Back Pain in Pregnancy

The good news is, your baby is growing. That's exactly what should be happening -- but it can still be tough on your back.

You've got lots of company -- most pregnant women experience back pain, usually starting in the second half of pregnancy.

You should know that there are things you can do to minimize your back pain. Here's what helps.

Causes of Back Pain in Pregnant Women

Pregnancy back pain typically happens where the pelvis meets your spine, at the sacroiliac joint.

There are many possible reasons why it happens. Here are some of the more likely causes:

• Weight gain . During a healthy pregnancy, women typically gain between 25 and 35 pounds. 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 center 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.
• Hormone changes. During pregnancy, your body makes a 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 rectal abdominis muscles), which run from the rib cage to the pubic bone, may separate along the center seam. This separation may worsen back pain.
• Stress . Emotional stress can cause muscle tension in the back, which may be felt as back pain or back spasms. You may find that you experience an increase in back pain during stressful periods of your pregnancy.

Treatments for Back Pain in Pregnancy

More good news: Unless you had chronic backaches before you got pregnant, your pain will likely ease gradually before you give birth.

Meanwhile, there are many things you can do to treat low back pain or make it rarer and milder:

• 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 . Applying heat and cold to your back may help. If your health care provider agrees, start by putting cold compresses (such as a bag of ice or frozen vegetables wrapped in a towel) 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 rolled-up towel behind your back for support; rest your feet on a stack of books or stool and sit up straight, with your shoulders back. Wearing a support belt may also help.
• Counseling. If back pain is related to stress, talking to a trusted friend or counselor may be helpful.
• Acupuncture . Acupuncture is a form of Chinese medicine in which thin needles are inserted into your skin at certain locations. Studies have shown that acupuncture can be effective in relieving low back pain during pregnancy. Check with your health care provider if you're interested in trying it.
• Chiropractic. When performed correctly, chiropractic manipulation of the spine can be safe during pregnancy, but consult with your doctor before seeking chiropractic care.

More tips:

• If you need to pick something up from the ground, use your legs to squat rather than bend over.
• Don't wear high-heeled shoes.
• Don't sleep on your back.
• Wear support hose.

If your back pain persists, you may want to consult your doctor to see what else you might try. Be sure to consult your doctor before taking pain medications. Acetaminophen (Tylenol) is safe for most women to take during pregnancy. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) or naproxen (Aleve) are not advised. In some cases, your doctor may recommend other pain medicines or muscle relaxants that are safe during pregnancy.

When to Seek Treatment From a Doctor

Back pain, by itself, usually is not a reason to call your doctor. But you should call your doctor right away if you experience any of the following:

• Severe pain
• Increasingly severe pain or pain that begins abruptly
• Rhythmic cramping pains
• Difficulty urinating or “pins and needles” in your extremities

In rare cases, severe back pain may be related to problems such as pregnancy-associated osteoporosis, vertebral osteoarthritis, or septic arthritis. Rhythmic pains may be a sign of preterm labor. So if you are experiencing any of these problems, it's important to be checked by your doctor.