How can I reduce irritable back pain?

Back ache or pain is very common in pregnancy, but there are things you can do to reduce it.

Why do I have back pain?

During pregnancy your ligaments loosen up and stretch to get your body ready for labour. This puts strain on your joints, which can cause back pain.

Pregnancy also affects your posture (the way you hold your body up while standing or sitting). When you’re pregnant, the natural curve in your spine increases because it’s trying to cope with the extra weight of your baby bump. This can cause pain.

Many women say the pain is worse in the evening and after 28 weeks of pregnancy (third trimester).

Some women with lower back pain also have pelvic girdle pain  (symphysis pubis dysfunction), which is a common condition in pregnancy. It describes the pain caused by the pelvic joints getting stiff or less stable during pregnancy.

Back problems can affect your sleep and make it harder to go about your everyday life. But there are a few things you can do to help ease the pain, sleep better and stay strong throughout your pregnancy.

Exercise

If you have back pain it’s tempting to lie down as much as possible. Rest is important, especially when you’re pregnant. But lying down for long periods of time isn’t recommended when you have a bad back. It’s generally better to stay active and exercise  as best you can.

Low -impact exercises such as pilates  and yoga  can help build your muscles to better support your back and improve your posture, flexibility and balance. These types of exercises can help you take care of your mental health during pregnancy too, reducing stress and anxiety.

If you choose a class, make sure the teacher is qualified and tell them how many weeks pregnant you are. It’s best to choose a class that’s for pregnant women.

You may also find exercising in water helpful because it can take the weight off your back and bump. You could try swimming, or an aquanatal class. Contact your local leisure centre to find out what they offer.

Some hospitals offer exercise classes to pregnant women being cared for by their maternity team. Ask your midwife what’s available.

Pain relief

If you have mild back pain, paracetamol may help. It’s safe to take paracetamol while you’re pregnant, but it’s best to check with your midwife or GP first. If you take it make sure you:

  • follow the instructions on the packet for how much you can take
  • try to take the lowest dose that works and for the shortest amount of time.

Find out more about what medications you can take in pregnancy.

If your back pain is very bad, your GP may be able to prescribe stronger pain relief. They may also refer you to a physiotherapist. In some areas you may be able to refer yourself without seeing a doctor first. Ask your midwife or the receptionist at your GP surgery.

You can also pay for private physiotherapy.

Think about your posture

When you’re standing up, keep your head up and your shoulders back as much as you can.

When sitting on a chair, try to keep:

  • your hips level with or slightly higher than your knees
  • your bottom at the back of the chair
  • your back supported by the chair 
  • your feet resting flat on the floor.

If you work in an office, the top of your computer screen should be set up just below eye level. Your keyboard should be at a comfortable height so your forearms are flat. Try to get up regularly so you don’t get stiff.

Try not to slump when you’re sitting on the sofa. Use cushions to support your back and have your feet resting on the floor. It may help to lie on your side if you are watching TV or relaxing.

Tips for getting in and out of bed with back pain

  • Try to avoid lying flat for long periods of time. It’s better for your back and your baby to lie on your side.
  • You may find it more comfortable to have a pillow under your bump or between your knees to support your back. This can help you sleep better, too.
  • Some women find pregnancy pillows can help, but they can be pricey. You may find a normal pillow does the trick.
  • If you are getting pain in your hip from lying on your side, it may help to place a duvet under your sheet or use a memory-foam topper for a softer mattress.

Getting in and out of bed can get more difficult as your bump gets bigger. To take the strain off your back, try rolling onto your side moving your shoulders, hips and knees at the same time. Let your legs ease off the edge of the bed and put your feet on the floor. At the same time, use your arms to push yourself up to a sitting position.

Doing this all as one movement can be more comfortable. Try the movement backwards to get back into bed.

Massage therapy

You may find massages help with back pain. It’s also a great way to have some quiet time to yourself and relieve any emotional stress  or anxiety.

Don’t have a full body massage during your first 12 weeks of pregnancy (first trimester) because your stomach (abdomen) shouldn’t be massaged then. It’s also best to have a massage that’s specifically for pregnant women.

