Pregnancy
Back pain in pregnancy: causes, relief and what can help
Back pain is a common complaint during pregnancy. Some women feel it mainly in the lower back, while for others the pain is closer to the sacrum, pelvis or pubic symphysis. What helps therefore also depends on where the discomfort occurs and which movements make it worse. Adapted movement, relief and small everyday changes often help.
Why pregnancy can put more strain on your back
During pregnancy, several things change in your body at the same time. As your bump grows, your centre of gravity shifts, your movement patterns adapt and some muscles take on different tasks than before. Pregnancy hormones also affect ligaments and joints.
Back pain can therefore rarely be traced to one single cause. Increasing load, altered movement patterns, muscle fatigue, pre-existing back problems and changes around the pelvis can all play a part.
Back pain is common in pregnancy – but that does not mean you simply have to put up with severe or persistent discomfort.
The idea that every pregnant woman inevitably develops a pronounced hollow back is also too simplistic. Each body finds its own ways to compensate for the changing centre of gravity.
Lower back, pelvis or pubic symphysis: the pain can be different
What we casually call “back pain” can actually come from different areas. A rough distinction can help you recognise typical triggers and describe your symptoms more precisely to a midwife, physiotherapist or doctor.
| Area | How it may feel | Typical situations |
|---|---|---|
| Lower back | dull pulling, pressure or muscular tension in the lumbar area | long periods of sitting or standing, bending, lifting, prolonged strain |
| Back of the pelvic girdle | pain on one or both sides deep around the sacrum or buttocks | walking, climbing stairs, prolonged activity, turning over in bed |
| Pubic symphysis | pain at the front of the pubic bone, sometimes radiating elsewhere | standing on one leg, stairs, getting in and out of a car, taking larger steps |
| Upper back and neck | tension between the shoulder blades or in the neck | long periods of sitting, screen work or unfamiliar strain |
| Radiating pain | pulling or pain extending into the buttock or leg | different possible triggers; not automatically “sciatica” |
The boundaries are not always clear. In particular, pain at the back of the pelvis can feel like classic lower back pain. The exact location alone is therefore not a diagnosis.
Pelvic girdle pain is easily mistaken for back pain
Pregnancy-related pelvic girdle pain can occur at the front around the pubic symphysis, at the back around the sacroiliac joints or in several places at once. The discomfort may also spread into the hips or thighs.
A typical feature is that certain asymmetrical movements become uncomfortable. Examples include climbing stairs, standing on one leg, getting in and out of a car or turning over in bed.
If you recognise these patterns and your mobility is becoming increasingly limited, it is worth seeking an assessment early. Physiotherapy can help identify the type of strain more precisely and tailor movement, exercises and relief strategies to you.
Back pain can also occur early in pregnancy
Back discomfort is not limited to the third trimester. It can also occur in early pregnancy. As an early sign of pregnancy, however, back pain is very non-specific and is not suitable for determining whether you are pregnant.
If you are not yet sure whether you are pregnant, a missed period and a pregnancy test taken at the right time are much more informative than back or lower abdominal discomfort. You can find a detailed overview in our guide to early pregnancy signs.
Back pain alone is also not a typical feature that can be used to identify an ectopic pregnancy. In early pregnancy, unusual or severe lower abdominal pain – especially on one side – as well as bleeding or marked circulation problems are more relevant. These symptoms should be medically assessed.
What to try first for mild back pain
If the discomfort is mild and feels familiar, you do not need to start a comprehensive exercise programme straight away. It is often more useful to first work out which type of strain makes the pain worse and which simple change brings relief.
- Change position: If you have been sitting or standing for a long time, adjust your posture and move around for a few minutes.
- Keep moving gently: A short walk or easy movements may feel better than lying still for a long time.
- Try comfortable warmth: A warm bath, heat pack or hot-water bottle can help relax tense muscles.
- Reduce the specific trigger: If lifting, climbing stairs or prolonged sitting makes the pain worse, temporarily change exactly that activity.
- Watch how it develops: If the pain becomes stronger despite adjustments, keeps returning or clearly limits you, professional assessment is sensible.
You do not have to “work through” all five steps in order. The sequence is simply intended to help you approach mild symptoms systematically without overreacting.
Adjust movement rather than resting for long periods
For typical muscular back discomfort, prolonged complete rest is often not helpful. Regular movement adapted to how you feel that day can maintain strength and mobility and helps prevent you from becoming less and less active because you are worried about pain.
Suitable activities can include walking, swimming, aqua fitness, pregnancy exercise classes or adapted strength training. The key is not one specific type of exercise, but whether the intensity and range of movement fit your previous activity level, the course of your pregnancy and your current symptoms.
If a movement clearly increases the pain, do not continue with the idea that you simply have to push through it. Modify the exercise, reduce the load or choose another activity. Especially with pelvic girdle pain, doing less of a painful movement may be more useful than simply exercising more.
Our guide to exercise during pregnancy explains in detail how to adapt activity, which types of exercise may be suitable and how to judge intensity.
Make everyday life easier on your back and pelvis
Many symptoms do not result from one single “wrong” movement, but from the same type of strain being repeated for hours. Small changes in your daily routine can therefore be more useful than trying to maintain a supposedly perfect posture all day.
- Break up long periods of sitting or standing by changing position regularly.
