Back pain during pregnancy has three interacting causes: the hormone relaxin softens ligaments and pelvic joints from the first trimester, so the joints become more mobile and the muscles have to work harder to keep things stable; the centre of gravity shifts forward as the belly grows, the lumbar curve increases and the muscles and joints of the lower back are loaded differently; and the abdominal muscles are stretched and can no longer support the back as before. The result is two main types of pain. Lower back pain sits above the belt line, in the small of the back itself, is dull, comes with standing, walking, lifting and bending forward, and is relieved by sitting or lying down; it resembles ordinary back pain. Pelvic pain (pelvic girdle pain) sits below the belt line: on one or both sides of the sacrum, deep in the buttock, in the groins or over the pubic bone at the front, and is recognised by worsening when turning in bed, getting in and out of the car, climbing stairs, standing on one leg (putting on trousers) and walking far, with a feeling of instability or of the "pelvis coming apart". It affects one in five pregnant women and is treated differently from lower back pain: with stability and offloading rather than stretching. Sciatica during pregnancy is less common than people think; pain radiating down the leg more often comes from the pelvic joints and gluteal muscles than from a pinched nerve. All of this is harmless for the baby and almost always passes within a few months after birth, but it affects sleep, work and mood, and there is a lot that helps. Here is how to tell the types apart, the warning signs, and what actually works, including how cupping can be used during pregnancy.
Which kind of back pain do you have?
| Lower back pain | Pelvic pain / pelvic girdle pain | Sciatica and nerve pain | Upper back pain | |
|---|---|---|---|---|
| Where | Above the belt line, in the small of the back, often both sides | Below the belt line: beside the sacrum, deep in the buttock, the groins, the pubic bone | From the buttock down the thigh, sometimes below the knee | Between the shoulder blades, around the bra strap |
| Worse with | Standing, walking, lifting, bending forward, long sitting with poor support | Turning in bed, stairs, standing on one leg, in and out of the car, wide stance, long walks | Sitting, bending forward, coughing | Heavier breasts, shoulders falling forward, feeding positions later |
| Feels like | Dull ache, stiffness, tiredness in the back | Sharp, stabbing with movement, instability, a "click" in the pubic bone | Burning, radiating, tingling, numbness | Dull, burning point at the shoulder blade |
| Helps | Movement, strength in back and glutes, posture, heat, cupping the lower back | Stability, pelvic belt, small steps, legs together, avoiding asymmetry; physiotherapist; not stretching | Nerve gliding, glute strength, sleeping position; investigate if weakness | A good bra, upper back mobility, cupping between the shoulder blades |
| Read more | Lower back pain | Pelvic girdle pain | Sciatica | Upper back pain |
When to contact your midwife or seek urgent care
- Call the maternity unit or emergency services: back pain that comes and goes regularly in waves, every ten minutes or more often, and increases, especially before week 37 (contractions, preterm labour can be felt only in the back); back pain with bleeding, waters breaking or the baby moving less; sudden severe back pain with fever, chills and pain in the side (kidney infection); numbness in the genital area or inner thighs, difficulty urinating or holding urine (nerve involvement, very rare but urgent); back pain with headache, visual disturbance, swelling of the face and hands or high blood pressure (pre-eclampsia).
- Contact your midwife within a few days: back pain that means you can't work, sleep or walk normally; pelvic pain worsening quickly; pain radiating down the leg with weakness or numbness; burning when urinating together with back pain (urinary infection should be treated in pregnancy); back pain that doesn't respond at all to the measures below in two weeks. The midwife refers to a physiotherapist, who is the most important resource for pregnant women with back problems.
What helps
1. Movement every day, in the right dose
Being in motion is better than rest for both lower back and pelvis: walks of the length that doesn't give more pain afterwards (with pelvic girdle pain often shorter and more frequent), swimming and aqua aerobics (offloads completely), stationary bike, pregnancy yoga and calm strength training. Studies show that pregnant women who train regularly have less back pain and less sick leave. Avoid what triggers it: long spells standing, heavy lifts, loaded twisting, and with pelvic girdle pain a wide stance, big steps and single-leg exercises.
