5 Common Causes of Pregnancy Back Pain and What You Can Do About Them

Back pain is incredibly common during pregnancy. As your body changes to accommodate your growing baby, your posture, movement patterns, muscles, joints and ligaments all have to adapt.

For some people, pregnancy back pain is mild and manageable. For others, it can make everyday activities such as walking, standing, sleeping, getting dressed or turning over in bed surprisingly difficult.

The important thing to remember is that pregnancy back pain is not usually caused by one single factor. Instead, several physical changes can overlap as your pregnancy progresses.

At Family Osteopathy in Hammersmith, we support women throughout pregnancy with individualised, gentle treatment and practical advice. In this guide, we’ll look at five common contributors to back pain during pregnancy, what it may feel like and what you can do to help.

1. Hormonal Changes During Pregnancy

What’s happening?

Pregnancy hormones help your body adapt as your baby grows and prepare your pelvis for birth. One of the hormones involved is relaxin, which contributes to changes in the ligaments and connective tissues around the pelvis.

These changes are a normal part of pregnancy, but they can alter how your joints and muscles move and how your body responds to everyday activities. This can contribute to discomfort around the lower back and pelvis. (nhs.uk)

It’s worth remembering that relaxin isn’t something your body needs to “get rid of”. It’s part of the normal physiological changes of pregnancy.

What might it feel like?

You may notice:

• Aching or discomfort around your lower back or pelvis

• Symptoms that vary from one day to the next

• Discomfort when changing position, such as turning over in bed

• Increased sensitivity to movements that previously felt comfortable

What can you do?

Rather than trying to avoid movement, the aim is to find ways of supporting your changing body.

Gentle, pregnancy-appropriate exercise can help maintain strength and mobility. Regular movement, changing positions and avoiding activities that consistently aggravate your symptoms can also be useful.

If you’re struggling, an osteopath experienced in pregnancy can assess how your back, pelvis and surrounding muscles are adapting and provide appropriate hands-on treatment and advice.

2. Changes in Posture as Your Baby Grows

What’s happening?

As your bump grows, your centre of mass changes. You may naturally alter the way you stand, walk and sit to accommodate your changing shape.

This can place different demands on the muscles and joints around your lower back and pelvis. It’s not necessarily about having “bad posture”; your body is continually adapting to keep you comfortable and balanced.

What might it feel like?

Pregnancy-related postural changes can contribute to:

• A dull or aching sensation in the lower back

• Back discomfort that builds throughout the day

• Symptoms after prolonged standing or walking

• Muscular fatigue around the lower back, hips or pelvis

What can you do?

Try to avoid staying in one position for too long.

If you’re sitting, make sure your back is comfortably supported. When standing, try to distribute your weight evenly between both feet rather than constantly shifting your weight onto one side.

Comfortable, supportive footwear can also help, particularly if you’re spending a lot of time on your feet. The NHS recommends maintaining good support when sitting and avoiding prolonged periods of standing where possible. (nhs.uk)

Your osteopath can also help you understand how your posture and movement patterns are changing as your pregnancy progresses.

3. Your Changing Weight and Load Distribution

What’s happening?

Pregnancy naturally changes the amount and distribution of load your body is carrying.

As your baby grows, your abdomen becomes larger and your centre of mass moves. Your muscles and joints therefore have to accommodate a gradually changing physical demand.

This doesn’t mean that pregnancy weight gain is “causing” your back pain. Rather, your body is adapting to a new and continually changing load.

What might it feel like?

You might experience:

• Increasing lower back or hip discomfort as pregnancy progresses

• Muscular fatigue after walking or standing

• Aching after physical activity

• A general feeling of heaviness or tiredness through your back and pelvis

What can you do?

Gentle, regular movement is usually preferable to becoming completely inactive.

Walking, swimming and pregnancy-appropriate exercise can help you maintain strength and mobility, provided they feel comfortable and are appropriate for your pregnancy.

It can also help to break up long periods of standing or sitting and avoid repeatedly lifting heavy objects where possible.

If an activity consistently increases your pain, don’t simply push through it. Modify the activity and speak to your midwife, GP or another appropriate healthcare professional if you’re concerned.

4. Changes to Your Abdominal and Pelvic Support

What’s happening?

As your baby grows, your abdominal wall stretches and the muscles and tissues around your abdomen, pelvis and pelvic floor adapt to accommodate your changing body.

This doesn’t mean your “core switches off” during pregnancy. Instead, the way your abdominal and pelvic muscles contribute to movement and stability changes as your body adapts.

Your back, abdominal, hip and pelvic floor muscles work together to support your trunk and pelvis. Changes in how these structures function can contribute to increased muscular fatigue or discomfort around the lower back and pelvis. (Gloucestershire Hospitals NHS Trust)

What might it feel like?

