Pregnant women undergo marked physical changes and various symptoms each week of pregnancy. Some symptoms disappear while others increase. By the 17th week, pelvic and lower back pain may begin to appear, which is normal and common as the baby grows, but it may require medical follow-up in some cases.
In this article, we will discuss the causes of pelvic and lower back pain at this stage, how to distinguish between normal pain and urgent issues, as well as the safest methods to relieve this pain.
Why does pain start in week 17?
There are several factors that lead to pelvic and back pain during pregnancy, such as:
- The body adapts with the progression of pregnancy and baby’s growth.
- By the 17th week, the uterus expands significantly, affecting the muscles and ligaments of the pelvis and back.
- Uterine expansion can press on certain nerves, such as the sciatic nerve, which may lead to pain extension from the back down to the leg.
- The hormonal changes greatly affect the flexibility of pelvic ligaments, especially relaxin hormone, which increases during pregnancy, leading to pelvic ligament relaxation in preparation for childbirth. This increases the flexibility of ligaments, makes them less stable, reduces their ability to withstand extra pressure, and increases discomfort or pain in the pelvis and lower back.
- The increased weight of the baby affects the mother’s posture and the center of gravity, increasing pressure on the lower back muscles.
What’s Normal and What Requires Attention?
According to medical studies, more than half of pregnant women experience some pain in the pelvic and back areas. Pain may be localized, extend to the leg, or be accompanied by numbness or tingling.
You should distinguish between normal pain and symptoms that may refer to a health problem:
- Normal pain: appears when standing or walking for long periods, usually mild to moderate, and improves with rest or changing body position
- Concerning pain: Severe, persistent pain, or that accompanied by other symptoms such as fever, bleeding, difficulty walking, or pain while urinating, seek medical consultation immediately.
How to distinguish between different types of pain?
The causes and intensity of back and pelvic pain vary from woman to another. Normal pain occurs occasionally and is associated with periods of rest or inactivity. Medical help may be needed in the following cases:
- Sciatica
Pain usually radiates from the pelvis down to the lower back or thigh due to uterine or ligaments on the sciatic nerve. The pain can be sharp, burning, or electric-like, and worsens when sitting or standing for long periods.
- Sacroiliac joint pain
Pain affecting the joint connecting the pelvis to the spine, when the ligament’s laxity increases and the joint moves excessively. It may be localized in the pelvis and lower back and worsen when walking or standing.
Natural ways to relieve pelvic and back pain
There are many natural and safe ways to relieve pain, such as:
Light Exercise
Strengthen the pelvic and lower back muscles, improve muscle flexibility and reduce pressure on the joints. They include:
- Posterior Pelvic Tilt Exercise
Strengthens the lower abdominal muscles, reduces pressure on the lower back and pelvis, and can alleviate lower back pain.
How to perform:
- Lie on your back with knees bent and feet flat on the floor (if unable to lie down, you can sit or stand).
- Gently tighten your abdominal muscles toward the spine while pressing your back to the floor.
- Hold for 3-5 seconds, then relax slowly.
- Repeat 8-12 times, once or twice daily.
- Kegel Exercises
Safe and easy pregnancy exercises that strengthen pelvic muscles, support the back, and reduce urinary incontinence.
How to perform:
- Make the pelvic muscles tight as if stopping urine flow.
- Hold for 5 seconds, breathe calmly, and avoid tension in the abdomen, buttocks, or thighs.
- Relax slowly for 5 seconds.
- Repeat 2-3 times daily, 10 repetitions each time.
You can gradually increase the contraction time from 5 to 10 seconds. Stop and consult your doctor if you feel any abnormal pain. Bridge exercises or stretches for the hips and hamstrings also help relieve tension and pain.
Ideal Positions
- Sit with proper posture and back support, using a small pillow behind your back, especially when sitting for long periods.
- Don’t stand or sit for a long time without movement. It is recommended to walk a few minutes every 30-60 minutes to prevent muscle strain or venous pooling.
- When sitting, keep your feet flat on the floor with knees at 90° or stretch your legs fully.
- Sleeping on the left side with a pillow between the knees and another under the abdomen reduces pressure on the pelvis and spine and improves blood flow to the placenta.
- Take breaks between activity periods to recharge and reduce muscle strain.
Warm or Cold Compresses
- Warm compresses relax muscles.
- Cold compresses may reduce inflammation and swelling.
Pelvic Support Belts
Pregnancy pelvic belts are wide, flexible bands wrapped around the lower abdomen and pelvis, secured with fastening straps. They may have one or more straps depending on pain severity. There are also the medical belts for severe ligament laxity or chronic pain.
Belts support the pelvis and back, reduce ligament and joint strain, and improve posture and balance while standing or walking. Choose belts made of breathable materials with appropriate sizing after consulting your doctor.
They are recommended when you complain:
- Difficult walking or standing for long periods.
- Pelvic or lower back pain as pregnancy progresses.
- Rapid weight gain or twin pregnancy.
- Increased pelvic ligament laxity due to increased relaxin hormone.
Physical Therapy
A gentle massage of the lower back can help relax muscles and reduce pain when performed by a qualified specialist. A physiotherapist can also evaluate the cause of pain, guide you on proper sleeping and sitting positions, and advise you on appropriate supportive footwear.
When to visit the doctor?
There are some symptoms requiring medical attention, such as:
- Severe, persistent or worsening pain.
- Pain accompanied by other symptoms, such as sudden leg swelling, difficulty walking, or loss of bladder or bowel control.
- Abdominal cramps with vaginal bleeding or abnormal discharge.
- Marked interference with daily activities or sleep.
- Fever with back pain.
How to prevent pelvic and back pain
It is normal to feel some pain as pregnancy progresses. You can prevent worsening or reduce it by:
- Avoiding heavy lifting.
- Sitting on a comfortable chair with good back support.
- Practising breathing and relaxation exercises regularly.
- Avoiding unnecessary weight gain.
- Eating nutrient-rich foods such as:
- Calcium and Vitamin D: Supports bone health and calcium absorption necessary for fetal bone development. It is found in dairy products and leafy vegetables. You can also obtain it in supplements after consulting your doctor.
- Magnesium: Supports the function of nerves and muscles and may reduce common leg cramps in pregnancy.
Finally…
Pelvic and lower back pain is a common and normal symptoms during pregnancy, due to physical and hormonal changes. This pain can be reduced with safe, natural methods, and you should consult your doctor if the pain is severe or significantly affects your quality of life.