Although there are many complications associated with pregnancy such as nausea and cramps, back pain is a common problem that most pregnant women face at some point in their pregnancy. This pain increases especially in the last trimester, as the weight of the fetus increases and the ligaments in the pelvic area become more flexible due to hormones. In this article from Dalili Medical, we will review some methods that can help relieve this problem and reduce stress.

The difference between back pain and pelvic pain during pregnancy***

 

There is a meeting point between the lower back and pelvis, which may lead to confusion between lower back pain and pelvic pain. This type of pain can be classified into two categories:

1. **Lower back pain**: You feel mild pain when bending forward, which hinders your ability to move the lower part of your body or move the lumbar vertebrae in the spine. You may feel pain when pressing on your back muscles.

2. **Pelvic girdle pain (PGP)**: In this area, there is a bone shared between the thigh bone and the last bone in the spine, known as the sacroiliac joint. When pain occurs in this area, you may feel a slight stinging sensation. Pelvic girdle pain is usually short-lived and is caused by the expansion of the ligaments and the relaxation of the joints in the pelvis. Doctors may confuse sciatica with pelvic girdle pain.

Causes of back pain in pregnant women***

 

There are many reasons that lead to back pain in pregnant women, including:

1. **Weight gain during pregnancy**: The pregnant woman gains additional weight, which puts additional pressure on the spine.

2. **Hormonal changes**: The body produces the hormone relaxin during pregnancy, which leads to relaxation of the ligaments in the pelvic area and spine, which may cause a feeling of instability and pain.

3. **Separation of the rectus abdominis muscles**: In some cases of pregnancy, separation of the rectus abdominis muscles may occur as a result of the expansion of the uterus.

4. **Stress and emotional stress**: The pregnant woman suffers from high levels of stress and emotional stress, which leads to increased muscle tension and tension.

5. **Changes in the body's center of gravity**: Changes in the body's center of gravity occur during pregnancy, which prompts the pregnant woman to adjust her body position and way of movement, which may lead to stress and back pain.

Causes of lower back pain in pregnant women***

 

Pregnant women may wonder at the beginning of their pregnancy about the cause of lower back pain in the second month. To answer this question, it should be noted that there are several factors that may lead to the appearance of back pain in the first trimester of pregnancy, which extends from the moment the egg is fertilized until the end of the third month. Among these reasons are:

1. A sign of pregnancy: Back pain may be an early sign of pregnancy.

2. Increased hormone levels: The hormones secreted by the body during pregnancy lead to relaxation of the ligaments and joints, especially in the pelvic area, which causes pain in the lower back, and the pain may extend to other joints in the body.

3. Stress: Stress can increase the severity of back pain, whether during pregnancy or at other times, and emotional stress may also contribute to the exacerbation of these symptoms.

**Symptoms of Back Pain in Pregnancy**

 

Pregnancy-related back pain usually appears in the lower back, and may take the form of a sharp pain or burning sensation in the posterior pelvic area. The pain can extend to the buttocks and include the thigh and back of the thigh, making it similar to the symptoms of sciatica. However, unlike sciatica, the exact location of the pain is difficult to pinpoint, and its type or the areas affected may change as the pregnancy progresses.

Women who experience back pain during pregnancy should contact their doctor if:

- If the pain is very severe.

- If the pregnant woman is in the second or third trimester of pregnancy.

- If she has a fever, vaginal bleeding, or pain when urinating.

- If she feels pain on one side of the body or on both sides below the ribs.

**Is back pain during pregnancy normal?**

 

Back pain is one of the most common problems that women face during pregnancy, especially in the last months. This pain usually goes away after the baby is born, but many women may continue to have pain for several months after giving birth.

**What is the right ointment for back pain during pregnancy?**

 

It is always necessary to consult a doctor before using any pain-relieving ointment or pain-relieving medication during pregnancy. Not all medications available in pharmacies can be used safely by a pregnant woman. The doctor chooses a pain-relieving ointment that is safe during pregnancy after assessing the woman's health, pregnancy status and stage.

