Back pain during pregnancy is so common that many women assume it is just something you have to live with. About two-thirds of pregnant women experience significant back pain, and it tends to get worse as the pregnancy progresses. But “common” does not mean “untreatable.” Physiotherapy is one of the safest and most effective ways to manage pregnancy-related back pain, and it can make a real difference in your comfort during the second and third trimesters.
Here is what Penang mothers-to-be should know.
Why Pregnancy Causes Back Pain
Several things happen to your body during pregnancy that put strain on your back. Understanding them helps explain why certain treatments work.
Weight gain and shifted centre of gravity. As your baby grows, your centre of gravity moves forward. Your body compensates by increasing the curve in your lower back – a posture called lumbar lordosis. This puts extra pressure on the joints and muscles of the lumbar spine, which were not designed to hold that position for months at a time.
Hormonal changes. The hormone relaxin increases during pregnancy, loosening the ligaments throughout your body – including the ligaments that stabilise your pelvis and spine. This is necessary to prepare for delivery, but it also means your joints are less stable and more prone to pain, especially the sacroiliac joints at the back of your pelvis.
Abdominal muscle changes. As your belly expands, the abdominal muscles stretch and separate (diastasis recti), reducing their ability to support the spine from the front. This leaves the back muscles doing more work than they should.
Pelvic girdle pain. Separate from lower back pain, many pregnant women develop pain in the pelvic joints – the sacroiliac joints at the back or the pubic symphysis at the front. This can make walking, turning in bed, and climbing stairs painful.
What a Physiotherapist Can Do
Physiotherapy during pregnancy uses techniques that are safe for both mother and baby. Your physiotherapist will avoid any positions or treatments that are contraindicated during pregnancy, and they will modify the approach as your pregnancy progresses.
Manual therapy. Gentle mobilisation of the thoracic and lumbar spine, along with soft tissue massage of the tight muscles in the lower back and hips. During the second and third trimesters, this is done with you lying on your side or in a supported seated position – not face down. Many women feel immediate relief after manual therapy, though the effect is temporary without supporting exercises.
Pelvic stability exercises. These are the most important part of pregnancy physio. Strengthening the muscles that stabilise the pelvis – the deep abdominals, pelvic floor, and gluteal muscles – directly counteracts the instability caused by relaxin. Your physiotherapist will teach you exercises that are safe at each stage of pregnancy and progressively adjust them as your body changes.
Pelvic floor work. Pelvic floor exercises (Kegels) are well known, but many women do them incorrectly. A physiotherapist can assess whether you are engaging the right muscles and give you a structured pelvic floor programme. Strong pelvic floor muscles help support the weight of the baby, reduce pelvic pain, and prepare you for delivery and recovery.
Postural education. Small changes in how you sit, stand, and sleep can significantly reduce back strain. Your physiotherapist will show you how to maintain a neutral pelvis position during daily activities, how to get in and out of bed without aggravating your back, and the best sleeping positions to reduce pain at night (side-lying with a pillow between the knees is usually the most comfortable).
Safe Exercises You Can Do at Home
These exercises are generally safe during a healthy pregnancy, but check with your physiotherapist or obstetrician before starting any new exercise programme.
Cat-cow stretches. On your hands and knees, alternate between arching your back (looking up) and rounding your back (tucking your chin). Do 10 repetitions, slowly and gently. This mobilises the spine and relieves stiffness.
Pelvic tilts. Standing with your back against a wall, gently flatten your lower back against the wall by tilting your pelvis. Hold for 5 seconds, release, repeat 10 times. This activates the deep abdominal muscles without putting pressure on the belly.
Glute bridges. Lying on your back with knees bent (safe during the first and early second trimester – switch to side-lying alternatives later), lift your hips off the floor, squeeze your glutes at the top, and lower slowly. This strengthens the muscles that support your pelvis. Your physiotherapist will modify this exercise as your pregnancy progresses.
Side-lying hip abduction. Lying on your side, lift the top leg toward the ceiling, keeping the knee straight. Lower slowly. Repeat 10-15 times on each side. This strengthens the gluteus medius, a critical pelvic stabiliser.
Walking. Regular walking is one of the best forms of exercise during pregnancy. Keep it at a comfortable pace and distance. The flat waterfront paths along Karpal Singh Drive or the shaded walkways at the Penang Botanical Gardens are good options that avoid the steep inclines found elsewhere on the island.
When to Start and How Often
Most women benefit from starting physiotherapy in the second trimester, around weeks 14-16, when back pain typically begins to appear. However, if you had back problems before pregnancy or if pain starts earlier, there is no reason to wait.
During the second trimester, one session every 2-3 weeks is usually sufficient. In the third trimester, when pain tends to intensify, weekly sessions are more helpful. Your physiotherapist will also give you a daily home exercise programme that takes 10-15 minutes.
Choosing Where to Get Treatment
For pregnant women, home visit physiotherapy has strong advantages. As your pregnancy progresses, driving becomes less comfortable – especially in Penang traffic. Finding parking and walking from a car park to a clinic while dealing with back pain and a growing belly is not pleasant. Home visits let you receive treatment in a comfortable, familiar environment without the hassle of travel.
If you prefer clinic-based care, Penang has good options. Several physiotherapy practices near the major maternity hospitals – Lam Wah Ee Specialist Centre in Jelutong, Gleneagles Penang in George Town, and Penang Adventist Hospital in Burma Road – are experienced with pregnancy patients. Some women also receive physiotherapy referrals through their antenatal care at these hospitals.
After Delivery: Post-Natal Recovery
Physiotherapy does not stop when the baby arrives. Post-natal physiotherapy helps with recovery from delivery, addressing diastasis recti (abdominal muscle separation), pelvic floor rehabilitation, and any ongoing back or pelvic pain.
Many new mothers in Penang follow the traditional confinement period, during which rest is emphasised. Gentle physiotherapy exercises are compatible with confinement practices and can actually help recovery during this period. Your physiotherapist can design a programme that respects your confinement preferences while keeping you on track physically.
If pregnancy back pain is affecting your daily life – making it hard to sleep, walk, or care for older children – do not wait for it to get worse. Send a WhatsApp message describing your symptoms and how far along you are, and we will match you with a physiotherapist experienced in pregnancy care.
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Reviewed by
M. Thurairaj
Registered Physiotherapist