2. Daily exercises, ten minutes
- Pelvic lifts on your back (as long as lying on your back feels fine, usually until week 20, then with the upper body raised): bent knees, lift the pelvis slowly, hold 5 seconds; 10 times. Glutes and pelvic floor.
- Cat and cow on all fours: round the back, arch gently, 10 slow ones; offloads the lower back and gives the belly room.
- Pelvic tilt standing against a wall: flatten the lower back against the wall by drawing in the belly and squeezing the glutes, hold 5 seconds; 10 times. The most important exercise for lower back pain.
- Pelvic floor squeezes: squeeze as if holding urine and wind, hold 5 seconds, relax fully; 10 times, several times a day. See pelvic floor training.
- Side-lying leg raises and clamshells: strengthen the outside of the hip that stabilises the pelvis; 10–15 per side. With pelvic girdle pain: small range, legs never further apart than hip width.
- Bird dog on all fours: extend opposite arm and leg, hold 5 seconds; 5 per side. Core stability without loading the belly.
- Seated upper back rotation with arms crossed over the chest, 10 each way, and shoulder rolls backwards.
- Stretch of the glutes (figure four, seated) and of the hip flexor (kneeling) 30 seconds per side, if it feels fine. With pelvic girdle pain: no stretch that pulls the legs apart or twists the pelvis.
Core exercises after birth are in diastasis recti and training after childbirth.
3. Sleeping position
Lie on your side (left is recommended from mid-pregnancy for blood flow, but change sides when you need to) with a thick pillow or a long pregnancy pillow between the knees and ankles so the upper leg is held at hip height, and a small pillow or folded towel under the belly so it doesn't pull on the back. Turn in bed with the knees together and the legs as one unit, ideally with a pillow between the knees: bend the knees, squeeze the glutes and roll the whole body at once. Satin or silk sheets make turning easier. See deep sleep and sleeping position.
4. Everyday tricks
- Get up from sitting by moving to the edge, leaning the upper body forward and pushing up with the legs, with the legs together.
- In and out of the car with the legs together: sit with your back to the seat first and swing both legs in at once; a plastic bag on the seat makes the swivel easier with pelvic girdle pain.
- Stand with the weight evenly on both feet, not on one hip; sit with support in the lower back (a cushion) and feet on the floor; change position often.
- Lift with bent knees, the load close to the body, without twisting; ask for help with heavy things; carry in a backpack or an equally heavy bag in each hand.
- Flat shoes with cushioning; no high heels.
- Put on trousers and socks sitting down; never stand on one leg with pelvic girdle pain.
5. Pelvic belt and support
A pelvic belt (a band that sits low, just above the groins, not around the belly) stabilises the pelvic joints and relieves pelvic girdle pain in many women when walking and standing; fitted by a physiotherapist or midwife and used during activity, not around the clock. For lower back pain, a belly support band that lifts the belly can offload the lower back on walks.
6. Heat, rest in the right position, and treatment
A heat pad (not over the belly, not too hot) or a hot shower on lower back and glutes for 15–20 minutes relieves and softens before the exercises. Resting on your side with a pillow between the knees, or on all fours with the upper body resting on a pilates ball or the sofa, offloads the back completely for a few minutes. A physiotherapist with pregnancy experience is the first choice for treatment and a programme; acupuncture and massage have support for pregnancy-related back and pelvic pain. Paracetamol can be taken when needed on the midwife's advice; anti-inflammatories should not be used in pregnancy without a doctor's prescription.