Back or spine pain affects all pregnant women to varying degrees. Pain can appear at any stage of pregnancy, in different areas and with varying severity. However, before a pregnant woman suffers from pain, she should take preventive measures that include practicing appropriate physical activity. A doctor should always be consulted if pain appears. If the pain is not caused by complications related to pregnancy, the pregnant mother should work to reduce it. Following a healthy lifestyle, a balanced diet, and practicing safe physical activity can help her in this.

**Is back pain dangerous for pregnant women?**

 

Back pain is a common symptom during pregnancy, but in some cases it may indicate complications. For example, back pain could be a sign of preterm labor or a urinary tract infection.

**How ​​can you tell if back pain is serious during pregnancy?**

 

While back pain is a common condition during pregnancy, it’s important to know when to worry. Some symptoms could be a sign of a more serious problem. Here are some signs that you should seek medical attention:

- **Fever:** If you have a fever along with your back pain, it could be a sign of an infection.

- **Spreading pain:** If the pain spreads to one or both legsWhat, causing weakness, tingling or numbness.

- **Difficulty moving:** If the pain is so severe that it affects your ability to walk or do daily activities, it may be necessary to seek medical help.

- **Vaginal bleeding or uterine contractions:** Sometimes, back pain can be a sign of something serious, such as premature labor, so pay attention to these symptoms.

When you have vaginal bleeding or a feeling of tightening in the uterus**: Back pain can sometimes be a warning sign of a serious problem. One of the most worrisome causes of back pain during pregnancy is the possibility of premature labor.

When you feel numbness**: Although numbness is often less serious than premature labor, it may indicate pressure on the sciatic nerve or other nerves that connect the spine to the lower body and pelvic area.

When you experience sudden, severe, intermittent pain**: Back pain that comes on suddenly and is severe for no apparent reason should be checked to rule out rare and painful conditions such as osteoporosis or pregnancy-related arthritis.

**Risks of lower back pain during pregnancy**

 

Severe lower back pain can be associated with health problems such as: miscarriage, ectopic pregnancy, pregnancy-related osteoporosis, premature placental abruption, preeclampsia, spondyloarthritis, septic arthritis, and premature birth.

**Types of back pain in pregnant women**

 

The nature of back pain in pregnant women varies from one woman to another and from one period to another. Back pain in pregnant women can appear in several forms, including:

**Lower back pain that extends to the legs**Lower back and abdominal pain are common signs of pregnancy. The causes of lower back pain that extends to the legs in pregnant women are due to the same causes that lead to lower back pain in non-pregnant women, including:

- Injury to the ligaments, muscles, and joints with a disc, which occurs as a result of fatigue or incorrect body positions.

- Incorrect way of carrying heavy objects.

- Weak back muscles.

- Exposure to an injury in the back area.

- Practicing some activities such as walking, standing for long periods, running, bending forward, turning over on the bed, and carrying heavy objects.

- Progression of pregnancy and weight gain.

The increase in fetal weight and progress of pregnancy cause increased pressure and stress on the joints and ligaments in the lower back area.

Weak abdominal muscles also contribute to the exacerbation of this problem.

In addition, some hormones are secreted that work to relax the muscles and ligaments to increase the flexibility and stretching of the birth canal. The effect of these hormones is not limited to the pelvic area only, but extends to include all joints, including the joints of the spine. This leads to the spine losing its ability and flexibility to face the increasing pressures and stresses resulting from changes in the pregnant woman's body and the increase in fetal weight.

**Lower back pain in pregnant women resulting from injury to the iliac joint** Pregnant women suffer from lower back pain as a result of injury to the iliac joint, which leads to a feeling of deep pain in the buttocks area, in addition to the back and sides of the thigh. This type of pain increases as pregnancy progresses, and may continue in some cases even after childbirth.

