Causes and treatment of lower back pain in early pregnancy

Most women have low back pain in late pregnancy. They arise due to overstretching of the ligaments of the uterus, excessive load on the spine or kidney disease. All these phenomena appear due to a strong increase in the size of the uterus, leading to compression of the internal organs. Due to the increase in the abdomen, the center of gravity of the pregnant woman shifts, it becomes difficult for her to walk, which causes constant aching pain in the back.

At first glance, it seems incomprehensible for what reasons the lower back hurts at the beginning of pregnancy. It would seem that a woman has not yet managed to gain weight, which could cause back muscle tension or overload of the spine. And the uterus in the first trimester is still small in size .

We will find out why expectant mothers have lower back pain during early pregnancy, how to avoid this symptom and what to do when it appears.

Do many women have lower back pain in early pregnancy? According to statistics, in the first 12 weeks, unpleasant sensations appear in half of the women. These pains are mild and have aching or pulling character.

Why pains appear in the early stages

Many expectant mothers complain that at the beginning of pregnancy they have pain, aching or pulling in the lower back. Most often, the cause of this phenomenon is natural changes in the body of a woman. However, pain can occur due to compression or damage to internal organs. In the early stages of pregnancy, the lower back can be sick due to impaired contractile function of the uterus, diseases of the spine or urogenital system.

We will understand for what reasons most often there are back pain at the beginning of pregnancy.

Table 1. Possible causes of pain in the first trimester

Provocative factor Causes of pain Description of the pain syndrome Concomitant symptoms
Embryo implantation Attachment of a fertilized egg to the endometrium on the inner surface of the uterus Pain in the lower abdomen of varying severity, radiating to the sacrum and lower back A small amount of bright red blood may be released from the vagina (the so-called implantation bleeding)
Chorion Formation Germination of chorionic tissue in the uterine wall, accompanied by physiological pain A woman has a slight pain in the lower back, sacrum, and lower abdomen in early pregnancy (4-5 weeks) The pregnant woman does not have any other disturbing symptoms.
Increased uterine blood flow Acceleration of blood flow in the uterus, aimed at protecting the fetus from oxygen starvation Aching pain in the lower back, first appearing at 6-7 weeks of pregnancy Lack of other symptoms that might be troubling
Hormonal changes in the body Increased relaxin hormone levels leading to relaxation of ligaments and increased mobility of the joints of the spine Aching character of pain. In a woman, as if pulling her lower back in early pregnancy Painful sensations may intensify after long walks, sitting or sleeping in an uncomfortable position.
Increased uterine tone Pathological contraction of the uterine muscles due to a lack of progesterone The pains are spastic or paroxysmal. Localized from the lower abdomen and in the sacral region, radiating to the lumbar The appearance of spotting from the vagina indicating a threat or a miscarriage has begun
Ectopic pregnancy Embryo implantation in the fallopian tube, leading to stretching or even rupture of the latter Aching, cutting, or cramping pains in the sacrum and lower back (on the right or left side) Pain when using the toilet. The appearance of scanty spotting from the vagina for a long time
Constipation Compression of the colon with an enlarged uterus, disrupting bowel movement A woman pulls in the lower back and sacrum in early pregnancy Violation of bowel movement, a feeling of incomplete bowel movement
Gestational pyelonephritis Inflammation of the kidneys causing pain The pains are quite severe, radiating to the lower abdomen, the external labia or even the hips Fever, chills, headaches, general weakness, frequent painful urination
Diseases of the musculoskeletal system Damage to the spine or excessive tension of the back muscles Aching pain, aggravated after sitting in the same position. In case of damage to the spinal roots or nerves, the pains are acute, shooting Limited mobility in the lower back, constant muscle tension. Radiculitis is characterized by motor, sensory and autonomic disorders

The physiological development of pregnancy

Mild pain in the lower back and lower abdomen in the early stages often occurs on the 6-7th day of pregnancy. From the genitals of a woman, a few drops of blood can stand out, which does not coagulate and does not form clots. All these symptoms indicate the implantation of a fertilized egg, that is, its attachment to the uterine wall.

At the beginning of pregnancy, the lower back can be sick due to the formation of chorion. From the latter, a placenta is formed in the future through which the fetus receives from the mother all the necessary nutrients. Germination of chorionic tissue in the uterine wall causes a woman to feel pain at 4-5 weeks.

Starting from 6-7 weeks, aching pains in the abdomen and back arise due to the active flow of blood to the uterus. This process is physiological, that is, completely natural. Accelerated blood flow helps saturate the fetus with the right amount of oxygen and nutrients. This ensures the normal course of pregnancy and the bearing of a healthy baby.

