Back pain during pregnancy: tips and exercises

You finally feel the flutters of movement — and it’s amazing. Sometimes, you even get to see the bulge of a tiny foot pushing out against your belly. It’s joyous and exciting, but it can also be really tough on your back.

Back pain during pregnancy is common, especially in the second and third trimester. One recent study found that more than 40% of pregnant women experience back pain during pregnancy. Other research shows that the number could be as high as 86%. 

Just because back pain in pregnancy is common doesn’t mean you just have to deal with it. There’s a lot you can do at home, with gentle exercises and stretches, to help relieve pregnancy back pain.

Here, learn more about what causes back pain during pregnancy, and how to prevent and treat it — especially with exercises from our Hinge Health physical therapists.

Causes of back pain during pregnancy

Back pain during pregnancy is often due to a combination of factors, including increased levels of the hormone relaxin (which loosens ligaments and can strain back muscles), changes in posture as the center of gravity shifts, and weakened abdominal muscles that provide less support to the spine. Other contributors include stress (which tenses back muscles), a history of previous back pain, and altered lifting techniques as the pregnancy progresses.

• Increase in relaxin. Your body produces more of a hormone called relaxin during pregnancy. Why? It’s to help loosen (get it? relax) pelvic ligaments in order to prepare your body for childbirth. But relaxin can affect ligaments all over your body, including the ones in your back. This can cause muscle strain and pain. Research shows a link between higher relaxin levels and low back and pelvic pain in pregnancy.

• Posture changes. When you’re pregnant, your center of gravity moves forward. Over time, this can cause strain and back pain even in early pregnancy.

• Weaker abdominal muscles. Your expanding uterus can cause the core muscles along the front of your abdomen to separate, creating a gap down the middle (called diastasis recti). This can reduce support for your pelvis and spine, which can lead to back pain.

• Stress. Normal stress of pregnancy and daily life can make your back muscles tense, leading to pain and muscle spasms.

• Previous back pain. If you had back pain before pregnancy, it can increase your risk of back pain during pregnancy. A history of back pain might make it more likely to occur earlier in your pregnancy.

• Lifting differently. As your baby grows, it can become harder to lift or carry things. You may find that you need to carry things on your side instead of in front of you. This may add strain on your back.

When is back pain during pregnancy a red flag?

Although pregnancy back pain is common and usually related to musculoskeletal (MSK) issues, it can sometimes be a warning sign of complications, such as preterm labor or a urinary tract infection. Watch for back pain that occurs with vaginal bleeding or a change in vaginal discharge, fever, contractions, or pain that feels new and cyclical. If you experience any of these symptoms, contact your healthcare provider.

Treatments for back pain during pregnancy

To treat back pain during pregnancy, regular exercise such as yoga, swimming, and walking can help stabilize the back and improve symptoms. Physical therapy and targeted exercises strengthen core and back muscles, while heat therapy (like a heating pad or warm shower) and prenatal massage can also provide relief. Acetaminophen may be used for pain, but always consult your provider first and avoid NSAIDs.

• Exercise. During pregnancy, the ligaments and muscles in your low back and pelvis can stretch, explains Samantha Charlotin, PT, DPT, a Hinge Health pelvic floor physical therapist. Exercise can be helpful to stabilize your back and improve symptoms. A 2023 review found that regular exercise can help manage low back pain during pregnancy and improve everyday function. “Yoga, swimming, and walking especially can be great for low back pain in pregnancy,” says Dr. Charlotin. 

• Try physical therapy and targeted exercises. Targeted exercises can strengthen and stabilize low back and core muscles to help relieve pain. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit. (See more physical therapist-approved exercises below.)

• Heat. A hot water bottle, heating pad, or warm shower will increase blood flow to your back, which can help relax tense back muscles and reduce pain. (Do not apply a hot water bottle or heating pad directly to your belly during pregnancy.)

