Back pain and pregnancy often go hand-in-hand, especially as your baby bump grows. But the aches and twinges don't typically start early on. So if you're experiencing back discomfort while you're trying to conceive, the pain likely has another culprit.
"Back pain really isn’t a sign of early pregnancy unless it is related to bloating or constipation," says Jennifer Wu, M.D., an OB/GYN in New York, New York, and a member of the What to Expect Medical Review Board.
Is lower back pain a sign of pregnancy?
Lower back pain can be par for the course in pregnancy. But it's more likely to hit in the second and third trimester compared to the first, according to the Office on Women's Health.[1]
So it may not be among the first physical changes that tip you off to a possible pregnancy. (Those are more likely to be things like missing your period, fatigue, tender or swollen breasts, or nausea.)
However, sometimes other symptoms can cause back pain, like gas and bloating.
"This is my second pregnancy ... I’m literally just 4 weeks ... The past couple days I have the worst gas pains, like my entire stomach, back, and shoulders are sore from it," says What to Expect Community member brimae2212.
"My bloating and gas are debilitating r.n.," agrees What to Expect Community mom bbweaver25. "It is causing back/neck/shoulder pain."
What causes back pain early in pregnancy?
Again, it's not super common to have back pain early in pregnancy, though sometimes things like bloating or constipation can be behind it if it does happen.
"Early pregnancy is when the hormones, like progesterone, are high and you have just started prenatal vitamins, which have iron," says Dr. Wu. "The combination of the two can lead to lots of gas and constipation. The gas pain may be beyond anything you’ve ever experienced. Avoiding raw vegetables like broccoli and cauliflower and gas-causing foods like beans can really help."
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When the aches and pains do start to strike — usually during the second trimester — the causes are multi-fold.
One culprit is your expanding uterus, which can change your posture and make you more likely to hunch. Your muscles and joints also have to work harder to support the extra weight you're carrying, so they're more prone to getting tired or sore as the day goes on, notes the American College of Obstetricians and Gynecologists (ACOG).[2]
Hormones like relaxin factor in too. It relaxes your ligaments and joints so it's easier for your baby to get through the birth canal during labor. But it can also loosen up the ligaments and joints in your back, which can leave you feeling wobbly or make you more prone to back injuries.
How can you relieve back pain early in pregnancy?
There are lots of things you can do to soothe your sore back and keep those aches and pains in check. Some strategies to try:
Check your posture. Your center of gravity naturally shifts forward as your baby (and belly) grow. Try to stand up straight with your shoulders and neck relaxed. When you sit, opt for a chair that supports your back and tuck a small pillow behind your lower back.
Try not to sit or stand for long stretches. Changing positions frequently can help you stay more comfortable. When you have to be in one position for a long time (like at work), use a box or stool to prop up one foot (when standing) or both feet (when sitting).
Avoid heavy lifting. It can strain your back, so ask for help whenever possible. If you have to lift something, squat down to bend with your knees and lift back up using the power of your legs (not your back).
Stick with comfy shoes. Low-heeled (not flat) shoes like sneakers will give you the best arch support. Steer clear of high heels, which will strain your back and test your wobbly balance.
Sleep on your side. Bend your knees and tuck a pillow in between them for more support.
Move regularly. Exercise can stretch and strengthen your back and leg muscles
Apply ice or heat. Both can relieve back discomfort. Try an ice pack or a bag of frozen peas wrapped in a kitchen towel, or a warm compress or hot water bottle.
Ask your doctor about safe medications. Acetaminophen is considered a pregnancy-safe pain reliever, so it may be an option for severe symptoms, according to ACOG.[3] Avoid taking NSAID pain relievers like ibuprofen and naproxen; they're harmful for fetal development.
When to call the doctor
Most pregnancy back pain is manageable with at-home options. But if the pain is severe or persistent, let your doctor know.
You should also alert your doctor if the pain is accompanied by other symptoms such as vaginal bleeding, fever, cramping or contractions, or burning while you pee. These could be signs of a urinary tract infection (UTI) or preterm labor.
- Back pain typically appears later in pregnancy: While back pain is common in pregnancy, it usually doesn’t begin until the second or third trimester. Early pregnancy back pain is less frequent and may be more related to other factors like gas, bloating, or constipation.
- Hormonal and physical changes contribute to pregnancy back pain: As pregnancy progresses, hormonal changes like the release of relaxin loosen ligaments and joints, making back pain more likely. The growing uterus can also shift posture and strain muscles, leading to discomfort.
- To relieve early pregnancy back pain, try strategies like having good posture, avoiding heavy lifting, wearing comfortable, supportive shoes, and sleeping on your side. Ice or heat and regular movement can also help. If the pain is severe or accompanied by other symptoms, like fever or vaginal bleeding, consult your doctor.
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