Back pain is one of the most common pregnancy complaints — affecting 50–70% of pregnant women at some point. For most, it starts in the second trimester, peaks in the third, and resolves within a few months of giving birth. The good news: most pregnancy back pain is manageable with simple changes — posture, stretches, sleep position and the right kind of support. The not-so-good news: it usually doesn't disappear until after delivery.
This guide covers exactly what's causing the pain, what helps (and what's a waste of money), the safe stretches you can do at home, when to use a support belt, and the warning signs that mean you should call your midwife straight away.
The short answer: sleep on your side with a pillow between your knees, sit with lumbar support, do daily pelvic tilts, walk for 20 minutes a day, and use a maternity support belt for the last trimester. Paracetamol is safe; ibuprofen is not.
Why your back hurts during pregnancy
Three things are happening at once:
1. Your centre of gravity is moving forward
As the bump grows, your weight shifts forward. To stay balanced, you compensate by leaning back — which means your lumbar spine arches more deeply than usual (an exaggerated curve called lordosis). The muscles either side of your spine work overtime, and the joints in your lower back take more load.
2. Hormones are loosening your ligaments
The hormone relaxin peaks in pregnancy to soften the pelvic ligaments for birth. The downside: it doesn't only target the pelvis. It loosens ligaments throughout the body, including your spine and sacroiliac joints — the joints connecting your spine to your pelvis. Looser joints + more weight = pain.
3. Your abdominal muscles are stretched and weaker
Your rectus abdominis (the "six-pack" muscle) often separates down the middle to make room for the uterus — a normal change called diastasis recti. With weaker abs, your back muscles do nearly all the work of holding you up.
Where the pain shows up
Lower back pain (lumbar)
The most common — a dull ache across the lower back, usually worse in the evening, after standing for a long time or after carrying things. Often described as a "pulled muscle" feeling.
Pelvic girdle pain (PGP / SPD)
Pain in the pubic bone, hips or sacroiliac joints — sharp on certain movements like getting out of the car, climbing stairs or rolling over in bed. Affects about 1 in 5 pregnancies. Caused by the pelvic joints loosening unevenly and grinding.
Sciatica
Sharp shooting pain from the buttock down one leg (sometimes to the foot), often with tingling or numbness. Caused by the uterus, pelvic ligaments or piriformis muscle pressing on the sciatic nerve. Usually one-sided.
Upper back / between the shoulder blades
Often from breast growth pulling forward, or from forward-rolled shoulders trying to balance the bump. Common in T2 and T3.
What actually helps
🦴 First-line relief (do all of these)
- Sleep on your side with a pillow between your knees — see sleep positions guide
- Walk for 20–30 minutes daily — gentle movement is better than rest
- Daily pelvic tilts (10 reps, 2× a day) — see exercises below
- Sit with lumbar support — a small cushion or rolled towel behind the lower back
- Avoid sitting cross-legged or with one leg tucked under
- Switch to flat shoes (heels worsen lordosis)
- Lift correctly — bend at the knees, never at the waist
- Warm bath or shower (not hot — under 38°C / 100°F)
- Hot/cold pack 15 minutes on, 15 off (avoid putting heat directly on the bump)
Safe stretches for pregnancy back pain
Do these once or twice daily — a few minutes is enough. Stop any stretch that causes sharp pain.
1. Pelvic tilts (the single best exercise)
- Get on hands and knees with hands under shoulders, knees under hips
- Inhale, gently tilt your pelvis so your tailbone points up
- Exhale, tuck your tailbone and round your lower back slightly
- 10 slow reps, 2 sets — twice a day
2. Cat–cow (don't fully arch)
- Same starting position
- Inhale: gentle slight arch, look forward (not up — keep neck neutral)
- Exhale: round the upper back like an angry cat, tuck chin
- 5 slow reps, focus on the upper back, not deep arching
3. Child's pose (modified for bump)
- Kneel with knees wide apart so the bump fits between
- Sit back toward your heels, walk hands forward, rest forehead on a cushion
- Hold 30–60 seconds, breathe slowly into the lower back
4. Piriformis stretch (for sciatica)
- Sit on a chair, place ankle of painful side on opposite knee (figure-4)
- Lean forward gently from the hips until you feel a stretch in the buttock
- Hold 30 seconds, repeat both sides 2–3 times
5. Wall side-stretch (for upper back)
- Stand sideways to a wall, palm on the wall above your head
- Lean hips away from the wall, feel the stretch along the side of your torso
- Hold 20 seconds, swap sides
For a fuller routine, see our safe exercises during pregnancy guide.
Sleep position for back pain
Lying flat on your back makes back pain worse (and is also unsafe after 28 weeks). Sleep on your side with:
- A pillow between the knees — keeps hips aligned, takes pressure off the sacroiliac joints
- A pillow under the bump — supports the weight rather than letting it pull on the spine
- A pillow behind the back — stops you rolling onto your back during the night
A C- or U-shaped pregnancy pillow does all three. See our full sleep positions guide.
Pregnancy support belts (maternity belts)
A maternity support belt is a stretchy band that sits under the bump and lifts some of the weight off the lower back. They're safe and many women find them very helpful in T3.
