Before getting into the emotional and physical stress of pregnancy, back pain should be one of your least worries. Climbing stairs, moving around, bending down and standing for a long time typically do not cause any problems.
Now you are pregnant, you’ve realized what’s unusual before pregnancy is common in a lot of women. Back pain in pregnancy is very common – about half to two-thirds of pregnant women will notice some back or pelvic pain, especially later in pregnancy, according to the American College of Obstetricians and Gynecologists (ACOG) and the NHS.
During pregnancy, taking your bath, bending down, sitting or standing for a long time, lifting light or heavy objects, or running around can cause a sharp and discomforting middle or lower back pain.
The truth is you may start experiencing mid upper back pain from the fourth month of pregnancy (second trimester).
If you’ve already begun having this kind of pains early in pregnancy, there is still no need to worry yet if the pain is mild and you feel well otherwise. Some women may start having back discomfort as soon as eight weeks into pregnancy.
In fact, if you’ve been noticing pain in your back before getting pregnant, the chances are, you will continue to feel such pain when you get pregnant.
Why does back pain happen?
During pregnancy, women will notice that as each week passes, your weight continues to increase and you weigh more.
As your baby grows bigger during pregnancy, you may start getting back discomfort. This is mainly because your growing uterus and extra weight change your posture and put more strain on the muscles and joints in your back and pelvis, not because of the round ligaments alone. Some women also develop pelvic girdle pain (PGP), a type of pain around the hips, buttocks or pubic bone described by the RCOG.
In some women, these kind of pains are not new and will not be severe. However, in others, it could result in serious problems affecting mood, daily activities and making some women stay idle.
If you now have this serious back pain, don’t lose hope. Back pain in pregnancy is very common, but that does not mean you must suffer in silence. It can often be improved with simple techniques discussed later in this article, and you should speak with your doctor or midwife if the pain is severe or getting worse.
This guide explains the types of back pain, causes of mid upper back pain during pregnancy, easy treatment, preventing tip and when your back pain means something more serious.
What are the types of back pain during pregnancy?
During pregnancy, between 4th and 8th weeks, you will notice pregnancy symptoms like breast soreness, body weakness, breast pain, nausea, and vomiting.
As your baby develops and increases in size, you will begin to notice ache at your back, buttocks or sometimes in your thighs.
These are the three types of pain you could experience while pregnant.
1. Mid upper back pain during pregnancy (lumbar pain)
Lumbar pain simply means pain in the lumbar region of your spine. Possibly, you’ve already had this pain before getting pregnant.
Pain is located just around your waist level and may occasionally extend to your thighs.
2. Posterior pelvic pain during pregnancy
This is the most common type of back pain women will experience in the second or third trimester, and is similar to what many guidelines call pelvic girdle pain (PGP). It is very common (about 3–4 times more common than the lumbar pain).
Usually, pain is located below your waist level (at the buttocks) either on one or both sides. Sometimes, pain may spread to the thighs. The NHS also describes this as pelvic girdle pain or symphysis pubis dysfunction.
3. Sciatica pain during pregnancy
This pain is usually sharp or burning and occurs because the sciatic nerve is irritated or compressed in the lower back or pelvis. In some women this can be due to a slipped (herniated) disc, but true disc herniation in pregnancy is not very common.
If you have sciatica during pregnancy, you will experience back pain, waist pain, and pain in your knees, legs, and foot.
Nevertheless, sciatica-type pain is less common than simple low back or pelvic pain in pregnancy.
If you have pain in your back, chances are, you are experiencing a lumbar or posterior pelvic pain.
What causes middle upper back pain (first, second and third trimester)?
During your first trimester (8–12 weeks), second and third trimester, you could experience a lumbar or posterior back pain. Here’s why it happens:
Prolonged postures
If you are taking a particular position for a long time, you will notice spasm at your back. Standing or sitting for too long or lifting heavy objects will result to back pain.
Hormone changes
During pregnancy, estrogen and progesterone are elevated. These hormones make you feel pregnant. One other hormone that is elevated during pregnancy is relaxin.
