What causes backache in pregnancy?

Generalised aches and pains in the back are usually musculo-skeletal. As your baby grows during the pregnancy, your centre of gravity will shift, and this often causes changes in posture which can put a strain on the muscles and ligaments in your back. This is exacerbated by the pregnancy hormones which act on the sacro-iliac joints [in the large bony area at the back of your pelvis] to make them looser and more stretchy.

If a backache is severe and comes on suddenly, and it doesnt feel as though you have pulled something in your back, it could be a urine infection. If so, you will probably also be feeling unwell, have a raised temperature, vomiting, or experience stinging/burning when passing urine.

If the backache seems to be coming and going every few minutes in a regular pattern, getting stronger and more painful as the time goes on, and particularly if you feel your uterus going hard at the same time, and/or have crampy pains in the lower part of your uterus, it could be an early sign of labour. If you think you might be in labour, contact the maternity unit for advice

What should I do about it?

Backache is such a common complaint of pregnancy, that many women just put up with it, but this can actually be harmful in the long-term. It is better to find out what is causing the pain and treat it appropriately.

  • Musculo-skeletal pain
    • Good posture can help a lot, whether you are standing or sitting.
    • If sitting, make sure you are not slouching, and have some support in your lower back. If you have a desk job, is your chair suitable?
    • If you are standing, try to keep your back straight and walk tall. Have a look at yourself sideways-on in a full length mirror. Are you slumping down with your tummy forwards and leaning backwards to keep your balance? See what effect it has if you make yourself taller by straightening your spine and trying to lift it up out of your pelvis.
    • Walking is great exercise, but are you wearing the right sort of shoes? High-heels will throw you off balance even more in pregnancy.
    • If you wake up with a backache every morning you probably dont need to rush out and buy a new mattress, you may just need to place pillows between your legs, and/or under your bump and /or behind your back for extra support when you are lying down.
    • A warm bath or shower can help to ease achy muscles, as can a gentle massage. Simple analgesia such as paracetamol is generally considered safe when taken according to the directions on the packet.
    • If you have persistent problems with backache despite trying these measures, ask your GP or midwife to refer you to see a physiotherapist or osteopath who is experienced in treating pregnant women.
  • Urine infection

    If you have the symptoms mentioned above under causes of backache, contact your GP or midwife for advice.

    Usually a urine sample is sent to the lab and you may need a short course of antibiotics. These might be oral, or intravenous, depending on the severity of your symptoms and the type of infection you have.

    You may also be prescribed analgesia and advised to increase your intake of clear fluids. If you feel very unwell, it is best to contact the maternity department at the hospital instead.