If you have aching lower back during pregnancy in the early stages, do not rush to panic. Minor pain can be a common occurrence. If the pain is very severe, go to the gynecologist for an examination. He will examine you and determine the cause of the unpleasant symptoms.

Hormonal changes

In the body of pregnant women, a number of hormonal changes occur. Their body is being rebuilt, preparing to endure and have a baby safely. In expectant mothers, the hormone relaxin begins to be actively synthesized. In the first trimester, it is produced by the ovaries. The main role of relaxin is softening the tissues of the pubic joint, preventing its damage during childbirth.

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The hormone slightly relaxes the ligaments of the spine, which leads to hypermobility of the intervertebral joints. Because of this, a woman may have lower back pain during pregnancy in the early stages (at the end of the first trimester). The pains are aching in nature and do not cause a decrease in performance. They do not pose any threat to the health of the future mother.

Physiological lower back pain during early pregnancy should be distinguished from pathological. The latter is of an intense nature and is accompanied by the appearance of purulent or bloody discharge from the vagina, fever and other disturbing symptoms.

Hypertonus of the uterus

Some women complain that they periodically pull their lower back in early pregnancy. The cause of unpleasant sensations may be increased contractile activity of the muscles of the uterus. It develops for various reasons and leads to miscarriage, spontaneous abortion.

  • hormonal disorders. A shortage of progesterone, which is produced in the early stages by the corpus luteum, leads to a pathological reduction in myometrium. Hypertonicity is also caused by hypo- or hyperthyroidism – a violation of the functioning of the thyroid gland;
  • genital infections. Chlamydia, mycoplasmosis, ureaplasmosis, genital herpes and some other infectious diseases lead to the development of endometritis – inflammation of the inner lining of the uterus. This provokes the release of biologically active substances, which increase the contractile activity of the muscles;
  • uterine disease. Adenomatous nodes, fibroids, polyps and other tumor-like formations interfere with the normal growth of the uterus, causing its hypertonicity. Increased contractile activity is the result of past curettage and abortion;
  • socio-economic factors. The development of pathology can be caused by frequent stresses, hard physical work, malnutrition, lack of sleep, smoking, or alcohol abuse. Increased contractile activity of the uterus is often observed in girls younger than 18 and older than 35 years.

In women with hypertonicity in early pregnancy, not only pulls the lower back, but also there are aching pains in the lower abdomen and in the sacral region. The pain syndrome resembles the sensations that occur during menstruation.

The appearance of bleeding from the vagina is an alarming symptom. Bleeding indicates a high risk of miscarriage or spontaneous abortion that has already begun.

Ectopic pregnancy

If you have a sore lower back on one side in the early stages (starting from 3 weeks of pregnancy), there are spotting from the vagina – you can suspect an ectopic pregnancy. According to statistics, it occurs in 2% of cases. Pathology most often occurs against a background of adhesions or obstruction of the fallopian tubes. Infectious and inflammatory diseases of the genital organs (chlamydia), endometriosis, hormonal disruptions, tumors, previous operations, etc. lead to this.

Characteristic signs of tubal pregnancy:

  • severe pains in the lower abdomen on one side, radiating to the lower back;
  • discomfort during bowel movements and urination;
  • frequent bleeding from the vagina in a small amount;
  • general weakness, apathy, irritability;
  • an increase in appendages with bimanual examination;
  • mismatch of the size of the uterus with the pregnancy.

Even “neglected” joint problems can be cured at home! Just remember to smear it once a day.

An ectopic pregnancy is dangerous because in the absence of treatment it leads to rupture of the fallopian tube. This causes internal bleeding and the development of peritonitis. In the absence of timely medical care, rupture of the tube can lead to the death of a pregnant woman.

If you find yourself having symptoms of an ectopic pregnancy, go to the doctor immediately. A specialist will examine you, confirm or deny the diagnosis. Then he will prescribe the necessary treatment for you. A confirmed ectopic pregnancy requires surgery. The fetus is removed laparoscopically.

If you understand that you are pregnant, immediately go to the gynecologist’s appointment. Your doctor will examine you and determine if your pregnancy is proceeding normally. After that you will be registered and issued an exchange card.

During the gestation of the baby, you will need periodic examinations of different doctors and passing certain tests. All this will help to identify dangerous complications and take appropriate measures.

Digestive system

In some cases, the lower back in early pregnancy is aching due to constipation. The latter develops due to compression of the colon by the growing uterus. Proper nutrition and the intake of certain herbal remedies will help get rid of the problem and normalize the stool. Using synthetic laxatives during pregnancy is undesirable.

If constipation occurs, consult a doctor. He will tell you how best to eat, what medications to take. Try to avoid self-medication, as it can harm you or your baby.