Lower back pain worsens while standing, walking, driving for long periods, or when lying on and getting out of bed.

**Lower Back and Hip Pain for Pregnant Women** A small percentage of women complain of hip pain during pregnancy, which may be caused by inflammation or pressure on the sciatic nerve, also known as sciatica. Pregnant women feel weak, tired, and tingling as a result of the sciatic nerve being affected, and this may be accompanied by back pain that sometimes extends down the leg.

It is important to note that lower back pain resulting from sciatic nerve injury is not limited to pregnant women, but can also affect non-pregnant women. This refutes the common belief that the baby is putting pressure on the sciatic nerve. In addition, the treatment methods used for this type of pain are completely different from those used to treat other types.

A pregnant woman should see a doctor or physical therapist if she feels pain in the pelvic bone or the area surrounding it from the front. This is because this pain needs to be distinguished from other types of back pain, as pain in the pelvic bone or the areas surrounding it from the front is associated with a condition known as dysfunctional pubic elevation.

Lower back pain while lying down or sleeping Pregnancy-related lower back pain, which increases at night, can occur as a result of the expansion of the uterus. This expansion may put pressure on one of the main blood vessels, the vena cava, leading to congestion of blood vessels in the pelvic area and lumbar spine.

**Back pain treatment for pregnant women**

 

Here are the most important ways to relieve back pain during pregnancy:

. **Standing correctly:**

- Avoid sitting or standing for long periods. Use a comfortable seat and avoid standing on one foot. Make sure to sit down periodically if you have been standing for a long time. 

- Choose chairs that support your back, use pillows behind your back, and try to sit up straight. 

- Make sure your shoulders are in a comfortable position while standing. 

- At work or while driving, make sure the chair provides you with adequate support, and avoid straining your legs. Make sure the position of the computer screen and chair is comfortable, and try to move away from your desk regularly to get some fresh air during lunch.

- Be careful while doing housework, and avoid strenuous work. 

- You can use a warm towel or heating pad on your lower back to relieve pain. 

- If you have a small child and you are pregnant, it is important to adhere to the correct lifting techniques. Try to kneel or squat when picking up your child, and if that is difficult, sit down and let your child come to you.

** Sleeping properly: It is best to sleep on your sideRight while avoiding locking the knees, and a pregnancy pillow can be used to make sleeping more comfortable. You can also place a pillow between your knees and another under your belly, as this helps prevent the upper leg from twisting across the body during sleep.

It is preferable to use a firm mattress to sleep on.

When getting out of bed, you should turn to one side and push yourself to reach a sitting position, then stand up slowly.

You can consult a gynecologist to learn some stretching and abdominal strengthening exercises, as these low-impact exercises are safe for you, and can help relieve back pain and enhance your body's flexibility.

You can also get a gentle massage during pregnancy from your life partner or from a center specializing in massage and relaxation.

Avoid taking any medications without consulting your doctor first, as they may cause complications during pregnancy later.

.** Ensure that you wear appropriate clothing**: It is important to choose appropriate clothing to support pregnancy, as the clothes should be the right size and wide enough, with large shoulders to avoid excessive pressure on the shoulders and rib cage.

It is preferable to wear abdominal support clothing or wide maternity pants that fit the lower abdomen area.

Tight clothing should be avoided during pregnancy, as it can lead to poor blood flow and discomfort, which may reduce the supply of oxygen to the muscles, which may cause back pain.

It is also recommended to avoid high heels, as doctors prefer to wear low-heeled shoes with good support. Although they may not be ideal in terms of style, they provide greater comfort and safety for you and your expected baby.

**Massage** Lower back massage for pregnant women helps provide relief for tired and sore muscles, as it focuses mainly on the muscles surrounding the spine and lower back area.

It is recommended that pregnant women consult a massage therapist or physical therapist to ensure that they receive proper medical assistance, in addition to helping them choose the best ointment suitable for back pain during pregnancy.

