What causes back pain during pregnancy?

Weight gain

It’s common to have back pain during pregnancy. As a woman progresses through her pregnancy, she gains weight and undergoes hormonal changes, both of which can affect the spine, causing back pain.

“Weight gain is the major factor but the hormone relaxin, released during pregnancy, does play a small role. Relaxin may cause ligaments that support the spine to loosen, causing instability and pain,” says Dr Jessie Phoon, Associate Consultant, KKIVF Centre, KK Women’s and Children’s Hospital (KKH), a member of the SingHealth group.

A pregnant woman’s significant weight gain causes a shift in the body’s centre of gravity which affects posture. Any posture change of this kind can cause back pain.


A pregnant woman’s emotional state may also play a part. While it isn’t a direct cause of back pain, it can worsen it. “Emotional stress may heighten the sensation of mild back pain that you are already experiencing from the weight gain and posture changes, and can cause muscle tension,” says Dr Phoon.

Back pain, particularly lower back pain, typically begins in the second trimester of pregnancy when the growing baby and expanding uterus begin to place undue pressure on the spine.

6 tips for relief from pregnancy back pain

There are several options for safe back pain treatment during pregnancy. A pregnant woman may consider the following:

  1. Apply heat or cold. Both heat or cold can be used based on personal preference. “The objective is to desensitise the nerve sensation for pain relief. Going into a sauna or steam room for short periods of time may relieve back pain. However, this is not advisable in the last trimester especially nearer to the due date, since there is a higher possibility of going into labour then,” says Dr Phoon.
  2. Exercise to strengthen back muscles. “Some of these exercises may involve weight lifting of less than 5kg. Pregnant women are advised to consult a physiotherapist or exercise physiologist before embarking on such exercises,” says Dr Phoon.
  3. Avoid standing and sitting for long periods. Also avoid bending down at the waist. Be careful of your posture and stand, sit and bend down with care.
  4. Avoid wearing sandals or high-heeled shoes.
  5. Avoid sleeping on your back. Try to sleep on your side with knees bent as far as possible.
  6. Wear a maternity support belt. “Some women may find them useful and we do recommend them. These belts are more commonly used in the second and third trimesters,” says Dr Phoon.

Ref: R14