Back pain is one of the most common complaints during pregnancy, affecting an estimated 50–70% of pregnant women. For many, it begins in the second trimester and intensifies as the pregnancy progresses. While some degree of discomfort is expected, significant back pain doesn't have to be accepted as an unavoidable consequence of pregnancy. Safe, effective treatments exist.
Why Back Pain Happens During Pregnancy
The Relaxin Hormone
During pregnancy, the body releases relaxin, a hormone that softens the ligaments of the pelvis to allow the birth canal to expand. The problem is that relaxin isn't selective; it affects ligaments throughout the body, including those supporting the lumbar spine and sacroiliac joints. With reduced ligamentous stability, these joints are more susceptible to strain and misalignment.
Shifting Center of Gravity
As the uterus expands, the center of gravity shifts forward. To compensate, many pregnant women arch their lower backs, increasing lumbar lordosis. This places added compression on the facet joints and lumbar discs, often causing a deep, aching pain in the lower back.
Weight Gain
The additional weight of pregnancy, typically 25–35 pounds, increases load on the entire musculoskeletal system. The spine, hips, knees, and ankles all feel the difference. Weakened core muscles (the abdominal wall stretches to accommodate the growing uterus) reduce the structural support available to the spine.
Types of Pregnancy-Related Back Pain
Understanding the type of back pain can guide appropriate treatment:
- Lumbar pain: Felt in the lower back, similar to typical lower back pain. Associated with postural changes and muscle strain.
- Posterior pelvic pain (PPP): Deeper pain felt below and to the side of the lower back, sometimes radiating into the buttocks or thighs. Associated with sacroiliac joint dysfunction and is more common during pregnancy than lumbar pain. PPP is often worse when climbing stairs, turning in bed, or sitting for long periods.
Safe Treatment Options
Chiropractic Care
Chiropractic care during pregnancy is safe when performed by a practitioner trained in prenatal techniques. The Webster Technique is a specific chiropractic analysis and adjustment designed to address sacroiliac joint dysfunction and reduce intrauterine constraint during pregnancy. It has been used by many women to relieve pelvic and low back pain and is recognized by the International Chiropractic Pediatric Association as a safe prenatal intervention.
Chiropractors use modified positions (pregnancy-specific tables or specialized pillows) to ensure the mother and baby are comfortable during treatment. No high-velocity adjustments are directed at the abdomen.
Prenatal Massage
Massage therapy during pregnancy reduces muscle tension, improves circulation, and lowers stress hormones. Research indicates that prenatal massage can reduce anxiety, improve sleep quality, and decrease both back and leg pain. Side-lying positioning or pregnancy-specific tables are used to ensure safety and comfort.
Safe Stretches and Exercises
- Cat-cow stretch: Gently mobilizes the lumbar spine and relieves muscle tension
- Pelvic tilts: Strengthen the lower abdominals and reduce lumbar lordosis
- Child's pose (modified): Relieves lumbar compression with knees wide for the belly
- Hip circles: Loosen the sacroiliac joints and hips
Prenatal Yoga
Yoga during pregnancy improves flexibility, strengthens stabilizing muscles, and promotes body awareness that helps manage postural changes. Choose classes specifically designed for pregnancy and inform the instructor of your stage and any complications.
What to Avoid
- Prolonged standing or sitting without breaks
- Heavy lifting, if unavoidable, always lift with the legs and keep the object close to the body
- High-impact exercise without prior medical approval
- Sleeping flat on the back after the first trimester (reduces compression of the vena cava)
- Anti-inflammatory medications (NSAIDs) without physician guidance, many are contraindicated in pregnancy
At Shin Wellness, our practitioners have extensive experience supporting pregnant patients through chiropractic care, massage, and corrective exercise. If you're experiencing back pain during pregnancy, we encourage you to reach out for a consultation tailored to your specific needs and trimester.