**Heat and water** Heat and water are effective factors in relieving back pain in pregnant women, so it is recommended to take a warm bath to help the pregnant woman relax and relieve back pain.

**Cold and warm compresses** Cold or warm compresses can be used on the painful area for twenty minutes several times a day, for a period ranging from two to three days. Care should be taken not to place the compresses directly on the abdominal area during pregnancy. It is necessary to consult a doctor before using compresses to relieve back pain in pregnant women.

**Using an auxiliary belt** The physical therapist recommends wearing an auxiliary belt, as this belt helps relieve some of the weight from the woman's back by supporting the baby.

**Auxiliary pillow while sleeping** Sleeping on one side with a special pregnancy pillow under the abdomen helps relieve back pain in pregnant women.

**Strength and balance exercises** Lower abdominal exercises help reduce the pressure caused by pregnancy on the pregnant woman's back. The pregnant woman can perform these exercises easily and safely by kneeling on her hands and knees while keeping her back almost straight. She should inhale, and when exhaling, she should perform lower abdominal exercises while pulling the abdomen inward and upward.

This position should be maintained for five to ten seconds without holding the breath or moving the back, then the pregnant woman should slowly relax her muscles after the exercise is finished. She can also stand with her back against the wall, slowly press her buttocks towards the wall until she touches it, then move away from it and repeat this exercise several times throughout the day.

**Acupuncture**Acupuncture is a traditional Chinese medicine method, where thin needles are inserted under the skin at specific points. This technique is believed to help relieve back pain in pregnant women.

Exercises to relieve back pain during pregnancy***

 

**Pelvic tilt exercise:**

1. Lie on your back with your knees bent and your feet on the floor.

2. Press your lower back into the floor so that there are no gaps between your back and the floor.

3. Make sure to relax your gluteal muscles to isolate your abdominal muscles.

4. Hold for 3 to 10 seconds, then repeat 10 to 30 times.

Squat: Lean your head, shoulders, and back against a wall, and place your feet about two feet away from the wall.

Slowly lower your body as if you were going to sit, making a 90-degree angle with your knees.

Slowly raise your body while keeping your back and buttocks in contact with the wall.

Repeat this exercise 10 to 30 times.

**. Kegel exercises** If you are in the second trimester of pregnancy, you can try this exercise that focuses on strengthening your pelvic muscles. This exercise helps promote pelvic and spinal health, and it also prepares you better for labor and delivery. In addition, doing up to five sets of Kegel exercises daily can help prevent fecal incontinence, which can be common during pregnancy.

* Squats * Squats are considered safe and beneficial exercises for pregnant women, as they are one of the best options to maintain their health. It is important to choose the right types of exercises during pregnancy and avoid strenuous activities. Squats help relieve lower back pain, which is one of the most common pains during pregnancy, as they stretch the ligaments in that area, which helps them withstand extra pressure without feeling pain.

This exercise can be performed without the need for any additional tools, which contributes to reducing pressure on the lower back. The pregnant woman can open her feet slightly outward to maintain her balance, while extending her arms in front of her and pressing her palms, then slowly bending her legs until reaching the final squat position. After that, she can raise her body again, repeating this movement ten times in a row, and it is preferable to repeat the exercise at least three times.

**. Lower Back Stretching Exercises**This exercise helps strengthen your back muscles and hamstrings. Start by resting on your hands and knees, making sure your head is level with your back. Tighten your abdomen while slightly rounding your back, and hold this position for a few seconds. Then, relax and work on making your back as flat as possible. Repeat this exercise gradually up to 10 times, and do not hesitate to consult your doctor about other stretching exercises.

*. Sleeping on your left side **If you sleep on your back, you may experience severe back pain, especially with the increase in weight in the abdominal area. In addition, you may have difficulty breathing properly, which may pose a risk to your health. For maximum comfort, it is preferable to sleep on your left side, with a pillow between your legs and another behind your back and under your belly. Alternatively, you can purchase a pregnancy pillow to support your back and ensure a comfortable sleep every night.

