What can you do about low back pain during pregnancy.

Exercise

You may feel more like curling up in bed than exercising if your back hurts, but don't take to your bed for long periods. Bed rest is generally not helpful in the long run for low back pain and may even make you feel worse. In fact, exercise may be just what you need.

Check with your caregiver before beginning an exercise program.

• Strengthening exercises to help build the muscles that support your back and legs, including your abdominal muscles.
• Stretching exercises to help the muscles that support the back and legs become more flexible. Be careful to stretch gently, because stretching too quickly or too much can put further strain on your joints, which have been made looser by pregnancy. Prenatal yoga is one good way to stay limber, and it can help improve your balance, too.
• Swimming is a great exercise option for pregnant women because it strengthens your abdominal and lower back muscles, and the buoyancy of the water takes the strain off your joints and ligaments. Consider signing up for a prenatal water exercise class, if one is available in your community. These can be very relaxing, and there's research suggesting that water exercise may decrease the intensity of back pain during pregnancy.
• Walking is another option to consider. It's low impact and easy to make part of your daily routine.
• For lumbar pain, try doing pelvic tilts, which can ease back pain by stretching your muscles and, over time, strengthening them as well. Here's how: Get on your hands and knees, arms shoulder-width apart and knees hip-width apart. Keep your arms straight, but don't lock the elbows. Tuck your buttocks under and round your back as you breathe in. Relax your back into a neutral position as you breathe out. Repeat at your own pace.
• Pregnancy may require you to change some of your usual exercise routines. (If you're new to exercise, check out our exercise suggestions for beginners.) In fact, there are some specific guidelines for exercising safely during pregnancy – such as not lying flat on your back and not getting up too quickly – that you'll want to keep in mind.
• Whether you're an athlete or a newcomer to exercise, listen to your body and don't do anything that hurts. Finally, watch for warning signs that you may be overdoing things or developing a problem that needs medical attention.
• Be aware of positioning and proper body mechanics.
• Stand up straight. This gets harder to do as your body changes, but try to keep your bottom tucked in and your shoulders back. Pregnant women tend to slump their shoulders and arch their back as their belly grows, which puts more strain on the spine.
• If you sit all day, be sure to sit up straight. Supporting your feet with a footstool can help prevent lumbar pain, as can using a small pillow called a lumbar roll behind your lower back. Take frequent breaks from sitting. Get up and walk around at least every hour or so.
• It's equally important to avoid standing for too long. If you need to stand all day, try to take a midday break and rest lying on your side while supporting your upper leg and abdomen with pillows.
• Be aware of movements that make the pain worse. If you have posterior pelvic pain, try to limit activities like stair climbing, for example. And avoid any exercise that requires extreme movements of your hips or spine.
• Wear comfortable shoes and avoid high heels. As your belly grows and your balance shifts, high heels will throw your posture even more out of whack and increase your chances of stumbling and falling.
• Always bend from your knees and lift things from a crouching position to minimize the stress on your back. This isn't the time to risk throwing your back out, so let someone else lift heavy things and reach for high objects. Avoid twisting movements, too. Pass up activities like vacuuming and mopping that require you to bend and twist at the same time. If there's no one else to do these chores, move your whole body rather than twisting or reaching to get to out-of-the-way spots.
• Divide up the weight of items you have to carry. Carrying a shopping bag in each hand with half the weight in each is much better than the uneven stress of carrying one heavier bag.
• Take care when getting out of bed: Bend your legs at your knees and hips when you roll to the side, and use your arms to push yourself up as you dangle your lower legs over the side of the bed.
• To get a good night's rest, try sleeping on your side with one or both knees bent and a pillow between your legs. As your pregnancy advances, use another pillow or wedge to support your abdomen.
• Treat yourself to a massage. Prenatal massage by a trained therapist may provide some relief. If your insurance plan doesn't cover therapeutic massage and paying for one will strain your finances, you may want to enlist your partner or a friend to give you a gentle back rub – it may not address the underlying problem, but it might help you relax. (Most insurance companies don't cover massage, though a referral from your caregiver might do the trick. It's worth looking into.)

What kinds of low back pain are common in pregnancy?

Experts describe two common patterns of low back pain in pregnancy: Lumbar pain occurs in the area of the lumbar vertebrae in your lower back, and posterior pelvic pain is felt in the back of your pelvis. Some women have symptoms of both types of low back pain.

Lumbar pain is like the low back pain you may have experienced before you were pregnant. You feel it over and around your spine approximately at the level of your waist. You might also have pain that radiates to your legs. Sitting or standing for long periods of time and lifting usually make it worse, and it tends to be more intense at the end of the day.

Even more pregnant women have posterior pelvic pain, which is felt lower on your body than lumbar pain. You may feel it deep inside the buttocks, on one or both sides or the back of your thighs. It may be triggered by activities such as walking, climbing stairs, getting in and out of a tub or a low chair, rolling over in bed, or twisting and lifting.

Positions in which you're bent at the waist – such as sitting in a chair and leaning forward while working at a desk – may make posterior pelvic pain worse. Women with posterior pelvic pain are also more likely to have pain over their pubic bone.