Common questions about pain in pregnancy and after the birth

In most cases, yes. Back pain is very common in pregnancy because the ligaments soften and stretch to prepare for labour, which puts more strain on the joints of the lower back and pelvis. It is usually an ache that gets worse with long standing or activity and eases with rest and a change of position. But contact your doctor straight away if the pain comes in waves like tightenings in the middle or later months, or comes with bleeding, a fever, burning when you pee or pain under the ribs. Go to the emergency department straight away or call an ambulance (911 in Jordan or 122 in Iraq and Kurdistan) if you lose feeling in your legs, buttocks or genital area.

Read more: Pregnancy back pain · Source: NHS — Back pain in pregnancy · Liddle SD, Pennick V. (2015). Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database Syst Rev.

Often, yes. Back pain is common in pregnancy, especially in the early stages, because the ligaments naturally soften and stretch, putting more strain on the joints of the lower back and pelvis. Gentle walking, changing position, sitting with your back supported and avoiding heavy lifting usually help. But see your doctor straight away if the pain comes with bleeding or a brown discharge, pain low in the tummy on one side, pain in the tip of the shoulder, a fever or burning when you pee. Go to the emergency department straight away or call an ambulance (911 in Jordan or 122 in Iraq and Kurdistan) if the pain is sudden and severe with dizziness or fainting.

Read more: Pregnancy back pain · Source: NHS — Back pain in pregnancy · NHS — Ectopic pregnancy

Yes, it can. As pregnancy advances, changes in your posture, larger breasts and long periods of sitting can strain the upper back and shoulders. Changing position often, sitting with your back supported, a supportive bra and gentle, comfortable exercise usually help, and a physiotherapist can advise you. But pain under the ribs or in the upper tummy needs medical help straight away, especially with a severe headache, blurred vision or sudden swelling of the face or hands, because it can be a sign of pre-eclampsia, even in the first weeks after the birth. For chest pain or sudden shortness of breath, call an ambulance straight away (911 in Jordan or 122 in Iraq and Kurdistan).

Read more: Upper back pain, Pregnancy back pain · Source: POGP — Other musculoskeletal symptoms in pregnancy · NHS — Pre-eclampsia

Treatment is usually based on movement and exercise rather than long rest. A Cochrane review suggests, from limited evidence, that exercise may ease back pain in pregnancy, and that combining manual therapy, exercise and education may also help. Useful tips include flat shoes, bending your knees and keeping your back straight when you lift anything, avoiding heavy lifting, sitting with your back supported and resting on a supportive mattress; a massage or a warm bath may also bring relief. Medicines are your doctor's decision. At Revibe we start with a gentle assessment and choose what suits your stage of pregnancy, and a female physiotherapist is available on request.

Read more: Pregnancy back pain, Female physiotherapist · Source: NHS — Back pain in pregnancy · Liddle SD, Pennick V. (2015). Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database Syst Rev.

Often, yes. Pregnancy-related pelvic girdle pain is common. It is felt at the front of the pelvis over the pubic bone or at the back, and may spread to the hips and thighs; stairs, turning over in bed and getting out of a car often make it worse. It does not harm your baby, it does not usually stop a vaginal birth, and you do not have to put up with it until the birth: physiotherapy with exercises for the pelvic floor, tummy, back and hip muscles and gentle manual therapy helps, sometimes with a pelvic support belt and a pillow between your legs in bed. Lower tummy pain with bleeding in the first weeks needs your doctor straight away.

Read more: Pregnancy back pain, Sacroiliac joint pain · Source: NHS — Pelvic pain in pregnancy · RCOG — Pelvic girdle pain and pregnancy (patient information)

It can be, if it comes with other signs. Signs that labour has begun include lower back pain or a heavy feeling in the pelvis together with tightenings of the womb that become longer, stronger and closer together, a show (the mucus plug coming away) or your waters breaking. A steady ache in the back, pelvis or thighs that changes with movement is usually from the muscle and joint changes of pregnancy, and upper back or knee pain on its own is not a recognised sign of labour. Contact the hospital or your doctor straight away if your waters break, you bleed, your baby moves less, or you think labour has started before thirty-seven weeks.

Read more: Pregnancy back pain · Source: NHS — Signs that labour has begun · NHS — Back pain in pregnancy

Usually not. Ordinary sitting positions are not known to harm the baby, who floats inside the womb in fluid that cushions it from everyday movements and knocks. But the way you sit does affect your comfort and back and pelvic pain: sit well back in the chair with your lower back supported by a small cushion, keep your hips slightly higher than your knees and your feet flat on the floor, and try not to cross your legs or lean to one side. There is no perfect posture; what matters most is changing position and getting up to move regularly before the pain builds, and putting your feet up if they swell.