**. Walking ** Back and leg pain are among the most common pains that pregnant women suffer from. Walking during pregnancy helps prevent these pains, keeps you more active and fit, and prevents any stiffness.

Walking is a simple activity that does not require much effort. Therefore, it does not affect the pregnant woman negatively as long as she wears appropriate shoes. In addition, walking is a preferred way to stay more active during pregnancy when you cannot stress your body with physical activities.

**Kneeling exercise** Exercises help strengthen the core abdominal muscles and relieve back pain in pregnant women. These exercises include pelvic floor exercises or Kegels, in addition to stretching and balance exercises. You can perform these exercises in a kneeling position on your hands and knees while keeping your back straight. Breathe slowly, inhale, and when exhaling, pull your abdomen inward and upward, while squeezing your pelvic muscles at the same time. Make sure to keep your back muscles straight without moving them. Hold this position for 5 to 10 seconds depending on your endurance. When the exercise is finished, slowly relax your muscles, and remember that you should not hold your breath.

**Superman Exercise**If you are comfortable with the kneeling and footing position, you can try the Superman position. Rest on your left hand and bend your right leg, then raise your right arm and left leg at the same time. Switch between legs and arms and repeat the exercise 10 times. You can do this exercise for 10 seconds.

**Ball Exercise**Start by kneeling with the ball in front of you, lean on it with your hand and then return to your previous position.

**Backward Stretching Exercise**In this exercise, sit on your knees while leaning on your hands, making sure to keep your back straight. Lean back slightly so that your legs are bent in front of your chest and your head is in front of your knees. Keep your back straight with your arms extended.

**Wall Standing Exercise**You will be surprised at how easy this exercise is. All you have to do is stand in front of a wall while keeping your back straight. Extend your legs so that they are shoulder-width apart, leaving a distance between you and the wall. Then, return your back directly towards the wall, then return to leaving the distance again. Repeat this exercise 10 times.

**Pelvic Tilt Exercise Using a Ball** Start by bringing a ball, then sit on it with your back bent, and spread your feet on the floor with your knees bent. Use your arms to support your back. Lift your body slightly up, and hold this position for several seconds, then return to the first position. Repeat this step 10 times.

**Trunk Rotation Exercise** This exercise strengthens your back muscles and supports the vertebrae of the spine. Prepare the floor and sit with your legs crossed. Place your left hand behind your back with the right side slightly open, and hold this position for several seconds. Then, switch hands and repeat this exercise 10 times.

**. Cardiovascular Exercises:**Cardiovascular exercises, such as walking, swimming, and cycling, are safe for pregnant women. These exercises increase your heart rate for long periods, which greatly contributes to relieving back pain. You can do these exercises for 20 to 45 minutes, three to five days a week. Make sure to do cardiovascular exercises at a moderate level, and avoid stress or excessive intensity that may harm your health.

**. Back Stretch:**Back stretches are very useful exercises to relieve back pain. You can start by lying on your back with your arms extended and your knees bent, leaving a small distance between your legs and placing your hands in front of your head. To support your abdominal area while performing the exercise, you can use a pillow under you. Then, sit on your knees with your arms extended forward, focusing on feeling the spine stretch.

**. Chest Stretch:**To do a chest stretch, stand with your back and head straight. Clasp your hands behind your back and gently stretch your arms up and down without moving your neck or pushing your shoulders forward. This exercise helps stretch your back, shoulders, and arms, which can significantly reduce back pain, especially during pregnancy.

**. Thigh Stretch: ** Thigh stretching is an effective exercise to relieve back pain during pregnancy, but it should be done slowly. Start by placing a chair in front of you and step onto it with one foot, keeping both feet and hips straight. Then, straighten your back and try to gradually bend forward to stretch the back of your thigh.