Everyone knows labor and delivery is painful, but what about the rest of pregnancy? If this is your first foray into the world of baby-growing, it might come as a surprise just how ridiculously uncomfortable — and sometimes downright torturous — those three trimesters can be (of course, if you’ve been pregnant before, it's likely all too familiar).
According to a 2008 study published in Current Reviews in Musculoskeletal Medicine, anywhere from 50 to 80 percent of pregnant people report lower-back pain during pregnancy, and roughly 50 percent of pregnant people report pelvic pain during pregnancy (according to a 2004 analysis in the journal Spine).
But because of the never-ending list of safety restrictions for treating ailments and illnesses during pregnancy, a lot of parents-to-be assume they have to grin and bear it through nine months of discomfort.
Not so, says physical therapist April Oury, founder and president of Body Gears Physical Therapy in the Chicago area.
Oury tells SheKnows pregnant people "suffer through common aches and pains during pregnancy because they hear, ‘Well, what do you expect?’ and don’t realize there are many techniques that are effective in changing those symptoms.” She also says, “Safe solutions are out there with caring, effective, licensed and trained professionals.”
Here, a list of the most common pregnancy-related aches and pains, why they happen and — thankfully — what you can do about them.
Back pain — either lower or upper, between your shoulder blades — typically appears during the second trimester and is a result of your growing uterus.
“Your posture changes to accommodate the weight you’re carrying in front of your body,” OB-GYN Christine Masterson, chief of the women and children’s service line for Summit Medical Group in New Jersey, tells SheKnows. “Your spine is curved more, you’re holding your body differently, and you’re using muscles in new ways.”
While this kind of back pain can be treated with acetaminophen, stretching and massage or chiropractic care (if approved by your physician or midwife first), pregnant people should make note of any lower-back pain that isn’t alleviated by any of these treatments — this could be a sign of preterm contractions.
Your sciatic nerve runs from your lower spine through both sides of your hips and buttocks, then down your legs to your feet. It’s sensitive to postural changes, so pregnancy often puts pressure on it, causing discomfort anywhere along that pathway. Some people feel a shooting pain, while others experience numbness or tingling. Masterson recommends moving around regularly (changing your position from sitting to standing, for example) and walking around once every hour to stretch.
As pregnancy advances, your body begins producing more hormones — specifically one called relaxin — to soften your ligaments and joints. This prepares your body for the hard work of giving birth, but it also leaves your pubic joint, which sits at the bottom of your pelvic bone, susceptible to soreness and tenderness.
It's more common in pregnant people who’ve had babies before or closely spaced pregnancies, "because those periods of body stress mean your body needs to repair itself,” Susan Hernandez, certified nurse midwife and codirector of the midwifery program at Massachusetts General Hospital, tells SheKnows.
If you’re experiencing pubic pain, Hernandez recommends regular low-impact exercise to strengthen the ligament. Physical therapy might also be particularly useful in this case; Oury says that pelvic pain is one of the most common pregnancy-related problems she sees in her work as a physical therapist (along with sciatica).
“Often, we go through the abdomen to access the front of the spine muscles, [but] clearly, we cannot do that for our pregnant patients,” Oury explains. “Our approach is to assess the pelvic, lumbar and hip bones and how they relate to one another statically. We look at these bones and muscles not just on the treatment table, but during real-life situations like sitting and standing.”
Partially caused by the loosening effects of relaxin and partially due to pregnancy-related swelling, wrist pain (i.e., carpal tunnel) is a common ailment during the second and third trimesters. A 2009 review in the Wisconsin Medical Journal estimates that as many as 62 percent of pregnant people may experience carpal tunnel, with most reporting improvement after delivery. Carpal tunnel may feel like numbness, tingling or stiffness in your hands and fingers. Masterson recommends making sure you’re drinking enough water and limiting your sodium intake to reduce swelling and utilizing ergonomic solutions to alleviate pain.
“There are carpal tunnel wrist braces you can buy at the pharmacy, and you can elevate your wrist at night by propping it up on a pillow,” she says. If your job requires a lot of repetitive motions, like typing, take regular breaks to stretch your hands, wrists and fingers.
This is one people are often surprised by, says Hernandez, though the reasoning behind it makes sense: as the size of your abdomen increases, your stomach muscles can separate and your ribs may “bow out,” causing stretching and inflammation of the cartilage that connects your ribs to your breastbone. This condition is called costochondritis.
“The cartilage [along your ribs] is working extra hard to stabilize your core and your center of gravity, so it can get inflamed and sore,” she explains. “This can be a stabbing pain that feels like chest pain, and it can make breathing painful.”
Hernandez recommends alternating hot and cold treatments to alleviate costochondritis, with cold always applied first to relieve any swelling.
Between 16 and 26 weeks, Masterson says your uterus grows rapidly and starts to move from your pelvis to your abdomen. This can cause something called round-ligament pain, in which the ligaments supporting your uterus stretch to accommodate these changes. The pain can be one-sided or bilateral and may feel either sharp and stabbing or throbbing and achy. Masterson recommends resting and emptying your bladder to see if it resolves and — similar to her advice for back pain — taking acetaminophen and stretching while monitoring for signs of preterm labor.
If you’ve ever woken up in the middle of the night with a Charley horse, you know it’s a special kind of agony. For some reason, Masterson says, leg cramps are more likely to happen during pregnancy; the American Pregnancy Association suggests that weight gain, pinching of nerves and changes in circulation may be to blame.
Thankfully, leg cramps don’t usually last very long — but they’re pretty excruciating while they’re happening. Don’t point your toes during the cramp, advises Masterson, and gently stretch or massage the leg muscles to help it go away. She also notes that if it doesn’t clear up or your leg starts to swell, you should seek medical attention; a leg cramp could be a sign of deep vein thrombosis, a life-threatening kind of blood clot.
What to remember
Unfortunately, very few people make it through nine months of pregnancy without experiencing at least a little bit of pain. (And even if you do, you’ve likely got a world of hurt waiting for you in the delivery room… sorry). But the sources of those aches and pains may even have been there before you got pregnant — perhaps you just didn’t realize it.
“Physical therapy can resolve issues that were present prior to the pregnancy but went unnoticed in the business of life,” says Oury. “With postural changes, weight gain, fluid retention and a change in the way the body carries weight, the unnoticed problems are now detected, [but can be] easily treated.”
So it’s not all bad news about pain during pregnancy, and you should always talk to your doctor or midwife about your concerns (it’s what they’re there for!). Every provider has a different opinion on massage, chiropractic care and prenatal yoga, but many will give you the green light for these alternative treatments. And don’t forget that the pain you’re experiencing during pregnancy might be a sign to listen more closely to your body.
“It’s simple body mechanics — the elements of how your body changes during pregnancy,” says Hernandez. “There’s a reason you’re body is telling you to slow down. It takes energy to grow a human being. That’s why you’re so fatigued in early pregnancy. You have to learn to use your body in a different way, and that might mean getting more support.”
Bottom line: Even though pregnancy pain is pretty common, there’s no reason to suffer. Your body is working around the clock for nine months, so don’t be afraid to get professional help with those growing pains if you need it.