• Over-the-counter pain relievers. Acetaminophen (Tylenol) has been shown to be safe to use for pain relief during pregnancy. Always check with your provider before you use it. It’s best to avoid NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen as some research shows increased risks with these drugs during pregnancy.

• Massage. Massage therapy can help loosen tight muscles. It’s best to check with your provider and find a massage therapist experienced with prenatal massage.

Physical therapy for pregnancy back pain

“Physical therapy is a primary approach for managing back pain during pregnancy, since much of the discomfort stems from musculoskeletal issues,” says Dr. Charlotin. “The aim is to encourage movement and strengthen the low back, core, and lower body muscles to provide better support around the lumbo-pelvic area." This can help ease back pain as you progress through pregnancy.   

During physical therapy, a PT can assess your movement patterns to customize a strengthening and stretching program that’s safe for you. “We can also help determine what in your day to day may be exacerbating or contributing to your low back symptoms, and then offer strategies for symptom management,” says Dr. Charlotin.  Recommendations may include adjusting your sleep position, wearing a support belt, or modifying daily movements.

You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit. Some exercises they may recommend can be found below.

These exercises are recommended by Hinge Health physical therapists to help relieve back pain during pregnancy. They help to stretch and strengthen a range of key low back, core and lower body muscles which may feel overworked as your body adjusts to pregnancy-related changes.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Other ways to relieve back pain in pregnancy 

For back pain relief during pregnancy, stay active with exercises like swimming, walking, prenatal yoga, and light resistance training. Make small adjustments to your daily activities, such as using supportive footwear, finding comfortable positions when standing, sitting, and lifting, sleeping on your side with a pillow for support, and using a belly band for added abdominal support. Also, focus on maintaining a healthy weight and try relaxation techniques like meditation or warm showers to ease discomfort.

• Stay active. Movement is medicine for pregnancy. If it’s more challenging to do your usual workout routine, swimming, water aerobics, walking, and prenatal yoga are all great options. Resistance training is also recommended during pregnancy. Use light weights, resistance bands, or your body weight for resistance. Ask your doctor or healthcare provider for activity suggestions and exercise considerations for each trimester. 

• Make minor adjustments to everyday activities. When you stand, use a wider, two-footed stance or rest one foot on a low stool to help ease tension in your back. When you sit, choose chairs that support your back or use a lumbar support pillow. Notice how you pick things up — keep objects close to your body and lift from below waist height. 

• Skip high heels (and certain flats). Shoes with a low heel and good arch support are better for pregnancy-related back pain than flat shoes with no support (like many flip-flops or ballet slippers) or high heels.

• Staying at a healthy weight. Pregnancy comes with weight gain. And while this may look a little different for everyone, gaining too much weight can put strain on your back. Talk to your doctor about what’s a healthy weight gain range for you.

• Change your sleeping position. Sleeping on your back can put pressure on your lower back and pelvic joints. Many healthcare providers recommend sleeping on your side after about 20 weeks of pregnancy, or halfway through your second trimester. This position allows for good circulation and can help ease lower back aches. Adding a pillow between your knees or using a pregnancy pillow may also help reduce symptoms. Here are more tips to help you sleep better during pregnancy. 

• Consider a belly band. These are worn low on your abdomen and can help support your bump by lifting your baby off your pelvis. This may help relieve lower back pain or pelvic pain caused by the increasing weight of your uterus on supportive ligaments.

• Try relaxation techniques. Meditation, breathing exercises, or a warm shower can help calm your mind and muscles, and reduce your pain.

PT tip: Give yourself a break 

“Low back pain during pregnancy is common, especially as you get further along,” says Dr. Charlotin. “While it may be frustrating, give yourself grace. Your body is going through a lot of changes.” Sitting or standing too long in any one position can make your back pain worse — and that’s true whether or not you’re pregnant, she explains. Consider frequent position changes when possible and modify your movements to give your body (and back) a break.

How Hinge Health can help you

If you have pelvic pain, bladder, bowel, or other pelvic symptoms that are affecting your quality of life, you can get the relief you've been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

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