Backache is a very common feature of pregnancy with about half of all pregnant women experiencing some form of back pain. It is often referred to as one of the 'minor ailments' of pregnancy, but some women will suffer severe, and even incapacitating pain.

Factors contributing to backache:

1. Posture - the increasing weight gain during pregnancy causes changes in the normal curve of the spine placing strain on the muscles and ligaments of the back.
   
2. Fatigue - a typical symptom of pregnancy, tiredness can also lead to poor posture.
   
3. Ligament laxity - during pregnancy the body releases hormones which soften the ligaments, particularly those which connect the bones of the pelvis and the lower back. This laxity allows movement to occur at joints when normally there would be very little movement. The increase in movement may give rise to pain.

How to avoid backache:

1. Maintain good posture
2. Standing - stand tall with weight evenly on both feet. Keep your 'tummy' and 'seat' muscles tucked in.
   Sitting - sit well back into your chair so that your lower back is fully supported. It may be necessary to place a small rolled towel at the small of your back, i.e. the normal curve of your back. Do not cross your legs. Very soft low chairs should be avoided.
   Lying - keeping your knees bent, whether lying on your back or on your side tends to reduce back strain. When getting out of bed keep your knees bent, roll onto your side and push up into a sitting position using your arms, swinging your legs out over the side.
3. Bending, lifting and carrying
   Bending - bend down into a squat when reaching into low cupboards, making beds, gardening etc. Make sure you put one foot in front of the other to counteract the extra weight. Always bend your knees, keeping your back straight, and don't stoop.
   Lifting - avoid heavy lifting, whenever possible. To lift correctly, stand close to the object, facing it, feet apart with one foot in front of the other. Squat down keeping your back straight. As you lift, bring the object in as close to you as you can. Never twist your body as you lift.
   Carrying - if you have to carry heavy bags, distribute the weight evenly on each side of you. If carrying babies or small children, change from one hip to the other frequent

To ease or relieve backache:

1. Avoid maintaining the one position for any length of time. Vary between sitting and standing throughout the day.
2. Try this exercise:
   Lie on your back with knees bent and feet on the bed/ floor. Draw in your tummy and press the small of your back (back of your waist) down into the bed/floor. Hold this flattened position for a few seconds (make sure to breath normally, without holding your breath), then let go gently. Repeat ten times.

If you experience severe back pain which does not respond to any of these measures, seek the advice of your doctor or obstetric physiotherapist.