Dr. Shiva Jain Sangoi (PT)
BPTh, MPTh (Ortho), FIFA Diploma in Football Medicine
"Every pregnant woman has back pain, na?"
It is the sixth month. Getting up from the sofa takes planning, turning over in bed feels like a project, and standing in the kitchen for twenty minutes leaves the lower back aching. When you mention it, everyone — your mother, your mother-in-law, the neighbour — says the same thing: it is normal, it will go after the delivery.
Then the baby arrives, and the back pain does not leave. Now it comes with feeding for hours, bending over the cot, lifting a baby who gets heavier every week, and very little sleep.
Back pain during pregnancy and in the months after delivery is extremely common. Research suggests that around half of pregnant women experience some form of lower back or pelvic pain. But common does not mean you have to simply endure it. This guide explains why it happens, how ordinary back pain differs from pelvic girdle pain, the warning signs that need a doctor, and when a physiotherapist can help.
Why back pain is so common in pregnancy
Several changes happen together, and each one adds a little load to the back and pelvis.
Hormonal changes. During pregnancy the body produces hormones, including relaxin, that help the ligaments of the pelvis become more flexible in preparation for birth. That flexibility is useful, but it can also leave the joints of the pelvis and lower back a little less stable and more easily irritated.
A shifting centre of gravity. As the baby grows, the bump moves your centre of gravity forward. Many women lean back to compensate, which increases the curve of the lower back and puts more load on the joints and muscles there.
Stretched abdominal muscles. The tummy muscles lengthen and separate to make room for the baby, so they offer the spine less support than usual.
Weight gain, tiredness and daily life. Normal pregnancy weight gain and poorer sleep mean the back has more to carry and less energy to do it with — and long commutes, low stools and stairs when the building lift is down all add up.
Lower back pain or pelvic girdle pain?
Not all "back pain" in pregnancy is the same, and the difference matters for how it is managed.
Lower back pain is usually felt across the lower back, above the waist and the buttocks. It often gets worse with long sitting or standing and eases with a change of position.
Pelvic girdle pain is felt lower down — at the back of the pelvis over one or both buttocks, at the front over the pubic bone, or in the groin and inner thighs. It is commonly made worse by standing on one leg, climbing stairs, getting in and out of a car or auto, turning in bed, and walking for long. Some women notice a clicking or grinding at the front of the pelvis. The overview of pelvic girdle pain explains this condition, which was previously often called symphysis pubis dysfunction (SPD).
The two can occur together. A physiotherapist can usually tell them apart with a careful history and examination, without needing a scan.
Back pain after delivery
For many women, back and pelvic pain settles within a few weeks to months after the birth. For others it continues, or starts for the first time once the baby is home. Common reasons include:
Feeding positions. Hours a day spent hunched over the baby, often without proper support for the back or arms, commonly leads to upper and lower back pain and neck ache.
Lifting and carrying. Lifting the baby out of a low cot, carrying the car seat or bucket, and bending to bathe the baby on the floor all load a back that is still recovering.
Recovering abdominal muscles. The tummy muscles take time to regain their strength after pregnancy. Some women have a noticeable gap between the two sides of the abdominal muscles, called diastasis recti, which can be checked by a physiotherapist.
C-section recovery. After a caesarean, the body is also healing from major abdominal surgery. Guarding the wound, moving awkwardly to protect it and spending more time in bed commonly leave the back stiff and sore. Our guide to lower back pain in the morning covers why backs stiffen after long periods of rest.
What commonly helps
This is general information, not a personal prescription. Always check with your obstetrician before starting any new exercise during or after pregnancy.
Change position often. Most back pain in pregnancy is worse with staying in one position for long. Short, frequent changes between sitting, standing and walking help many women.
Support yourself in bed. Lying on your side with a pillow between the knees, and sometimes one under the bump, is commonly suggested and often makes nights more comfortable. When turning over, keeping the knees together and rolling as one unit can reduce pelvic pain.
Set up feeding comfortably. Bring the baby up to you with pillows rather than bending down to the baby, and support your back and arms. A few minutes spent setting up each feed can save hours of aching.
Lift smartly. Bend at the knees, keep the baby close to your body, and avoid twisting while lifting. Raising the bathing and changing area to waist height, where possible, makes a real difference.
Stay gently active. For most women with an uncomplicated pregnancy, research suggests that regular, appropriate activity helps with back pain and general wellbeing. What is appropriate depends on your pregnancy and should be agreed with your doctor.
Do not wait for it to "just pass". Pelvic girdle pain in particular tends to do better when it is recognised and managed early rather than left until the third trimester.
Warning signs that need a doctor first
During pregnancy, contact your obstetrician or go to hospital promptly if back pain comes with regular tightening or cramping in the abdomen, vaginal bleeding or a leak of fluid, fever or burning when passing urine, pain in the side or under the ribs, a sudden severe headache or swelling of the face and hands, or reduced movements of the baby. Back pain can sometimes be a sign of early labour or a kidney infection.
At any time, seek urgent medical care for numbness around the groin or buttocks, new difficulty controlling the bladder or bowels, or weakness in the legs.
After delivery, see a doctor promptly for a swollen, warm or painful calf, breathlessness or chest pain, fever, or a C-section wound that is red, hot, leaking or increasingly painful.
When to see a physiotherapist
Consider an assessment if:
- Back or pelvic pain is stopping you from walking, sleeping or managing daily tasks
- You have pain at the front of the pelvis, in the groin, or when standing on one leg
- Pain after delivery has not settled after six to eight weeks, or is getting worse
- You notice a bulge or gap along the middle of your tummy
- You are leaking urine when you cough, sneeze or lift, which is common but treatable
- You want guidance on returning to exercise safely after the birth
The first consultation at our Borivali West clinic is free — a full assessment with Dr. Shiva Jain Sangoi (PT), MPTh (Ortho), FIFA Diploma in Football Medicine, with over 10 years of practice and 8,000+ cases treated. If getting out with a newborn is difficult, home visits are available and are charged separately as they involve travel time; online consultations are a paid service. You can reach us through the PhysioSthanak homepage or visit us at Shop No. 14, Hari-Smruti Premises, SVP Road, opposite HDFC Bank, Borivali West.
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*This article is for general information only and is not a substitute for professional assessment. Consult a qualified physiotherapist for advice specific to you, and always check with your obstetrician before starting exercise during or after pregnancy.*