Pregnant women and back pain
Eighty percent of women will experience back pain
at some point during their pregnancies. The severity
of this pain during pregnancy ranges from mild discomfort
after standing for long periods of time to debilitating
pain that interferes with daily life. Although back
pain can be a sign of a more serious condition, including
labor, in most cases, it is the result of changes happening
within the body.
Factors that influence back pain during pregnancy
The spine is vulnerable due to the following factors
• Hormone production during pregnancy makes joints
less stable (to allow the pelvis to spread as the baby
• Typical weight gain of 25-35 pounds during pregnancy,
with the majority or extra weight distributed around
• Increase in postural strain as the body compensates
for changes in the pregnant woman’s center of
Although it may seem enticing to rest when experiencing
pain and not undertake an exercise routine, gentle stretching
and movement will often decrease muscle spasm and restore
improved spinal function, resulting in decreased pain
(1). Exercise also boosts energy levels and contributes
to an easier labor, delivery and post partum recovery.
The components of a balanced exercise program during
pregnancy include cardiovascular, strength and flexibility
Cardiovascular exercise for back pain during pregnancy
An activity that increases the body’s heart rate
for a sustained period of time is considered cardiovascular
exercise. Walking, biking, and swimming are all considered
safe for most pregnant women and can be performed for
20 to 45 minutes, 3 to 5 days a week. Pregnant women
should take care to exercise at a mild to moderate level,
but not to the point of exhaustion. Keep in mind that
any exercise is better than none, so even a 10 minute
walk at lunch time is beneficial.
Strengthening exercises for back pain during pregnancy
Strengthening the abdominal muscles, back muscles,
pelvic floor, buttock, and thigh muscles can effectively
help prevent and decrease back pain. It is recommended
that the strengthening exercises be performed in a slow
and controlled manner. The strengthening poses can be
held for 3 to 10 seconds and repeated 10 to 30 times.
Breathe out during the exertion phase of the exercise
and inhale as you relax. The following are suggested
exercises for each of the major muscle groups mentioned:
• Pelvic Tilts (for abdominal muscles): The
simplest way to learn the pelvic tilt is to lie on the
back with knees bent, feet resting on the floor. Place
your hand in the small of your back, and you will most
likely notice a space between your back and the floor.
Now try to flatten the lower part of the spine against
the floor, so that you feel no space between your back
and the floor. The buttocks should be relaxed in order
to isolate the abdominals. The pelvic tilt can be performed
while lying on your back, standing, on your hands and
knees, or sitting.
• Arm and Leg Raises (for back muscles and buttock):
Kneel on your hands and knees with a straight spine.
Do a pelvic tilt to keep your pelvis stable and then
lift your right arm and left leg to form a straight
line with your spine. Pause in this position and then
slowly lower your arm and leg. Alternate lifting the
opposite arm and leg. If you have difficulty keeping
your balance in this position, modify the exercise by
performing only the leg or arm raises separately.
• Kegels (for pelvic floor muscles): To exercise
the pelvic floor muscles, try to envision pulling the
muscles of the vaginal area up and in towards your baby.
You should not feel your buttocks, thighs, or abdominals
tightening as you do this.
• Wall Squats (for abdominal muscles, buttock
muscles and thigh muscles): Stand with your head, shoulders,
and back against a wall with your feet about 1 to 2
feet away from the wall. Press your lower back into
the wall and squat as if you were going to sit down,
with the knees approaching a 90-degree angle. Come back
up slowly, keeping your back and buttocks in contact
with the wall.
Stretching exercises for back pain during pregnancy
Stretching is at least as important as cardiovascular
and strength training for back pain prevention and treatment
during pregnancy, so try not to sacrifice this crucial
component of the exercise program. In order to improve
flexibility, it is recommended that stretches be performed
daily after you are warmed up. Hold the stretches (never
bounce) for 20 to 30 seconds, and repeat 3 times.
Although there are many stretches that can safely
be performed during pregnancy, the muscles that most
often contribute to back pain are the back, hamstring
(in the back of the thighs), and chest and neck muscles.
• Back stretch: Start on your hands and knees,
with your legs wide apart and hands placed forward just
a little in front of your head. Place a small pillow
under you to give support to your abdomen, if needed.
Sit back on your knees and stretch your arms forward
to feel a stretch along the spine.
• Hamstring stretch: Face a chair and place one
foot up on it, keeping both hips and feet facing forward.
Keep your back straight and lean forward from your hips
to feel a stretch in the back of the thigh. If you can’t
stand tall or your knee bends, try a lower step.
• Chest stretch: Stand with your head upright
and with your back straight. Clasp your hands behind
your back, and without leaning your shoulders forward,
gently stretch your arms up and back to feel a stretch
in the front of your shoulders and arms.
• Neck stretch: Sitting or standing, bring your
head forward and tipped to one side. With the hand on
the same side as your head is tipped, reach up behind
your head and give a gentle pull. Turning your head
as you pull can help isolate the specific neck muscles
Due to the multitude of changes happening within the
pregnant body, back pain tends to be a common complaint,
and exercise is a simple way to achieve comfort and
relief during this exciting time. It is important to
always discuss your symptoms with your health care provider
to ensure exercise is appropriate for you and to be
informed of any guidelines or restrictions that may
be recommended. Some pregnant women may benefit from
more intensive or individualized treatment for their
1. Silva, A. Preventing and Managing Back Pain During
Pregnancy. Expect Fitness. 2004.