Low Back Pain During Pregnancy: Causes and How Chiropractic Helps
Quick answer: Low back pain in pregnancy usually comes from the mechanical changes your pelvis and spine go through as your body makes room for your baby: looser ligaments around the pelvic joints, a shifting centre of gravity and changes in how your stabilising muscles respond. Gentle, pregnancy-adapted chiropractic care, along with regular movement and lower stress, can help many women move more comfortably. Always coordinate it with your obstetrician or midwife.
Key takeaways
Back and pelvic pain are common in pregnancy, and they are more likely if you've had back pain before, are carrying twins or gain more weight.
The pain often comes from the pelvis and its joints, especially the sacroiliac joints, not just from "weak muscles".
Your nervous system's sense of position and control plays a real part in back pain.
Gentle adjustments, daily movement and lower stress can all support comfort and function.
Tell your obstetrician or midwife about any severe, unusual or worsening pain.
Why does my lower back hurt during pregnancy?
Your lower back hurts because your pelvis and spine are adapting to carry and deliver a baby, and that adaptation puts new demands on joints, ligaments and muscles.
In my clinic I often see the same picture. The ligaments around the pelvis become looser so the pelvis can open for birth. That is exactly what your body should do. But it also means the joints at the back of the pelvis, the sacroiliac joints, can move less evenly than before. One side may lock up a little while the other works overtime. The European guidelines on pelvic girdle pain (Vleeming et al., 2008) treat this pelvic area as a distinct and common source of pain in pregnancy.
At the same time, your weight moves forward and your lower back adjusts its curve to keep you balanced. Long days sitting at a desk or in the car in Dubai, then standing to cook or carry a toddler, add to the load.
Who is more likely to get back pain in pregnancy?
You are more likely to get back pain in pregnancy if you've had back pain before, if you are carrying more than one baby, or if you gain more weight during the pregnancy.
The guidance on chiropractic care in pregnancy (Alcantara et al., 2023), the European pelvic girdle pain guidelines (Vleeming et al., 2008) and a review of women carrying twins (Hiebert and Alcantara, 2025) point to these same risk factors. None of them mean pain is certain. They are simply worth knowing so you can start looking after your back early.
Is it just weak muscles?
No. Back pain is often less about strength and more about how well your nervous system senses and controls your spine.
The way I explain it to my patients is this: your joints constantly send your brain information about position and movement. Your brain uses that information to switch on the deep, automatic muscles that steady your spine before you even think about moving. When a joint isn't moving well, that information gets noisier. The deep stabilisers respond a fraction later, and the area feels vulnerable and sore. So doing more sit-ups isn't the answer. You need good joint movement and good control.
Do I need an X-ray or scan to find the cause?
Usually not. A careful history and a hands-on examination are what guide care for most back pain.
Clinical guidelines for low back pain (Kreiner et al., 2020; Airaksinen et al., 2004) note that early imaging does not necessarily improve outcomes for non-specific low back pain. They also note that a careful history and examination are used to screen for anything more serious. In pregnancy, your obstetrician will decide if any imaging is ever needed.
Which exercises help low back pain in pregnancy?
Gentle, regular movement that keeps your pelvis and spine moving helps most. Check with your obstetrician or midwife before starting anything new.
Daily walking. Walk at an easy pace for 10 to 20 minutes, once or twice a day. In the summer heat, use a mall, a shaded track or an indoor treadmill.
Pelvic rocks on hands and knees. Kneel with your hands under your shoulders and your knees under your hips. Gently tuck your tailbone under, then let it tip back out, moving slowly with your breath. Do 8 to 10 rocks, 1 to 2 times a day.
Side-lying rest. Lie on your side with a pillow between your knees and one under your bump. This keeps your pelvis level. Use it for rest breaks and for sleep.
Movement breaks. If you sit for work, stand up and walk for a minute or two every 30 to 45 minutes.
Slow breathing. Breathe in through your nose for about 4 seconds and out for about 6 seconds, for 2 to 3 minutes, once or twice a day. It helps your nervous system settle.
Stop any movement that causes sharp pain.
Why does stress make back pain worse?
