What happens to your back during pregnancy?

During pregnancy, changes to your hormones cause the ligaments in your body to relax and stretch to prepare you for labour.

This can put a strain on the joints of your lower back and pelvis, which can cause backache. The weight of your growing baby also puts extra strain on the arch in your lower back.

How can I avoid backache during pregnancy?

You can protect your back during pregnancy by avoiding or changing the way you do some things. This becomes more important the further along in your pregnancy you are.

• Avoid heavy lifting. If you have to lift something heavy, bend your knees, keep your back straight and tighten your pelvic floor and abdominal muscles. Make sure the object you are lifting stays close to your body. Allow toddlers to climb onto your lap or into the car or bath, and squat down next to them rather than picking them up.
• Always have a good posture. Try to keep your pelvis symmetrical. Stand with your weight evenly on both legs, your back straight and your pelvis tucked under. Avoid standing for a long time. Sit up straight with your bottom at the back of your chair and your feet on a stool if necessary.
• Avoid activities that might hurt your back. These include bending or twisting, climbing ladders, or walking up steep hills.
• Be careful in bed. Sleep on your side with a pillow between your knees. To get out of bed, roll onto your side with your knees together. Then use your arms for support as you swing your legs onto the floor.
• Wear shoes with low heels (not flats). These have good arch support. Avoid high heels.
• Consider a maternity support belt.

A firm mattress can also help to prevent and relieve backache. If your mattress is too soft, put a piece of hardboard under it to make it firmer.

If you are unfit, overweight or if you smoke, you are more likely to experience backache or sciatica during pregnancy.

How is a back injury treated during pregnancy?

If you injure your back while you are pregnant, simple exercises and using back support are usually enough to fix the injury. In very rare cases, pregnant women can have a serious injury such as a herniated disc. In this case you might need surgery. Back surgery is usually safe, however, both for you and your baby during pregnancy.

Many women have a pre-existing back condition before they become pregnant, such as scoliosis, spondylolisthesis or a lumbar disc condition. Sometimes your back problems get better during pregnancy, but sometimes they get worse. It's important to mention any back problems to the medical team who are looking after you.

Talk to your doctor if you need to take medicine to control back pain. Paracetamol is one of the safest painkillers during pregnancy. Do not take aspirin or non-steroidal anti-inflammatories such as Nurofen while you are pregnant.

Your back injury should not affect labour or pain relief during labour. It is also usually possible to have an epidural if you have a back injury. Tell the hospital about your condition because there are different positions you can use to ease back pain during labour.

What exercises I can do to ease backache when I pregnant?

The gentle exercises below may help ease backache in pregnancy.

Stretches for lower backache:

• sit with your bottom on your heels with your knees apart
• lean forward towards the floor, resting your elbows on the ground in front of you
• slowly stretch your arms forward
• hold for a few seconds

Stretches for middle backache:

• go down on your hands and knees
• draw in lower tummy
• tuck your tail under
• hold for a few seconds
• gently lower your back down as far as feels comfortable

Stretches for pain in the shoulder blades and upper back:

• sit on a firm chair
• brace your tummy muscles
• interlock your fingers and lift your arms overhead
• straighten your elbows and turn your palms upwards
• hold for a few seconds

If back pain persists, changes or becomes severe, see your doctor or midwife for advice. They may advise you to see a physiotherapist. At any stage, if the back pain is associated with any blood loss from the vagina, seek medical advice urgently.

How can I strengthen my back during pregnancy?

Regular physical activity is important when you are pregnant and can protect your back. If your doctor says it's OK, you can do some gentle exercise like walking or water exercise. Talk to a physiotherapist for specific exercises to strengthen your back.

Stretch your lower back by kneeling on all fours with your head in line with your back. Pull in your stomach and round your back. Hold the posture for a few seconds and then relax. Repeat 10 times.

Keep your tummy muscles strong with pelvic tilt exercises. Lie on your back with your knees bent and your feet flat on the ground. Tilt your pelvis and hips backwards so the curve of your back is flat to the floor. Hold for 3 to 5 seconds. You can also do this exercise standing up or sitting on a gym ball.

Strengthen your tummy muscles and pelvic floor by gently drawing in the lower part of your tummy (bellow the belly button) towards your spine. Keep breathing. Gradually lengthen the time you hold the posture. Brace these muscles whenever you lift, push or pull something heavy.

Complementary therapies such as yoga and pilates can help some women, but always talk to your doctor or midwife first.

When should I see a doctor?

Talk to your doctor if the back pain is severe or if it lasts for more than 2 weeks.

Sometimes back pain can be a sign of premature labour or a urinary tract infection. See your doctor straight away if you also have bleeding from your vagina, painful urination or any signs of premature labour.