Upper Back Pain during Pregnancy

by gaylehope | 16 Comments

There is a lot of focus on pre-natal lower back pain, but clinically I treat many women in this population that experience upper back (thoracic spine) pain as well. Upper back pain during pregnancy can occur at any point, but is most common in the third trimester. This occurs for several reasons. First, as pregnancy progresses, the growing size of the baby and the uterus shifts the center of gravity forward placing increased pressure on the muscles in the back. Secondly, a woman can gain 25-30% of their body weight in a relatively short period of time, which also places increased stress on the muscles in the back. The changing hormones in the later stages of pregnancy can also have an effect. As the body prepares for delivery, hormones are released that loosen the ligaments and muscles in the body. When this occurs there is less inherent stability in the pelvis and back, which causes the muscle to work harder, and sometimes this increased demand on the muscles can cause muscle spasm. Lastly, the enlargement of breast tissue during pregnancy can alter posture and increase strain on the neck, shoulders, and thoracic spine.

While upper back pain during pregnancy is common there are some steps that you can take to prevent this from occurring and relieve symptoms when they do occur. 

  • Maintaining a neutral standing posture. Stand up straight and tall with your chest high and shoulders back and relaxed. Don’t lock your knees. Use a wide stance for a good base of support and try to keep weight equally distributed between sides. If you are statically standing for prolonged periods of time, rest one foot on a small step stool and change feet regularly to change the weight distribution.
  • Maintain a neutral sitting posture. Use a chair that has good lumbar support or purchase a lumbar support pillow. Do not cross your legs and keep your feet flat on the floor approximately shoulder width apart. If your feet do not sit comfortably on the floor consider using a foot stool. Make sure that your chair is of a proper height with the hips positioned at approximately 90 degrees. Your knees should never be higher than your hips in sitting. By keeping the lower back supported, the muscles in the upper back can relax more in sitting.
  • upper back pain during pregnancyMaintain a neutral spine while sleeping. It is recommended that pregnant women, especially in the second and third trimesters of pregnancy, sleep on their side. Placing a pillow between the knees and under the abdomen can help to maintain a neutral spine with sleeping. Also, using the appropriate number of pillows to ensure a neutral neck or cervical spine position is important.
  • Avoid lifting and carrying heavy objects and, when necessary, use proper body mechanics with lifting. Some helpful reminders for lifting are: Face the object that you are going to lift. Keep the object close to your body at all times to decrease the lever arm and in turn the force that is placed on your back. Bend from your knees not your back when lifting the object. If you need to bend forward to lift the object hinge from the hips do not bend at the back. Do not twist while lifting. Wait until you have lifted the object and have it close to your body before pivoting or turning.
  • Wear a good supportive bra and comfortable clothing during pregnancy. Also wearing supportive shoe wear without a heel can help relieve some of the back discomfort by keeping the spine more neutral and providing a good base of support.
  • Perform daily physical activity or exercise such as walking or swimming. This will keep your back muscles strong and can help to relieve discomfort. Always consult with your healthcare provider before beginning any new exercise program during pregnancy. 
  • Performing a few simple stretching exercises daily can also help prevent or alleviate upper back pain. The two exercises that follow can help to reduce some of the postural stresses and therefore decrease upper back pain.
    • Doorway pectoralis stretching: Stand in a door frame and place your arms on the door frame at shoulder height with the elbows bent to 90 degrees. Place one foot forward and gently lunge forward until you feel a moderate stretch at the front of the chest into the front of the shoulders. Hold for 30 seconds and repeat 3-5 times several times a day.
    • Scapular retraction: After you have stretched the pectoral musculature as noted above, keep the arms relaxed at your side and gently pinch the shoulder blades together as if you are trying to hold a pencil between them. Hold for 5 seconds and then relax. Repeat 20-30 times several times a day. 

If you do experience upper back pain during pregnancy you can use ice, heat, or massage to relieve symptoms. Do not leave either on for extended periods of time (greater than 15 minutes at a time). Make sure there is proper padding between your skin and the hot pack to prevent burns and place a barrier between your skin and the ice pack to prevent skin irritation. Ask your partner to massage the area or schedule a professional prenatal massage. Also, talk to your healthcare provider about physical therapy. A physical therapist can evaluate you to determine the specific factors that are contributing to your upper back pain and design an individualized program to address these factors and facilitate your return to pain-free functioning.