Stress makes back pain worse because a body under constant stress stays on guard, with tighter muscles, poorer sleep and a more sensitive nervous system.
Pregnancy brings plenty of this, from work deadlines to sleepless nights to the normal worries of becoming a parent. I think of it as a stress load that builds up over time. Lowering that load matters for your back as much as anything I do with my hands. Good sleep, real food, time outdoors in the cooler hours and people around you who support you all help your body adapt.
How does Dr Ben approach back pain in pregnancy?
I look for the specific joints in your pelvis and spine that aren't moving well, and I adjust them gently so your body can adapt to pregnancy with less strain.
My approach is simple. Your body already knows how to adapt and heal. My job is to find what is getting in the way. I don't try to force your spine into some ideal shape. Every pregnancy and every pelvis is different. Instead, I check each joint, especially the sacroiliac joints and the lower back. I find the specific areas that are restricted, and I correct only those.
In pregnancy, everything is adapted for you. You are positioned comfortably, often on your side or with support for your bump, and the adjustments are gentle and precise. I watch how your body responds from visit to visit. Then we build the rest around it: how you sit at work, how you sleep, how you lift your toddler, and the movement and breathing habits above.
Chiropractic care is generally considered a safe option for low back pain (Airaksinen et al., 2004). There are also published best-practice guidelines for chiropractic care in pregnancy (Alcantara et al., 2023). The research on pregnancy-related pain is growing, and everyone responds differently. I see this care as support for your comfort and function, alongside your obstetrician or midwife, never instead of them.
When should I see someone?
See someone if the pain stops you sleeping, walking or working, or if it isn't easing after a week or two of gentle movement.
Contact your obstetrician or midwife straight away, or seek urgent care, if you have any of these:
Vaginal bleeding or leaking fluid
Regular tightening, cramping or pain that comes and goes like contractions
Fever, or pain or burning when you pass urine
Numbness around the groin or inner thighs, leg weakness, or changes in bladder or bowel control
Sudden, severe pain, or pain that is getting steadily worse
Any change in your baby's movements
Frequently asked questions
Is chiropractic care safe during pregnancy?
Chiropractic care is generally considered a safe option for low back pain, and there are published guidelines for adapting it to pregnancy. Care should be gentle, positioned for your comfort, and coordinated with your obstetrician or midwife.
When in pregnancy can I start chiropractic care?
You can start at any stage once your obstetrician or midwife is happy for you to. Many women come in when the aches first begin, rather than waiting until the third trimester.
Can I keep going to the gym while pregnant with back pain?
Many women can keep moving, with changes, and staying active is good for your spine. Check your plan with your obstetrician or midwife, and avoid anything that causes sharp pain.
Will my back pain go away after birth?
For many women the pain eases as the body recovers after birth, but it varies from person to person. Feeding, lifting and carrying a newborn bring their own strains, so it's worth getting checked if the pain lingers.
Should I tell my obstetrician I'm seeing a chiropractor?
Yes, always. I work alongside your medical team, and it helps everyone to know what care you're receiving.
About the author
Dr Ben is a chiropractor at Heal Hub in Umm Suqeim, Dubai.
If your back or pelvis is making pregnancy harder than it needs to be, book a first visit with me at Heal Hub in Umm Suqeim, Dubai. It takes 45 minutes: drbentinker.com/booking-calendar/new-patient-first-visit
References
Alcantara, Kent, McCoy (2023). Best Practices for Chiropractic Care During Pregnancy. Vertebral Subluxation Research.
Hiebert, Alcantara (2025). The Chiropractic Care of Pregnant Women with Twins: A Case Series & Review of the Literature. J. Pediatric, Maternal & Family Health.
Vleeming, Albert, Ostgaard (2008). European guidelines for the diagnosis and treatment of pelvic girdle pain. European Spine Journal.
Kreiner, Matz, Resnick (2020). Evidence-Based Clinical Guidelines for Multidisciplinary Spine Care: Diagnosis & Treatment of Low Back Pain. North American Spine Society.
Airaksinen, Brox, Cedraschi, et al. (2004). European Guidelines for the Management of Chronic Non-Specific Low Back Pain. COST B13 Working Group on Guidelines for Chronic Low Back Pain.
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