7. Cupping during pregnancy
Light cupping of the lower back, glutes and upper back is something many pregnant women use to release the muscles that work overtime and ease the pain, and it can be done safely with a few rules: not in the first trimester (as a precaution), never on the belly, the lower abdomen, the lowest part of the lower back right at the sacrum or over the inner thighs and ankles (classic acupuncture points avoided in pregnancy), only light suction and short sessions, never static cups with strong suction, and always with the midwife's or doctor's OK, especially with a complicated pregnancy, high blood pressure, bleeding, placenta praevia or previous preterm birth. How to: sit astride a chair with your arms on the backrest, or lie on your side with a pillow between the knees; ideally let your partner do the cupping. Oil the skin and glide the dynamic cup with light pressure along the lower back muscles on each side of the spine from a hand's width above the sacrum up towards the lowest ribs, 2 minutes per side, and over the glutes from the sacrum out towards the hip, 2 minutes per side; between the shoulder blades and along the upper trapezius 2–3 minutes. Static cups with very light suction can be placed on the upper trapezius and in the middle of the buttock for 3 minutes. Finish with cat and cow. Don't cup with fever, bleeding, contractions, swelling with high blood pressure, or if anything feels wrong; stop and contact your midwife. The full set of rules is in cupping during pregnancy and breastfeeding and when to avoid cupping.
After birth
The back and pelvis recover during the first months, but feeding positions, carrying and sleep deprivation often keep the back pain alive. Continue the exercises, vary feeding positions with support under the arms and the baby up to the breast (not you down to the baby), carry in a sling with the weight high, start pelvic floor and core training early and heavier training gradually after the postnatal check. Pelvic pain not improved three months after birth should be assessed by a physiotherapist. Cupping without pregnancy restrictions is fine as soon as you feel ready, also while breastfeeding; see the guide above.
Read more
Pelvic girdle pain in pregnancy, cupping during pregnancy and breastfeeding, swollen feet and legs in pregnancy, pelvic floor training, diastasis recti and training after childbirth, lower back pain and lower back stretches.
Frequently asked questions
Why do you get back pain when pregnant?
The hormone relaxin softens ligaments and pelvic joints from the first trimester, the centre of gravity shifts forward as the belly grows so the lumbar curve increases and the lower back is loaded more, and the abdominal muscles are stretched and support less. The result is lower back pain (above the belt line, from standing and bending) or pelvic girdle pain (below the belt line, from turning, stairs and standing on one leg), sometimes sciatica and upper back pain. Two in three pregnant women are affected; it is harmless for the baby and passes after birth.
How do I know if it is pelvic girdle pain or ordinary back pain?
Pelvic girdle pain sits below the belt line: beside the sacrum, deep in the buttock, in the groins or over the pubic bone, is stabbing and worsens with turning in bed, climbing stairs, standing on one leg and getting in and out of the car. Lower back pain sits above the belt line in the small of the back, is dull and worsens with standing, walking and bending forward. Pelvic girdle pain is treated with stability, a pelvic belt and keeping the legs together; lower back pain with movement, strength and posture. Many have both.
When should I seek care for back pain in pregnancy?
Call the maternity unit or emergency services for back pain that comes regularly in waves and increases (contractions, especially before week 37), for bleeding or waters breaking, for fever and pain in the side, for numbness in the genital area or difficulty urinating, and for back pain with headache, visual disturbance and swelling. Contact your midwife if you can't work, sleep or walk normally, with pain down the leg with numbness, with burning when urinating, or if nothing helps in two weeks; ask for a referral to a physiotherapist.
Which exercises help back pain in pregnancy?
Ten minutes daily: pelvic tilt against a wall, cat and cow, pelvic lifts (with raised upper body after week 20), pelvic floor squeezes, side-lying leg raises and clamshells with small range, bird dog, upper back rotation and gentle stretching of glutes and hip flexor. Plus walks, swimming or aqua aerobics and pregnancy yoga. With pelvic girdle pain: stability before stretching, legs never wide apart, no single-leg exercises.
Can you cup when pregnant?
Light cupping of the lower back, glutes and upper back is fine for most women from the second trimester with the midwife's OK: light suction, short sessions, never on the belly, lower abdomen, lowest lower back at the sacrum, inner thighs or ankles, no strong static cups, and not with a complicated pregnancy, high blood pressure, bleeding or contractions. Many pregnant women find it very helpful for tight lower back and gluteal muscles. The full set of rules is in the guide on cupping during pregnancy.
Related guides
Written by Curam. Last updated 17 October 2026. This is general self-care information and does not replace medical care. For sudden, severe or unusual symptoms, contact your doctor. Talk to your doctor before cupping if you are pregnant, take blood thinners or have a condition affecting skin, blood vessels or blood.
