up to 20 minutes a few times a day.

You can alternate between hot and cold. Use a heating pad in the painful area. Always check with your healthcare provider; they will tell you if it is safe for you to use heat and cold therapy while pregnant.

Improve Posture

Avoid slouching to reduce strain on your spine and use proper posture with walking, sitting, and sleeping. Wearing a pregnancy support belt might help with improving posture during pregnancy.

Sleep Adjustments

To relieve back pain during pregnancy while sleeping, be sure you sleep on your left side. This sleep position provides the best circulation for you and the growing fetus. It is also helpful to sleep with one or both knees bent.

Using pregnancy support pillows between your knees, behind your back, and under your growing belly can also help.

Regular Stretching

Talk to your healthcare provider or physical therapist about safe stretching exercises you can do to strengthen your back and pelvic muscles.

Chiropractic

Done correctly, chiropractic spinal adjustment can be safe during pregnancy. You should check with your healthcare professional if it is safe for you to seek out chiropractic care.

Acupuncture

Studies have found acupuncture to be effective in relieving low back pain during pregnancy. Acupuncture is a type of Chinese medicine that uses thin needles inserted in the skin at certain locations of the body. Check with your healthcare provider before seeking out acupuncture while pregnant.

Stress Reduction

Meditation is a stress-reduction technique that can be utilized at any time and in any place. There are many ways to practice meditation. One of the easiest ways to meditate is to sit or lie down in a quiet place and focus on your breathing. You can meditate in silence or make use of an audio program.

Meditation has been shown to promote a biological relaxation response that stimulates the brain to reduce the release of stress hormones, which in turn reduces muscle tension and pain.

Choosing Safe Pain-Relieving Medications

All medications should be used with caution during pregnancy to reduce the risk of harm to the growing fetus. Fortunately, there are some medications that are safe to use during pregnancy.

For lower back pain in pregnancy, acetaminophen is considered safe and is often given as a first-line drug to treat all types of pain during pregnancy.

You should always consult with your healthcare provider before starting any medication, including supplements, vitamins, and over-the-counter (OTC) medications, while pregnant.

When to Call Your Healthcare Provider

While some low back pain and discomfort are normal during pregnancy, there will be instances where you should reach out to your obstetrician or another healthcare professional.

Contact your healthcare professional for the following low back symptoms:

Any severe pain in your back
Low back pain that lasts more than two weeks
Low back pain accompanied by abdominal cramping that gets gradually worse
Pain or other difficulties with urinating
Numbness or tingling in the legs
Vaginal bleeding
Any abnormal vaginal discharge
Fever and/chills

These symptoms are concerning and require immediate medical attention. Back pain in pregnancy might be a sign of preterm labor or a urinary tract infection. If back pain is accompanied by vaginal bleeding, fever, or burning with urination, you should reach out to your healthcare provider right away.

A Word From Verywell

Back pain during pregnancy can be uncomfortable and frustrating, but most of the time it resolves after delivery. Remember to always listen to your body and stop activities that make back pain worse.

Check with your healthcare professional before you start exercising. If you experience symptoms, such as bleeding or severe pain, stop exercising and seek out immediate medical help.

16 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Carvalho MECC, Lima LC, de Lira Terceiro CA, et al. Low back pain during pregnancy. Rev Bras Anestesiol. 2017 May-Jun;67(3):266-270. doi:10.1016/j.bjan.2016.03.002
Katonis P, Kampouroglou A, Aggelopoulos A, et al. Pregnancy-related low back pain. Hippokratia; 15(3):205-210.
Treede RD, Rief W, Barke A, et al. A classification of chronic pain for ICD-11. Pain. 2015;156(6):1003-1007. doi:10.1097/j.pain.0000000000000160
Mei Q, Gu Y, Fernandez J. Alterations of pregnant gait during pregnancy and post-partum. Sci Rep. 2018;8(1):2217. doi:10.1038/s41598-018-20648-y
Yoo H, Shin D, Song C. Changes in the spinal curvature, degree of pain, balance ability, and gait ability according to pregnancy period in pregnant and nonpregnant women. J Phys Ther Sci. 2015;27(1):279-284. doi:10.1589/jpts.27.279
Cleveland Clinic. Psoas syndrome.
Cedars-Sinai. Back pain during pregnancy.
American College of Obstetricians and Gynecologists. Back pain during pregnancy.
Sehmbi H, D'Souza R, Bhatia A. Low back pain in pregnancy: Investigations, management, and role of neuraxial analgesia and anaesthesia: A systematic review. Gynecol Obstet Invest. 2017;82(5):417-436. doi:10.1159/000471764
Chandrasekharan B, Cyril Vincent S, Arulappan J. Effectiveness of back-stretch exercise on back pain among pregnant women. IEJNSR. 2020;1(1):1-5. doi:10.21608/ejnsr.2020.30590.1000
Quintero Rodriguez C, Troynikov O. The effect of maternity support garments on alleviation of pains and discomforts during pregnancy: A systematic review. J Pregnancy. 2019;2019:2163790. doi:10.1155/2019/2163790
KidsHealth From Nemours. Sleeping during pregnancy.
Stuber KJ, Wynd S, Weis CA. Adverse events from spinal manipulation in the pregnant and postpartum periods: a critical review of the literature. Chiropr Man Therap. 2012;20:8. doi:10.1186/2045-709X-20-8
Vas J, Aranda-Regules JM, Modesto M, et al. Auricular acupuncture for primary care treatment of low back pain and posterior pelvic pain in pregnancy: study protocol for a multicentre randomised placebo-controlled trial. Trials. 2014 Jul 16;15:288. doi:10.1186/1745-6215-15-288
Zeidan F, Vago DR. Mindfulness meditation-based pain relief: a mechanistic account. Ann N Y Acad Sci. 2016;1373(1):114-127. doi:10.1111/nyas.13153
Shah S, Banh ET, Koury K, et al. Pain management in pregnancy: multimodal approaches. Pain Res Treat. 2015;2015:987483. doi:10.1155/2015/987483

By Lana Barhum
Lana Barhum has been a freelance medical writer since 2009. She shares advice on living well with chronic disease.

See Our Editorial Process

Meet Our Medical Expert Board

Share Feedback

Was this page helpful?

Thanks for your feedback!

What is your feedback?