How to use one well
- Wear it for short bursts — 1–3 hours when you're standing or walking, not all day
- Take it off when sitting or sleeping
- If you wear it constantly, your core muscles can weaken further
- It should feel supportive, not tight or restrictive
Look for the term maternity support band, belly band or maternity belt. Most cost £15–40 and are widely available.
Painkillers — what's safe?
💊 Pain relief during pregnancy
- Paracetamol (acetaminophen) — safe at any stage; use the lowest effective dose for the shortest time
- Topical heat patches (not on the bump) — safe
- Pregnancy massage — safe with a qualified prenatal therapist after T1
Avoid:
- Ibuprofen and other NSAIDs — avoid completely after 20 weeks; ideally avoid in T1 too
- Aspirin — avoid unless prescribed by your doctor (low-dose aspirin is sometimes prescribed for pre-eclampsia prevention)
- Codeine and stronger opioids — only with medical supervision
- Topical NSAIDs (Voltarol gel etc.) — same restriction as oral NSAIDs
- Hot tubs / saunas — anything raising core body temp above 38°C / 100°F
- Anti-inflammatory herbal supplements — most are not pregnancy-tested; ask your pharmacist
Other things that help
Prenatal physiotherapy
If pain is interfering with daily life, ask your midwife for a referral to a women's health physiotherapist. They can assess pelvic alignment, prescribe targeted exercises and (in some areas) provide pelvic support belts on the NHS or insurance.
Prenatal yoga and Pilates
Both consistently reduce back pain in studies. Look for a qualified prenatal instructor — generic yoga is not the same.
Swimming and aqua-aerobics
The water takes the bump's weight off completely. Many women find a 30-minute swim is the only time they're pain-free.
Acupuncture
A 2022 Cochrane review found moderate evidence that acupuncture helps pelvic and back pain in pregnancy. Use a practitioner trained specifically in prenatal acupuncture.
Red flags — when to call your midwife
Contact your midwife or maternity unit the same day if you have:
- Severe back pain that doesn't ease with rest or paracetamol
- Back pain coming in waves at regular intervals — could be early labour
- Fever alongside back pain — could be a kidney infection
- Burning or pain when urinating + back pain — UTI / kidney involvement
- Vaginal bleeding or fluid leak with back pain
- Loss of bladder or bowel control + severe back pain — emergency
- Pain shooting down both legs with weakness — emergency
- Reduced fetal movement after 28 weeks (see kick counts)
- Sudden severe back pain with bump tightening — possible placental abruption
FAQ — Pregnancy back pain
Is back pain normal during pregnancy?
Yes — about 50–70% of pregnant women experience back pain, most often in the second and third trimesters. It's caused by hormonal loosening of ligaments, the shifting centre of gravity, weight gain, and weaker abdominal support. Most cases resolve within a few months of giving birth.
Can I take painkillers for back pain while pregnant?
Paracetamol (acetaminophen) is the safest option at any stage of pregnancy when used at the lowest effective dose for the shortest time. Avoid ibuprofen and other NSAIDs, especially after 20 weeks. Always check with your midwife or pharmacist before taking anything.
What is pregnancy sciatica and what helps?
Sciatica is sharp pain shooting from the lower back down one leg, often caused by the uterus or pelvic ligaments pressing on the sciatic nerve. Sleep on the opposite side, use a pillow between your knees, do piriformis stretches, and avoid sitting cross-legged for long periods.
Are pregnancy support belts safe and do they work?
Yes — pregnancy support belts (also called maternity belts or belly bands) are safe and many women find them helpful from the third trimester. They take pressure off the lower back by lifting the bump. Wear them for short periods (1–3 hours) rather than all day to keep your core muscles engaged.
Can I get a massage while pregnant for back pain?
Yes — prenatal massage from a qualified therapist is safe after the first trimester and can be very effective. Make sure they're trained specifically in prenatal massage (positioning is different — you can't lie on your stomach or flat on your back).
Will my back pain go away after birth?
Most pregnancy back pain resolves within 3–6 months of giving birth as ligaments tighten back up and your core regains strength. Persistent pain after 6 months should be assessed by a women's health physiotherapist — sometimes pelvic-floor dysfunction or unresolved diastasis recti is the cause.
When should I worry about back pain during pregnancy?
Call your midwife the same day if back pain is severe, accompanied by fever, vaginal bleeding or fluid leak, comes in regular waves, includes burning during urination, or is associated with reduced fetal movement. Sudden severe back pain in late pregnancy can be a sign of preterm labour or placental abruption.
Pregnancy back pain — at a glance
Back pain is normal but manageable. Sleep on your side with a knee pillow. Walk daily. Do pelvic tilts twice a day. Switch to flat shoes. Use lumbar support when sitting. Try a maternity belt for the last few weeks. Take paracetamol if you need it; skip the ibuprofen. And listen to red flags — severe pain, fever, regular waves of pain or reduced fetal movement always warrant a call to your midwife. Most pregnancy back pain disappears within months of giving birth.
Inside Baby Novum: log daily symptoms including back pain, get personalised stretching routines, and access trimester-specific exercise programmes built into the wellbeing tools.