If upper back pain is not relieved by the above, contact your physician. While upper back pain during pregnancy is common, it isn’t something to ignore. In some cases back pain may be a sign of pre-term labor or other obstetrical conditions, so always mention the back pain to your doctor so that they can evaluate the cause and suggest the proper treatment. Upper back pain during pregnancy can be successfully treated, which can improve the quality of your pregnancy and make your post-partum recovery and transition easier. Have a healthy and happy pregnancy!

16 Comments

  1. Lana

    Thankyou so much! My upper and middle back pain is excruciating and the doctors just said there’s nothing that can be done. So unhelpful and my physio couldn’t manage to do anything for the pain either. Pain relief doesn’t work. I’m going to book into a new physio/massage therapist to see what they can do for me.
    I hardly slept well for months.

  2. Stacy Koenigs

    Depending upon where the pain is located, it can be normal for some muscular pain to be present. Your body goes through a lot of changes as the hormone levels increase and you can have neck, mid-back and lower back pain present. I would contact your physician and either discuss it at your next appointment, or if it cannot wait until then, I would make an appointment with them sooner.

  3. B

    I have found that doing prenatal yoga (at least twice a week but more is better) has kept my back pain away. I have a Shiva Rea DVD that I do. If I don’t do the prenatal yoga then the pain becomes unbearable. I hope this helps someone. I rarely see yoga as a recommendation and it saved me from going to a chiropractor.

  4. Stacy Koenigs

    Thank you for sharing with everyone! Yoga is a great way to stretch out and improve your core strength. It will help you keep you in good posture and decrease your back pain.

  5. Jessica Roberts

    Hello. I’m at the end of my 7th month and on the third baby in a 4 year span. I went through horrible upper back pain in my second pregnancy and it was even worse post-pregnancy. I have been so lucky to have avoided this pain so far in this pregnancy, but it’s here again and in full force and it has only been a week of pain. I have to do something now to help because I have two children who solely rely on my strength every day all day. I know about the exercises and have been doing them. I just want helpful pointers of websites or store who sell anything to buy for sleep and something else primarily for sitting because that’s when it is the worst. I’ll buy anything you might have in mind for relief when it’s time for me to relax because it’s always when my upper back pain starts. Any special mattresses or mattress padding, special cushions, special relaxing chairs which can be used when nursing baby? Just gotta do something now and buying something seems the best thing for me to do because I haven’t ever bought anything so far to help my body out during pregnancies and I owe it to myself to pamper the rest of this pregnancy and prepare myself for the recovery process and however long that may be.

  6. Stacy Koenigs

    Jessica, I would recommend a “Prenatal Cradle” or a “Best Cradle” brace for you. It will support your back by lifting and supporting your abdomen. This will allow the pressure to decrease on your upper back. As you have a lot of pain while sitting, I would really focus on monitoring your posture. Be sure to avoid sitting in a slumped posture which will add to your upper back pain. While feeding, I would be sure to put a pillow underneath the child to bring them up to you and avoid supporting them fully with your arms. For sleep, I would recommend a body pillow. It’s long enough to fit between your knees (to help with hip/back pain), support your belly, and wrap your arms around when you are lying on your side. This will support your upper back as well. A regular body pillow works well, but there are also ones specifically for pregnancy out there.

  7. Jeruto Josphine

    I have been suffering upper back pain seens 2013 may after delivery i have gone for madication but there is no change how can i do?

  8. Stacy Koenigs

    I have included another blog article below for you to look at which discusses the back pain in both the lower and upper back after delivery. There is a lot of stress on the upper back following delivery as you are now carrying, holding and feeding your infant. Everything we do brings us into a forward hunched position while caring for the little ones and this will lead to increased upper back pain. I would guess with some work on body mechanics (how you do everyday things), strength in the upper back, and perhaps some massage to release the tension in the muscles, you could get some relief. Ask your doctor for a prescription for physical therapy to get some help.

    http://www.athletico.com/2014/01/27/postpartum-back-pain/

  9. Kate

    I have been suffering with back ache since 7 weeks of my second pregancy (now 25 weeks). It started with chronic spasms mid to upper back which also came round to my abdomen – this eased after 6 weeks or so (whilst seeing a cranial osteopath). My pain is now mainly on the right hand side in the mid rib area (including spasms) and mid to upper back (ache). I am struggling to sleep and find most things painful/uncomfortable.

    I have been told I have a problem with my pelvis (probably from the 1st birth and associated weakness in my right leg).

    What can you recommend in terms of exercises and is there a type of specialist I can tell my doctor I want to see who can help me? I am starting to reach the end of my tether and I have another trimester to go! Thanks in advance for any help you can provide.

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