Back Pain During Pregnancy: What Actually Helps and What to Skip

My daughter is now 9 months old. Crazy to think that she’s now been out in the world with us for as long as my wife was pregnant with her. That brings us to today’s topic: pregnancy back pain. If your low back hurt during pregnancy or is currently hurting during pregnancy, you’re not alone. It’s estimated that 50-70% of pregnant women experience back pain, and that severity increases throughout the process [1]. I assume that you yourself are not currently preparing for pregnancy, pregnant, or recovering from a birth, but I’m sure that you know someone who is. Send this along to them if you feel inclined.

Why pregnancy loads your low back

To put it simply, your body has to make space for an additional organ (placenta) and a baby. Besides the space constraint, there’s also the added strain of carrying the weight of the baby, the placenta, water weight, and general weight gain during pregnancy. As the baby grows, your centre of gravity moves forward, which tips your pelvis forward to compensate for the extra weight in front. Hormones like relaxin create laxity in the ligaments around your pelvis so your body can prepare for birth. While this is all normal during pregnancy, that doesn’t mean that it’s easy or that there won’t be some aches and pains along the way.

Ligaments connect from one bone to another and add stability to our joints. When ligament laxity increases, our muscles have to work harder to maintain stability. The increased laxity of pelvic ligaments means that there’s additional strain on pelvic floor musculature to pick up the slack. Spinal erector muscles must work harder to keep the trunk upright with the added weight and shifted centre of gravity.

So we’ve got increased muscular demand and joint laxity. What can we do about it?

What actually helps

The best treatment is often prevention. And in this case, that looks like strengthening musculature of the pelvic floor, hips and back before pregnancy. That doesn’t mean that there would be no back pain during pregnancy, but the capacity to tolerate it may be improved. Further, starting to strengthen these muscle groups during pregnancy has its merits as well. A few other benefits of exercise during pregnancy:

• Increased insulin sensitivity (reduced chances of gestational diabetes)
• Body composition improvements
  • greater likelihood of appropriate maternal weight gain during pregnancy
• Improved postpartum recovery

Exercise is safe and encouraged for most pregnancies. Disclaimer: please speak to your doctor/OBGYN/midwife to determine if you have a high risk pregnancy that requires special planning. My wife and I had a great experience with our midwife and really liked one thing that she told us:

“You’re pregnant, not sick.”

It empowered my wife to continue going to the gym, spin classes and daily walks. She even went to the gym the day before our daughter was born.

As far as what the literature shows for reducing back pain, a 2026 review study [1] found that 8/9 studies showed that exercise reduced back pain during pregnancy. Exercise types varied, but aerobic, strength/resistance, aquatic, and core stability training were all supported.

After birth, movements that target building trunk and pelvic stability gave the largest reduction in lumbopelvic pain [2]. The good news is that a lot of this can be done without a gym membership. Walking, core exercises, hip and glute movements are all easily completed at home.

There’s also good reason to include pelvic floor exercises during pregnancy. A strong pelvic floor is protective against vaginal prolapse and might even help with back pain. Unrelated to pregnancy now, a study examined the research on pelvic floor training for back pain [3]. A small effect, with low certainty, was found, hinting that back pain may be slightly reduced by strengthening the pelvic floor. The effect was the most pronounced when pelvic floor training was combined with standard physical therapy [3]. While the effect was modest, pelvic floor training is still a great idea before, during, and after pregnancy to help mitigate pelvic floor dysfunction.

What to do this week

As always, the general recommendations of staying active, walking lots, and breaking up sitting time apply.

Preparing for pregnancy

1. Prioritize exercise. Build capacity now. Research shows that people who exercise have reduced back pain severity during pregnancy [4].
2. Focus on strengthening muscles of the hips, glutes, core, and back. Strength in these muscle groups will support you throughout your pregnancy. Think (gym version/at home version):
   1. hip thrusts/glute bridges
   2. Romanian deadlifts/hip hinges
   3. McGill Big 3 core exercises

During pregnancy

1. Continue moving in ways that you feel comfortable with. Resistance training is safe and encouraged to continue (as long as you are not advised otherwise by your clinician).
2. Begin pelvic floor work [3,5]. Here’s a Mayo Clinic Kegel exercise guide to get you started:

https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/kegel-exercises/art-20045283

After birth

1. The general advice is to wait for clearance from your doctor/midwife/care provider before beginning exercise. This will come at different times for different people. Some are cleared after 6 weeks, some later.
   1. It is important to wait for clearance but don’t be afraid to ask your care provider if they neglect to bring it up.
2. Start with walking. Your care provider should advise you to focus on watching for additional bleeding. If there’s an uptick, scale back activity.
3. Re-start pelvic floor work, and core stabilization exercises. From this point on, you can scale back into exercise as you see fit.

When to check with your OB

Movement is the general answer, but pregnancy adds a few specific reasons to get checked first. Call your provider if your pain is severe, came on suddenly, or is climbing fast. Call too if it wraps around the front of your pelvis and makes walking hard, or if it arrives with any bleeding, fluid, fever, or regular tightening.

When in doubt, contact your pregnancy care provider.

As always, have a great weekend.

Best,

Mitch

Want to know which back pain pattern matches you? Take my free 2-minute quiz and find out.

References

1. Chen et al., 2026. doi.org/10.3389/ijph.2026.1608730
2. Özyurt et al., 2025. doi.org/10.1186/s12905-025-03881-2
3. Lim et al., 2024. doi.org/10.1177/02692155241287766
4. Davenport et al., 2019. https://doi.org/10.1136/bjsports-2018-099400
5. Mottola et al., 2019. https://doi.org/10.1136/bjsports-2018-100056

Disclaimer: this content is educational only and does not constitute medical advice. See a practitioner if you suspect serious spinal trauma from a fall or accident, or if you experience any of the following red flag symptoms: loss of bowel or bladder control, numbness in the groin or saddle area, rapidly worsening leg weakness, back pain with fever or feeling generally unwell, or unexplained weight loss with back pain. If you are pregnant, clear any new, severe, or rapidly changing back pain with your OB or provider before starting or continuing exercise, and stop any movement that causes pain, dizziness, leaking fluid, or contractions.