First Trimester Back Pain Explained

You barely have a bump so how does your back hurt already??? Although you may not see any visible signs yet, your body is changing dramatically in this first trimester to support your growing fetus. As your hormones shift, your cardiovascular, pulmonary, and gastrointestinal systems are all impacted. It's also likely that you're adjusting your day-to-day behavior and movements in response to being pregnant — including in ways that you may not even be aware of.

It's these hard-to-see changes that could be contributing to your early pregnancy back pain. As many as 7 in 10 pregnant people suffer from back pain, and it can start in any trimester.

Below are four likely causes for early pregnancy back pain. Be sure to talk to your doctor to investigate what might be causing your pain. They may also recommend that you work with a physical therapist who specializes in pregnancy so you can find out what's going on with your body, and get some much-needed relief.

Lax Ligaments Are Letting Your Spine Down

Early in pregnancy, hormonal fluctuations are already starting to impact the structural integrity of your joints. Relaxin triggers changes in your ligaments during pregnancy that allow for more flexibility and movement. These changes are critical because they allow your body to accommodate your growing baby. Relaxin increasing steadily in your first trimester and will peak around the 14th week of your pregnancy.

Unfortunately, as with all hormones, relaxin does not only affect the joints of your pelvis —it affects every joint in your body. That means that the ligaments that once held your spine stable are suddenly less supportive. This sudden ligament laxity around your spine is one of the primary reasons for back pain in the first trimester.

This sudden ligament laxity around your spine is one of the primary reasons for back pain in the first trimester.

With the help of a physical therapist, you can retrain and strengthen your back muscles to compensate for this instability, which will help prevent and relieve low back pain. Staying aware of your posture making adjustments to keep it balanced can also reduce strain on your joints.

'Morning Sickness' is Derailing Your Workouts

As anyone who has experienced it can testify, the name "morning sickness" doesn't come close to describing the all the stomach issues that can arise during pregnancy. They can range from mild nausea or food aversions to daily bouts of vomiting. The degree of morning sickness that you experience can tremendously impact your willingness and ability to exercise.

Decreased muscle strength combined with decreased ligament support can lead to even more back pain.

What does that have to do with back pain? It's related because decreased exercise will lead to decreased muscle strength. As your ligaments become less supportive, your body relies on muscle strength to stabilize your joints. Decreased muscle strength combined with decreased ligament support can lead to even more back pain.

In addition, if you had back pain prior to pregnancy, any exercise you were doing was likely helping to alleviate it. So if morning sickness prevents you from maintaining your regular exercise routine, that pain can start coming back.

Constipation is Contributing to Back Pain

Another common complaint in the first trimester is increased gas, bloating and constipation.For some people, this gastrointestinal discomfort can lead to low back pain due to increased abdominal 'muscle guarding' (an involuntary muscle response to stomach pain) and reduced postural awareness during periods of discomfort (aka the way you might slump and hunch over when you have a stomach ache).

Gastrointestinal discomfort can lead to low back pain due to increased abdominal 'muscle guarding.'

Recent studies also show a link between constipation, gut flora, and back pain, though more research is needed to determine if these connections are also present during pregnancy. Regardless, if you experience back pain or abdominal discomfort related to constipation or bloating, tell your healthcare provider to determine if other underlying issues may be contributing to your back pain.

Stress is Taking a Toll On Your Nervous System

Bringing a new life into the world, even when planned and eagerly anticipated, can be a source of immense stress. For many, that stress can trigger increased muscle guarding, decreased postural awareness and, for those who already struggle with chronic pain, reemergence of past back pain. All of which makes a stressful period even more emotionally draining. There is a strong link between back pain and psychological stress and, although not adequately researched, this connection is likely even more pronounced during pregnancy.

There is a strong link between back pain and psychological stress.

The one thing NOT to do if your back hurts during pregnancy is to tell yourself — or let anyone else tell you — that pain is "normal" or something you "just have to put up with." Yes, pregnancy can be uncomfortable, but pain isn't something you have to bear for 10+ months. Talking to your doctor and seeing a physical therapist who has an expertise in pregnancy will help you troubleshoot pain and feel better in your body.