Urinary system diseases

In pregnant women, the kidneys are quite often affected. Most often, gestational pyelonephritis develops – acute inflammation of the pyelocaliceal system. According to statistics, the disease is detected in 12-17% of expectant mothers. Pathology occurs in the second trimester of pregnancy (especially at 22-27 weeks), less often – at the end of the first.

If you have a fever, a lower back pain during pregnancy is very painful – you may have pyelonephritis. If you experience suspicious symptoms, see a doctor immediately. Timely referral to the hospital will help to avoid complications.

During pregnancy, a number of changes occur in a woman’s body that contribute to the development of pyelonephritis. Firstly, the kidneys of a pregnant woman increase in size. Secondly, due to the gradual growth of the uterus and the action of progesterone in the expectant mother, the ureters and renal pelvis expand. Thirdly, against the background of hormonal changes in a woman, peristalsis of the upper urinary tract slows down. This causes a violation of urodynamics and stagnation of urine in the kidneys. Under such conditions, pyelonephritis develops with particular ease.

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Characteristic symptoms of the disease:

  • rapid and painful urination;
  • increase in body temperature to 38-40 degrees;
  • severe headache, chills, and other signs of intoxication;
  • back pain radiating to the inguinal region, labia, inner thighs;
  • palpitations, drop in blood pressure;
  • sharp pains when striking at the site of the projection of the kidneys (the symptom of striking is checked by a doctor).

In 30% of women with gestational pyelonephritis, premature birth occurs. Perinatal mortality is 25%. This means that every fourth baby dies during childbirth and shortly after birth. In the early stages of pregnancy, the disease can lead to spontaneous abortion.

Musculoskeletal system diseases

If a woman previously had problems with the spine, during the period of bearing the baby her condition may worsen. In the early stages of pregnancy, the lower back can be sick due to osteochondrosis, spondylosis, spondylitis, or radiculitis. At a young age, these diseases are rare.

Unpleasant sensations in the lower back are explained by sitting in an uncomfortable position or walking in high heels. In this case, the pain occurs due to tension of the muscles of the lower back (the so-called myofascial pain syndrome).


To find out a reliable cause, a woman should undergo an examination by a gynecologist. After a conversation with the patient, the doctor will be able to suspect the presence of a particular pathology. A bimanual study will help him identify various neoplasms, uterine hypertonicity or an increase in its appendages during tubal pregnancy.

To distinguish physiological pain from pathological, the doctor draws attention to:

  • the presence of pathological discharge from the vagina;
  • type, strength and nature of pain;
  • the state of the uterus and appendages during bimanual examination;
  • the appearance of other pathological symptoms (high fever, difficulty urinating and defecating, limiting movements in the spine, etc.).

Of great importance in the diagnosis of complicated pregnancy is an ultrasound examination (ultrasound) of the pelvic organs, which allows to assess the condition of the embryo, uterus and its appendages. To identify infectious diseases of the genitourinary system, a woman needs to pass a urine test and a smear on the microflora from the vagina. If necessary, pregnant appoint additional studies or consultations with other specialists.

How to relieve physiological back pain

You can get rid or alleviate discomfort with the help of elementary measures. If you have a low back in your early pregnancy, try simple exercises. They will strengthen muscles, improve blood circulation in the pelvic organs, help in the formation of proper breathing in order to safely endure and give birth to a healthy baby.

It is also possible to alleviate painful sensations with the help of fitness, aerobics, water gymnastics, yoga, etc. Courses designed specifically for pregnant women are also useful. You need to choose the most attractive program and do it for fun.

Treatment of pathological lower back pain in early pregnancy

Consider the option when a woman began to break her lower back in the early stages of pregnancy, she went to the doctor, but she was given a disappointing diagnosis. What awaits her and the baby in the future? Does she have a chance to bear and give birth to a healthy baby?

Uterine hypertonicity can lead to spontaneous abortions, but abortion can be avoided with adequate treatment. Diseases of the kidneys, spine, heart and organs of the endocrine system also worsen the prognosis and make the course of pregnancy more difficult. However, adequate therapy helps to avoid unpleasant consequences.

An ectopic pregnancy has a poor prognosis for the baby. It requires artificial interruption and always ends in fetal death. Untimely treatment can lead to serious consequences for a woman.

Table 2. Methods of treatment of various diseases in pregnant women

Shishkevich Vladimir
Shishkevich Vladimir
Orthopedic doctor, traumatologist
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An orthopedic traumatologist is involved in the diagnosis, treatment, and prevention of pathologies of bones, muscles, ligaments, and joints. He owns the methods of applying gypsum for fractures, correcting acquired or congenital pathologies of the limbs. Anatoly Kudravets specializes in the treatment of various types of injuries: bruises, sprains, fractures, subluxations, dislocations. The doctor deals with the consequences of radioactive, thermal, electrical, chemical lesions.