Read more: Pregnancy back pain · Source: NHS Lothian Physiotherapy — Care of the Body in Pregnancy: Advice and Exercise (v6.0) · MedlinePlus (US National Library of Medicine) — Amniotic fluid

Usually they do not stop a pregnancy, but back pain may increase during it. A systematic review, based on weak evidence, suggests that pregnancy does not raise the risk of a disc herniation by itself, that an existing disc problem can make back pain more likely, and that non-surgical care is tried first. With scoliosis, the way women give birth is broadly similar, but an epidural or spinal anaesthetic may need planning ahead, especially after spinal surgery, so tell your obstetrician and anaesthetist early, and if you have had disc surgery, ask your surgeon about the timing of pregnancy. Numbness around the genitals, weak legs or bladder or bowel problems need the emergency department straight away (911 in Jordan or 122 in Iraq and Kurdistan).

Read more: Disc herniation, Scoliosis · Source: Chan NY et al. (2024). Lumbar disk herniation in pregnancy: its incidence, presentation and management: a systematic review. J Spine Surg 10(2):274–285 · Theroux J et al. (2023). The impact of pregnancy on women with adolescent idiopathic scoliosis: a scoping review. Eur J Phys Rehabil Med 59(4):505–521

In most cases, yes, as long as the therapist knows you are pregnant and how many weeks, and adapts positions and techniques to suit pregnancy. A Cochrane review found that, when side effects of the exercises and treatments studied in pregnancy were reported, they were minor and short-lived, and massage is one of the suggested ways to ease back pain in pregnancy. At Revibe we ask about your pregnancy first and avoid anything unsuitable, and a female physiotherapist is available on request. Tell your doctor if your pregnancy is high-risk. Bleeding, severe pain or a painful, swollen calf need your doctor or the emergency department straight away, not a session.

Read more: Female physiotherapist, Pregnancy back pain · Source: Liddle SD, Pennick V. (2015). Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database Syst Rev. · NHS — Back pain in pregnancy

Usually not. Numbness or tingling in the thumb, index and middle fingers, especially at night, is often caused by carpal tunnel syndrome, and pregnancy is a known cause; it may get better on its own after the birth. A wrist splint worn at night usually helps, and hand exercises may help a little. Pain on the thumb side of the wrist after the birth, when you lift your baby, may be De Quervain's tendinopathy, which may settle with changing how you lift and a thumb-and-wrist splint. See your doctor if your grip gets weaker or the numbness becomes constant, and straight away if your face and hands swell suddenly with a headache or blurred vision.

Read more: Carpal tunnel, De Quervain’s tenosynovitis · Source: NHS — Carpal tunnel syndrome · British Society for Surgery of the Hand — De Quervain’s syndrome

It may feel wider or looser at first, because pregnancy and a vaginal birth stretch the pelvic floor muscles that surround the vagina and support the bladder and womb. This usually improves with time and pelvic floor exercises, which you can start gently soon after the birth and build up over weeks and months. They help after a caesarean too, because pregnancy itself stretches these muscles, and they help bladder control and may improve your sex life. If leaking or pain during sex continues, you feel heaviness or a bulge in the vagina, or you find the exercises hard, see your doctor and ask about a pelvic health physiotherapist.

Source: POGP (2024). Fit for the Future — Essential Exercises and Advice After Childbirth · NHS — Your post-pregnancy body

After a straightforward vaginal birth you can usually start gentle activity as soon as you feel up to it, such as walking, light stretching and pelvic floor exercises, and build up gradually. It is best to get your doctor's advice at your postnatal check, around six weeks after the birth, before running or other high-impact exercise. After a caesarean, recovery takes longer because it is abdominal surgery: move gently, avoid lifting anything heavier than your baby in the first weeks, and check with your doctor before anything strenuous. Your body can take months to return to how it was before pregnancy, so there is no need to rush.

Read more: Female physiotherapist · Source: NHS — Keeping fit and healthy with a baby · POGP (2024). Fit for the Future — Essential Exercises and Advice After Childbirth

Pelvic girdle pain usually improves after the birth, but some women have ongoing pain; continuing treatment and exercise and seeing your doctor to rule out other causes then helps. Back pain after the birth is often linked to the changes of pregnancy, lifting your baby and frequent bending, and strengthening the tummy and back muscles, bending your knees to lift and adjusting your feeding position usually help. Many women blame the epidural, but research on epidurals in labour found they do not cause long-term back pain. See a doctor the same day for pain with a fever; numbness in the legs or genital area, or bladder or bowel problems, need the emergency department straight away (911 in Jordan or 122 in Iraq and Kurdistan).

Read more: Back pain, Sacroiliac joint pain · Source: RCOG — Pelvic girdle pain and pregnancy (patient information) · Anim-Somuah M et al. (2018). Epidural versus non-epidural or no analgesia for pain management in labour. Cochrane Database Syst Rev 5:CD000331