Relaxin, like the name will imply, causes some joints and ligaments (especially in your pelvis) to soften and loosen in preparation for birth, which can make the joints in your lower back and pelvis move a bit more and cause pain.
Increased weight during pregnancy
Usually, during pregnancy, it’s normal for women to gain more weight as baby grows. In a healthy pregnancy, about 20–35 pounds will be added to your pre-pregnancy weight.
This extra weight shifts your centre of gravity forward and puts more load on your lower back muscles. Extra weight gain and effect of relaxin contribute to making you feel pain at your back. Usually, after pregnancy, the pain subsides and goes away.
How to ease mid back pain during pregnancy?
If you are already experiencing a persistent back pain or pain that comes and goes, these are some prove ways you could feel better.
1. Exercise and stretching
Don’t hide from your routine work or mild exercise. If you are getting pain on your back, you should quickly get going, and engage in mild to moderate exercise.
It’s also important that you inform your doctor or midwife about an exercise routine. For most healthy women, regular moderate exercise in pregnancy is safe and does not increase the risk of miscarriage, early delivery or low birth weight, as explained by ACOG’s guidance on exercise during pregnancy. Your doctor can help you decide what is safe for you.
A simple exercise routine is supporting your back on your hands and knees, then raising the right hand and left leg for a minimum time of 5 seconds. You should then try the same for the other side (by lifting the left hand and right leg). Gentle stretches, pregnancy yoga or walking – as suggested by the Mayo Clinic’s tips for back pain in pregnancy – can also help many women. Charities like Tommy’s also recommend warm baths, support belts and massage for some women.
2. Don’t just sleep, do it right
If you are about to sleep, it’s important you stay off your back. Lie on your side and get pillows to support your tummy from under.
Using pillows between legs will help you feel better.
3. Don’t forget yourself for too long
Does your work or academic activity make you stand or sit for a very long time?
It’s important you take a break from time to time. Taking a particular position for a long time may worsen your pain.
4. Talk to your doctor
If your pain is now beyond your control, talk to your doctor. Some pain relief medications do help to ease pains fast. However, taking drugs without informing your doctor is unsafe during pregnancy. In many places, paracetamol (acetaminophen) is usually the first medicine doctors recommend for pain in pregnancy, and anti-inflammatory drugs like ibuprofen are avoided unless your doctor specifically tells you to.
When to worry about upper back pain during pregnancy
Though a lower or upper back pain occurs in about two-thirds of pregnant women, other symptoms may indicate something more serious and need urgent medical attention.
1. Severe abdominal pain
If you are in your first trimester, a severe abdominal pain and back pain may mean something more serious. Talk to your doctor as ectopic pregnancy or a miscarriage will present this way, especially if you also feel dizzy, faint, or have shoulder tip pain.
Read more:
2. Vaginal bleeding
If your back pain is now occurring with vaginal bleeding, it may mean you are having a miscarriage or another pregnancy problem and you should see a doctor or go to the hospital urgently. Miscarriage bleeding will occur with clots and severe abdominal cramps.
See causes of bleeding during pregnancy here.
Back pain in pregnancy can also be a sign of other problems such as kidney infection, kidney stones, or preterm labour. If your back pain comes with fever, burning when you pass urine, difficulty walking, sudden weakness or numbness in your legs, chest pain, shortness of breath, or a gush or continuous leakage of fluid from the vagina, you should seek urgent medical care.
Worried about your mid upper back pain while pregnant? Ask The Medplux Team!!!
Dr Akatakpo Dunn is a Nigerian medical doctor, sonologist and Medical Director of Verah Clinic & Maternity in Warri, Nigeria. He holds an MBBS from the University of Nigeria, Nsukka, a Postgraduate Diploma in Diagnostic Ultrasound (India) and a Professional Diploma in Obstetrics & Gynaecology (RCPI). Through Medplux, he explains women’s health, pregnancy, fertility and ultrasound in clear, practical language so readers can make informed decisions with their own doctors.
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