Types of Back Pain in Pregnancy

Fig. 1: Typical pain distribution.
(larger view)

Back pain is very common in pregnancy. It is estimated that between 50% and 80% of women experience some form of back pain during their pregnancy, ranging from mild pain associated with specific activities to acute back pain that can become chronic back pain.

Studies show that low back pain usually occurs between the fifth and seventh month of pregnancy, but can begin as early as eight to twelve weeks into your pregnancy. Women with pre-existing low back problems are at higher risk for back pain, and their back pain can occur earlier in the pregnancy.

There are two common types of back pain in pregnancy, lumbar (lower back) pain, and posterior pelvic pain (see Figure 1). For obvious reasons it is useful to know the difference between the above two types of pain and labor pain, which is also felt in the back during pregnancy.

Lumbar Pain and Posterior Pelvic Pain during Pregnancy

Lumbar pain during pregnancy is generally located at and above the waist in the center of the back. Such lower back pain may or may not be concurrent with pain that radiates into your leg or foot.

In general, lumbar pain during pregnancy is similar to low back pain experienced by non-pregnant women. This type of pain typically increases with prolonged postures (such as sitting, standing, or repetitive lifting). Tenderness may also be present in the muscles along the spine during pregnancy.

Posterior pelvic pain (in back of the pelvis) is four times more prevalent than lumbar pain in pregnancy. It is a deep pain felt below and to the side at the waistline, and/or below the waistline on either side across the tailbone (sacrum). This type of pain may be experienced on one or both sides.

Posterior pelvic pain during pregnancy can extend down into the buttock and upper portion of the posterior (in back of) thighs, and does not usually radiate below the knees. It can be associated with pubic pain. The pain does not quickly resolve with rest, and morning stiffness may also be present.

Posterior pelvic pain during pregnancy can be brought on or exacerbated by the following activities:

• Rolling in bed
• Climbing stairs
• Sitting and rising from a seated position (such as getting in and out of cars, bathtubs, bed)
• Lifting, twisting, bending forward
• Running and walking.

A job that involves prolonged postures at extreme ranges (such as sitting at a computer and leaning forward, standing and leaning over a desk or workstation) increases the risk of developing posterior pelvic pain during pregnancy.

Unlike many other forms of low back pain during pregnancy, a previous high level of fitness does not necessarily prevent this problem.

Labor Pain during Pregnancy

It is important to note that labor pain is a different type of pain. It is similar to an intense menstrual cramp and has the following characteristics:

• The pain is persistent
• It increases in intensity and frequency over a short period of time
• It is not affected by your level of activity (while back pain associated with pregnancy is often activity induced)

• Article written By:
• Linda Sawyer, PT
• Stephen Montgomery, MD

January 10, 2000

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