You may notice:

• Lower back fatigue during everyday activities

• A feeling that movements require more effort than they used to

• Discomfort when getting in and out of bed or standing from a chair

• Increased muscular tension around your lower back or hips

What can you do?

Staying active within your comfort level can help maintain strength and confidence in movement.

Pregnancy-appropriate exercises can be useful, particularly when they’re tailored to your individual needs. If you’re unsure what is appropriate for you, speak with your midwife, GP or a suitably qualified exercise or healthcare professional.

Your osteopath can also look at how your back, pelvis and surrounding muscles are moving together and provide treatment and advice appropriate to your stage of pregnancy.

5. Pelvic Girdle Pain (PGP)

What’s happening?

Not all pregnancy-related lower back pain is the same.

Some women develop Pelvic Girdle Pain (PGP), which can affect the joints at the front and/or back of the pelvis. PGP was previously often referred to as symphysis pubis dysfunction (SPD).

PGP is relatively common, affecting around 1 in 5 pregnant women, and can range from mild discomfort to pain that significantly affects mobility and everyday life. (RCOG)

What might it feel like?

Typical symptoms can include:

• Pain around the lower back, pelvis, hips or groin

• Pain around the pubic bone

• Difficulty walking

• Pain climbing stairs

• Discomfort when getting in or out of a car

• Pain when turning over in bed

• Clicking or grinding around the pelvis

• Difficulty with movements that involve standing on one leg or separating the legs

If this sounds familiar, you don’t simply have to put up with it until your baby is born.

Early assessment and appropriate management can help many people manage their symptoms and remain mobile throughout pregnancy. (RCOG)

What can you do?

Small changes can make everyday movements more comfortable.

For example:

• Keep your knees together when getting in and out of the car

• Avoid standing on one leg for prolonged periods

• Change position regularly

• Avoid movements that consistently aggravate your symptoms

• Use pillows between your knees when sleeping if this feels comfortable

• Keep active within your limits, while allowing yourself enough rest

If you think you may have PGP, speak with your midwife or GP. You may be referred to a physiotherapist for assessment, and manual therapy from a suitably trained healthcare professional, including an osteopath experienced in pregnancy-related pelvic pain, may form part of your care. (RCOG)

How Can Osteopathy Help With Pregnancy Back Pain?

Because pregnancy involves so many physical changes, there isn’t always one structure or one movement pattern responsible for your discomfort.

At Family Osteopathy, we take the time to understand what your body is experiencing rather than simply treating where it hurts.

Your appointment will include a detailed history and an appropriate physical assessment. This allows us to understand how your symptoms are affecting you and identify factors that may be contributing to your discomfort.

Depending on your individual needs and stage of pregnancy, treatment may include gentle hands-on techniques to the muscles and joints, alongside practical advice around:

• Posture and positioning

• Movement and activity

• Sleeping comfortably

• Getting in and out of bed or the car

• Supporting your growing bump

• Appropriate exercise

• Managing everyday activities

Treatment is adapted throughout pregnancy, with your comfort and safety at the centre of every appointment.

For pelvic girdle pain in particular, early assessment and appropriate management are important. RCOG guidance notes that treatment can be effective at any stage of pregnancy and that early treatment may help prevent symptoms from becoming more limiting. (RCOG)

When Should You Seek Help for Back Pain During Pregnancy?

Most pregnancy-related back pain isn’t serious, but severe, sudden or unusual symptoms should not simply be treated as normal pregnancy discomfort.

Speak to your midwife, GP or maternity team if your back pain is severe, rapidly worsening or significantly affecting your ability to move or carry out everyday activities.

You should seek urgent medical advice if back pain occurs alongside symptoms such as:

• Vaginal bleeding

• Fever

• Pain when urinating

• Pain under your ribs or in your side

• Contractions or other signs that labour may be starting

• Significant neurological symptoms

If you develop loss of sensation in your legs, bottom or genital area, the NHS advises seeking emergency medical attention. (nhs.uk)

If you’re unsure whether your symptoms are part of normal pregnancy changes, it’s always better to ask.

Pregnancy Back Pain: You Don’t Have to Just Put Up With It

Back pain can be a normal part of pregnancy, but that doesn’t mean you have to accept being uncomfortable throughout your pregnancy.

Hormonal changes, your changing posture, increasing load, changes around your abdominal and pelvic support, and conditions such as pelvic girdle pain can all contribute to symptoms.

The key is understanding what is contributing to your pain and what you can do about it.

At Family Osteopathy in Hammersmith, we provide gentle, individualised osteopathic care for women throughout pregnancy, helping you feel more comfortable and confident as your body changes.

If pregnancy back pain is affecting your sleep, movement, work or everyday life, we’d be happy to help you understand what’s going on and discuss whether osteopathic treatment may be appropriate for you.

Book a pregnancy osteopathy consultation at Family Osteopathy Hammersmith and take a proactive step towards a more comfortable pregnancy.