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It’s common to experience pregnancy aches and pain, especially in the third trimester. The added weight and pressure of your uterus on your muscles and ligaments can cause pelvic, tummy, back, and leg pain. Making matters worse, the options for pain relief during pregnancy are more limited, as many pain medications aren’t safe in pregnancy.

But small changes to your day-to-day routine and treatments like massage and physical therapy can make a big difference.

Let’s look at why pregnancy aches and pains occur after 27 weeks, and what you can do about them.

Back Pain During the Third Trimester: Why It Happens and How To Respond

In pregnancy, your abdominal muscles get stretched out and weaken. This means they’re less able to support your core. So, your back muscles take on more of the work of supporting you as you sit and stand.

Plus, your belly throws off your posture, adding strain on the back.

To lower the strain on your back:

• Avoid high heels. Instead, wear shoes with good arch support, like running shoes.
• Avoid standing in one spot for long periods at a time.
• Consider a maternity support belt (some call it a girdle or brace). This helps to stabilize your spine and pelvic bones and more evenly spread out the weight of your belly.
• Keep moving. While it’s tempting to sit or lie on the couch, too much time in one position can cause stiffness. Plus, it can weaken the core and back muscles, making your pain worse.
• Sleep on your side with a pillow between your knees to keep your back in a neutral position.
• Tuck a small pillow or lumbar support pad behind your lower back when you sit.

Pelvic Pain During Pregnancy: Why It Happens and How To Respond

You may feel pain in your lower tummy, or pelvis, throughout pregnancy and especially in the final months. Pelvic pain can also shoot down into your groin and inner thighs.

You may especially feel pelvic pain when you climb stairs, change positions, or stand on one leg (such as to get out of a car). You can thank the added pressure from your growing baby.

Plus, experts think that the hormone relaxin also plays a role in pelvic pain. Relaxin loosens the muscles and ligaments in your abdomen and pelvis to make space for your baby. In response, other muscles have to do more work, leading to overstrain.

To avoid pelvic pain:

• Avoid having to stand on one leg. Sit down to get dressed, and swing both legs out the car door before standing up.
• Do pelvic floor exercises, or kegels. To do a kegel, you tighten the muscles you use to avoid peeing. Hold for a few seconds and release. Gradually work up to 20 or 30 Kegels a day, resting after each set of 10.
• Don’t stand or sit for a long period at a time. This keeps your weight on one area and can lead to strain.
• Sleep on your side with a pillow between your knees to keep your back in a neutral position.
• Try a maternity support belt or girdle to support your pelvic muscles.
• Try to keep your pelvis level. Keep the same amount of weight on each leg when standing.
• Wear low-heeled shoes with arch support, like running shoes.
• When sitting, keep both feet on the floor.

Headaches

Headaches can occur at any time in pregnancy. To prevent them, make sure you drink eight glasses of water a day. Try to go to bed at the same time every night, which makes it easier to fall asleep and get enough sleep.

Acetaminophen (Tylenol) is safe in pregnancy, according to the American College of Obstetrics and Gynecologists. But try to only use once in a while, and be sure not to exceed the recommended dose. Avoid taking ibuprofen (Advil), which is not recommended in pregnancy.

In the third trimester, severe, unusual, or frequent headaches can be a sign of preeclampsia. This is a problem related to the placenta that causes high blood pressure and is dangerous for you and your baby. If you have headaches that seem worse than what you would normally have, call your health provider for an urgent check-up.

Leg Cramps

Leg cramps are more likely in pregnancy, especially in the second and third trimesters. Many people find leg cramps are worse at night. While experts aren’t sure why they’re linked to pregnancy, they do know what helps.

To prevent or reduce leg cramps, you can:

• Ensure you’re drinking enough water; aim for 8 glasses a day.
• Straighten your legs and flex your toes up toward the knee when you feel a cramp. This will stretch the muscles that are cramping.

How Do I Deal With an Uncomfortable Pregnancy? Safe Pain Relief Options

The following options are safe in pregnancy:

• Acupuncture can help with low back pain, carpal tunnel, and other pain in pregnancy.
• Heating pads or warm water bottles can relieve muscle pain. Use electrical heating devices at the lowest setting.
• Massage therapy is safe in pregnancy. Try to find a therapist who commonly treats pregnant patients.
• Light exercise throughout pregnancy helps to relieve and prevent pain. Try prenatal yoga, light stationary cycling, or other low-impact activities.
• Over-the-counter acetaminophen is safe. The American College of Obstetricians and Gynecologists advises taking the lowest dose that relieves pain, and taking it only when needed.
• Physical therapists can help you strengthen muscles to better support your pregnancy body and relieve pain.
• Water therapy takes the pressure off your muscles and joints. Try soaking in a pool or bath, but avoid hot tubs.

When to See a Provider for Pregnancy Pain

Call or visit your provider if:

• You have back or pelvic pain that goes on for more than two weeks.
• You have pain associated with other worrying symptoms, like dizziness, a fever, or a burning feeling when you pee.
• You have severe pain.
• You have unusual headaches in the third trimester (more frequent or severe than normal).

It’s important to see a provider to rule out causes of pain beyond typical pregnancy. Your provider can examine you, ask about your symptoms, and order blood and other tests. For example, you could have a urinary tract infection, kidney stone, or other problems.

Once your provider rules out causes beyond typical pregnancy, they can refer you to a physical therapist or someone else who can help. For severe pain, they can also prescribe pain medications that are safe in pregnancy for short-term use.