- Sit down to put on trousers, socks or shoes if standing on one leg triggers discomfort.
- Distribute loads as evenly as possible and avoid carrying heavy weight on one side.
- Keep objects close to your body when lifting and avoid unnecessary twisting under load.
- If you carry an older child, change sides and avoid carrying them on the same hip for long periods.
- With pelvic girdle pain, smaller steps and more symmetrical movements may feel more comfortable.
The aim is not to perform every movement perfectly. Instead, notice which everyday situations reliably make your symptoms worse and adjust those specific situations.
Use warmth, relaxation and massage sensibly
Comfortable warmth can feel soothing for muscular tension. A warm, not excessively hot bath, a heat pack or a hot-water bottle may help the muscles relax.
A gentle massage can also feel good when your back feels tense. It should always remain comfortable and should not be used to simply “massage away” severe or unexplained pain. If pain is pronounced, very localised or becoming stronger, professional assessment is more useful than increasingly intensive self-treatment.
Relaxation can also matter: pain often makes you move more cautiously and tense your muscles further. Short breaks, calm breathing and alternating activity with rest can help interrupt this cycle.
Sleeping and lying down: easing strain on the pelvis and back
As your bump grows, finding a comfortable sleeping position can become more difficult. Side sleeping is often comfortable. A pillow between your knees can support your legs and pelvis; depending on the size of your bump, another pillow under your abdomen may also feel helpful.
Our guide Sleeping Position During Pregnancy explains which position is recommended later in pregnancy, whether left or right is better and what applies from 28+0 weeks.
If you have pelvic girdle pain, keeping your knees closer together when turning over in bed and moving more slowly may help. Again, a position is only useful if it actually feels comfortable for you.
You do not need to consciously monitor your sleeping position all night. If a position becomes uncomfortable or makes you feel dizzy or unwell, change it.
When physiotherapy may be useful
If back pain keeps returning, limits your mobility or does not improve with simple adjustments, a physiotherapy assessment may be useful. Early assessment is particularly helpful for pelvic girdle pain because specific triggers and movement patterns can often be identified.
If you also notice a clear bulge along the midline of your abdomen, our guide to diastasis recti explains how to interpret this change. Diastasis recti is not automatically the cause of back pain.
Physiotherapy does not simply mean receiving a standard set of back exercises. Depending on your symptoms, movement strategies, individually selected strengthening exercises, positions that relieve strain and practical changes to your daily routine may all play a role.
A pelvic or pregnancy support belt can also provide temporary relief for some women. Whether a belt suits your particular symptoms and how it should fit is best assessed individually rather than solely by the week of pregnancy.
Discuss pain relief medicines during pregnancy
You do not necessarily have to endure more severe back pain without pain relief. At the same time, a medicine you used without problems before pregnancy is not automatically the right choice at every stage of pregnancy.
Which active ingredient is suitable depends, among other things, on the week of pregnancy, dose, duration of use and any medical conditions you have. If you need pain relief – especially repeatedly or for several days – discuss it with your doctor or pharmacist.
Conversely, do not stop necessary prescribed medicines on your own. An individual benefit-risk assessment is more reliable than general medication lists from the internet.
When back pain should be medically assessed
Most back and pelvic pain during pregnancy is associated with physical changes and strain. Certain patterns or accompanying symptoms, however, do not fit ordinary muscular discomfort and should be assessed professionally.
Contact your gynaecology or general practice, or another appropriate medical service, particularly if the pain starts suddenly and severely, increases quickly, persists for a longer period or clearly limits your mobility.
Back pain together with vaginal bleeding, loss of fluid, regular or wave-like recurring pain, fever, or pain and burning when urinating also needs medical assessment.
New pronounced numbness or weakness in the legs, or changes in bladder or bowel control, are not typical pregnancy-related back pain and require urgent medical assessment.
These points do not mean that severe back pain automatically indicates a pregnancy complication. They are intended to help distinguish symptoms for which self-care alone is not the right next step.
Frequently asked questions about “Back pain in pregnancy: causes, relief and what can help”
Back and pelvic pain are common during pregnancy. Common does not mean you simply have to tolerate severe or persistent symptoms. If pain clearly limits your daily life or feels unusual, professional assessment is sensible.
Yes. Back discomfort can occur early, but it is not a reliable pregnancy sign. Unusually severe lower abdominal pain, bleeding or marked circulation problems in early pregnancy should be medically assessed.
Changing position, gentle movement and comfortable warmth often help. Which measure suits you best depends on where the pain is and which movements trigger it.
Short periods of rest can feel good. Prolonged complete rest is often not helpful for typical muscular pain. Movement should be adapted to your symptoms and should not clearly make the pain worse.
This term describes pain around the front or back of the pelvis. Typical triggers can include walking, climbing stairs, standing on one leg, getting in and out of a car or turning over in bed.
Many pregnant women find side sleeping with a pillow between the knees comfortable. Depending on the size of your bump, extra support under the abdomen may also help. The position should feel comfortable for you.
Some painkillers can be used during pregnancy, but not every active ingredient is equally suitable at every stage. Discuss the choice and use with your doctor or pharmacist.
Assessment is particularly sensible for pain that starts suddenly and severely or increases quickly, and when it occurs with bleeding, loss of fluid, fever, urinary symptoms or new pronounced neurological changes.
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