Acupuncture

Acupuncture is a type of complementary therapy that involves a practitioner inserting thin needles at particular points on your body. It’s used to control and relieve pain. Research has shown that it can help with back pain for pregnant women.

Acupuncture is generally safe to have when you’re pregnant but talk to your midwife or GP before you book a session. If you do want to try it, make sure your acupuncturist is fully qualified and that they use disposable needles at every treatment session. Tell your practitioner that you’re pregnant because certain acupuncture points can’t be used safely in pregnancy.

Some NHS doctors and physiotherapists can give acupuncture alongside regular medical treatment. Talk to your GP or midwife to find out more. Most people pay privately for acupuncture. 

More useful tips for reducing back pain

  • bend your knees and keep your back straight when you lift or pick up something from the floor
  • avoid lifting heavy objects
  • wear flat shoes
  • move your feet when you turn to avoid twisting your spine
  • try to carry your shopping in 2 bags on each side to balance the weight.

When to get help for back pain straight away

Back pain can sometimes be a sign of something more serious. There’s no need to panic, but you should contact your midwife or hospital maternity unit if you have back pain and you:

More support and information

Acupuncture Associated of Chartered Physiotherapists  is a professional network for physiotherapists who also do acupuncture.

British Acupuncture Council  is a self-regulating body for the practice of traditional acupuncture in the UK.

British Medical Acupuncture Society  is a charity where members are regulated healthcare professionals who do acupuncture.

Chartered Society of Physiotherapy  is a recognised professional body with details of registered private physiotherapists.

The Council for Soft Tissue Therapies is the governing body for massage therapies in the UK with details of qualified practitioners.

 

Sources

1. Sue Macdonald and Gail Johnson (2017) Mayes’ Midwifery, Edinburgh: Baillir̈e Tindall Elsevier

2. NHS Choices. Pelvic pain in pregnancy https://www.nhs.uk/conditions/pregnancy-and-baby/pelvic-pain-pregnant-spd/ (Page last reviewed: 28/07/2016. Next review due: 28/07/2019)

3. Clinical Knowledge Summaries (2017) Back pain – low (without radiculopathy) https://cks.nice.org.uk/back-pain-low-without-radiculopathy#!topicsummary

4. NHS Choices. A guide to pilates https://www.nhs.uk/live-well/exercise/guide-to-pilates/ (Page last reviewed: 11/05/2018. Next review due: 11/05/2021)

5. NHS Choices. A guide to yoga https://www.nhs.uk/live-well/exercise/guide-to-yoga/ (Page last reviewed: 11/06/2018. Next review due: 11/06/2021)

6. Clinical Knowledge Summaries (2016) Antenatal care – uncomplicated pregnancy https://cks.nice.org.uk/antenatal-care-uncomplicated-pregnancy#!topicsummary

7. NHS Choices. Can I take paracetamol when I am pregnant? https://www.nhs.uk/common-health-questions/pregnancy/can-i-take-paracetamol-when-i-am-pregnant/ (Page last reviewed: 01/06/2018. Next review due: 01/06/2021)

8. NHS Norfolk and Norwich University Hospital Physiotherapy advice in pregnancy (Last reviewed 20/03/2018 Next review due: 20/03/2021)

9. NHS Choices. Are complimentary therapies safe during pregnancy? https://www.nhs.uk/common-health-questions/pregnancy/are-complementary-therapies-safe-during-pregnancy/ (Page last reviewed: 23/05/2018. Next review due: 23/05/2021)

10. Pennick V and Liddle SD (2013) Interventions for preventing and treating pelvic and back pain in pregnancy The Cochrane Database of Systematic Reviews 2013 Aug 1;(8):CD001139. doi: 10.1002/14651858.CD001139.pub3

11. NHS Choices. Acupuncture https://www.nhs.uk/conditions/acupuncture/  (Page last reviewed: 22/08/2016. Next review due: 22/08/2019)

12. NHS Choices. Back pain in pregnancy https://www.nhs.uk/conditions/pregnancy-and-baby/backache-pregnant/ (Page last reviewed: 14/02/2018. Next review due: 14/02/2021)

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Last reviewed on September 10th, 2018. Next review date September 10th, 2021.

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