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Sure, it’s worth it in the end, but pregnancy comes with a lot of annoying side effects. The acne! The morning sickness! And don’t forget back pain.

Pesky pregnancy symptoms can show up in the first trimester, before you’ve even announced your news to the world.

Back pain: The new normal?

About two-thirds of pregnant women deal with regular back pain.

Sometimes back pain even begins in the first trimester. It’s no surprise, really — your hormones are changing, and your world ‘s been turned upside down, even if you’re thrilled about it. Everything’s a little off-balance.

The source of the pain

Most pregnant women experience lower back pain. You might also feel it in your central back (that’s called lumbar pain) or down in your tailbone or hips (this is posterior pelvic pain). It’ll feel achy and tense, much like prepregnancy back pain.

Days 1 to 90

Later in pregnancy, you’ll have what feels like a bowling ball strapped to your stomach. Back pain makes sense then. But some women feel achy even in the first trimester — it’s actually a low-key sign of early pregnancy. Blame it on the hormones and stress.

All the feels

Growing a baby isn’t all rainbows and butterflies. It’s tough on your body and emotions. Stress makes your muscles tight, whether you’re pregnant or not.

So take a deep breath, be gentle with yourself, and talk through your feelings — the good and the bad!

Hormone happenings

Hello, pregnancy hormones! Your body is already preparing for birth (overachiever much?), which includes flooding your system with two hormones that affect your muscles.

Progesterone relaxes your pelvic muscles, which can cause your lower back to overcompensate and tighten up.

Appropriately named relaxin makes your uterus soft and comfy for the baby. It also loosens your pelvic joints and ligaments, which forces your back to do all the heavy lifting.

Here’s the scoop on trimesters two and three: Your uterus will expand, your bump will grow, and your back will be working overtime.

Growing baby = weight gain

Weight gain during pregnancy is a fact of life. As the baby grows, you’ll feel a little off-balance, which will make your back muscles work harder. Your joints will take a hit too.

Every woman’s preggo journey is different. Some mamas have itty-bitty bumps, while others gain more weight. In general, you’ll have a higher risk of back pain during pregnancy if you’re at a higher weight before pregnancy or if you’ve had back issues in the past.

The CDC recommends weight gain ranges based on your pre-preggo BMI. (Note that these are for mamas with just one baby on board.)

How much should you gain?

  • 28 to 40 pounds if you’re considered medically underweight before pregnancy
  • 25 to 35 pounds if you’re in a moderate weight range
  • 15 to 25 pounds if your weight is a little higher
  • 11 to 20 pounds if you’re in the highest BMI category

Growing belly = poor posture

As your belly grows, your center of gravity will shift. It’s tempting to do the “expecting mom” pose — belly forward, spine curved, hand on your lower back for support.

But don’t let “Lean Back!” become your new hype song: Bad posture triggers back pain.

Separating abs (yep, it’s a thing!)

Six-pack #fitspo aside, the truth is that your abs are made up of two parallel muscle bands. They connect in the middle to support your core.

During the last trimester, some pregnant women experience something called diastasis recti. Basically, the baby could push so hard against your abs that they separate.

It’s a pretty common condition — just ask Drew Barrymore. Aside from changing the look of your postpartum belly, diastasis recti puts a whole lotta pressure on your back muscles.

Don’t rely on pain relievers when you’re expecting. Instead, try these preggo-approved remedies for back pain:

  1. Gently stretch your lower back whenever it feels tight.
  2. Sleep on your side with a pillow between your legs. Extra support gives your lower back a break.
  3. Schedule a prenatal massage. You deserve it!
  4. Catch some Zzz’s! Sleep is a low-key muscle relaxer.
  5. Go “om” with some prenatal yoga. Cat-Cow for the win.
  6. Sit with your feet up and a lumbar pillow tucked behind your lower back.
  7. Buy a supportive maternity belt to evenly distribute the baby weight.
  8. Try a heating pad or warm compress when your muscles feel super tight.
  9. Consider acupuncture — Fergie swore by it during her pregnancy. But check with your doc about this one first.
  10. Find a local chiropractor who specializes in pregnancy-friendly adjustments.
  11. Buy more supportive shoes. Shopping spree — it’s for the baby!

Prevention is the best medicine, right? Lower your risk of pregnancy back pain with these habits:

  • Keep your weight gain in the recommended range.
  • Practice good posture. That’s chest up, shoulders back and relaxed, head high. Don’t lock your knees!
  • Stay active. It might be tempting to sit back and put your feet up while you grow a whole human, but daily walks or swims (think super chill cardio) will prevent tense muscles.
  • Avoid standing in one place for a long time.
  • Squat, don’t bend. Hey, it’s good for your glutes too!
  • Don’t lift heavy things.
  • Sleep on your side or back, not your belly.
  • Wear low-heeled shoes instead of high heels or flats.
  • Strengthen your back and core with regular pregnancy-friendly exercises.

It’s normal to have some muscle pain in your back during pregnancy. You might even get nerve pain that radiates down your butt and leg (aka sciatica). But in rare cases, back pain can signal a bigger problem.

These are the signs your achy back warrants a trip to the doctor:

  • excruciating pain
  • pain that lasts longer than 2 weeks
  • frequent cramps (this can indicate early labor)
  • trouble peeing
  • tingly arms and legs
  • vaginal bleeding
  • weird discharge — green, gray, yellow, smelly, or chunky
  • fever

Back pain is a normal part of pregnancy, even in the first trimester. Hormonal changes, weight gain, and muscle separation can all put a strain on your lower back. The good news is that there are several ways to soothe the pain and prevent major back issues.

If you have severe back pain that lasts longer than 2 weeks, it’s best to call your healthcare provider. You might need some extra medical TLC or even physical therapy.