Scientific evidence shows that regular prenatal exercise significantly reduces lower back pain in second and third trimester pregnant women.
Lower back pain is a very common complaint experienced by pregnant women, especially during the second and third trimesters. Body changes during pregnancy often burden the spine and pelvis, causing discomfort that can interfere with daily activities, sleep quality, and even affect mental health. The good news is that recent research proves that prenatal exercise is not only safe but also highly effective in reducing pain intensity, providing a reliable non-pharmacological solution for experiencing pregnancy more comfortably.
Lower back pain (LBP) and pelvic girdle pain (PGP) during pregnancy are not conditions to be taken lightly. Their prevalence is very high, experienced by 50-90% of pregnant women 2 . About one-third of them even experience significant pain, which is often accompanied by reduced capacity for productive work and poor quality of life 2 .
50-90% of pregnant women experience lower back pain 2 .
The causes are complex and involve several factors:
Increased levels of relaxin, progesterone, and estrogen cause loosening of ligaments and joints, particularly in the pelvic area, which increases the risk of injury and instability 2 .
Fetal growth causes a shift in the body's center of gravity forward. Naturally, the body compensates by making postural adjustments, often by arching the back, which actually puts extra pressure on the lower back muscles 2 .
Natural weight gain during pregnancy increases the load that must be supported by the spinal and pelvic structures.
A study conducted in Tulungagung provided strong evidence regarding the effectiveness of prenatal exercise. This study involved 32 respondents in their second and third trimesters who experienced lower back pain 1 .
The research design used was a one group pretest-posttest design, where pain intensity was measured before and after the prenatal exercise intervention. The measurement tool used was the Visual Analog Scale (VAS), a standard and reliable pain intensity measurement tool 1 .
Before participating in regular prenatal exercise, 68.75% of respondents (22 people) reported back pain levels in the moderate category 1 .
After participating in regular prenatal exercise twice a week for two months, there was a dramatic improvement. As many as 53.13% of respondents (17 people) reported that their pain had decreased to the mild category 1 .
Statistical analysis with the Wilcoxon Sign Rank Test yielded a p-value = 0.000, which scientifically proves that there is a very significant influence between prenatal exercise and reduction of lower back pain in pregnant women 1 .
Source: Data processed from research at TPMB Siti Nur Cahyani, Tulungagung (2023) 1
The effectiveness of prenatal exercise is not only found in local scale research. A Randomized Controlled Trial (RCT)—the gold standard in clinical research—conducted in Europe also proved the same thing.
In that study, 45 pregnant women were divided into two groups: an experimental group that followed a structured exercise program and a control group that only received standard antenatal care 3 .
The exercise program for the experimental group consisted of aerobic and resistance exercises performed twice a week, plus brisk walking for at least 30 minutes every day 3 . Results measured at 36 weeks of pregnancy showed a very striking difference between the two groups.
| Measurement Parameter | Prenatal Exercise Group | Control Group | p-value (Significance) |
|---|---|---|---|
| Pain Scale (NRS) | Lower | Higher | 0.017 |
| Roland-Morris Disability Questionnaire (RMDQ) | Lower | Higher | < 0.001 |
| Pelvic Questionnaire (PGQ) | Lower | Higher | 0.005 |
Source: Summarized from Journal of Rehabilitation Medicine (2017) 3
These results clearly show that the group that performed regular exercise not only experienced a reduction in pain intensity, but also experienced much lower disability in performing daily activities due to their back and pelvic pain 3 .
Movements in prenatal exercise are specifically designed to strengthen abdominal and back muscles. These strong core muscles function like a more effective "natural corset" in stabilizing the spine and pelvis, reducing the load on joints and ligaments 1 .
Physical activity during prenatal exercise stimulates the release of endorphins, hormones that function as natural pain relievers and provide comfort in the body. This increase in endorphins not only helps relieve pain but also provides a calming effect 1 .
Prenatal exercise teaches mothers to be aware of and correct their body posture, thereby reducing unnecessary tension in the lower back area.
Certain exercises help control and stabilize the pelvic joints, which are a primary source of pain for many pregnant women.
To understand how research on the effectiveness of prenatal exercise is conducted, here is the "toolkit" or main tools commonly used by scientists and therapists.
| Tool / Method | Function and Explanation |
|---|---|
| Visual Analog Scale (VAS) | Simple questionnaire to measure the patient's subjective pain intensity, usually in the form of a 10 cm line where the patient marks according to their pain level 1 . |
| Numeric Rating Scale (NRS) | Numerical scale (0-10) to assess pain intensity, with 0 meaning no pain and 10 meaning worst pain 3 . |
| Roland-Morris Disability Questionnaire (RMDQ) | Questionnaire to measure the extent to which back pain limits a person's ability to perform daily activities 3 . |
| Pelvic Girdle Questionnaire (PGQ) | Specific questionnaire designed to assess the impact of pelvic pain on the activities and symptoms of pregnant women 3 . |
| Aerobic & Resistance Exercise | Core form of exercise in prenatal exercise programs aimed at improving heart fitness and strength of supporting muscles 3 . |
| Prenatal Yoga | Another form of exercise proven effective, combining stretching, strengthening, and breathing to reduce back pain . |
Based on strong scientific evidence, it can be concluded that prenatal exercise is an effective, safe, and natural intervention for addressing lower back pain in the second and third trimesters of pregnancy. Although exercise may not completely eliminate pain for everyone, women who follow regular exercise programs are proven able to manage their condition more effectively and have better functional status 2 .
With a commitment to practice regularly—such as twice a week—pregnant women can strengthen their bodies, relieve pain, and experience pregnancy in a healthier, more comfortable, and higher quality way. Prenatal exercise is not just about movement, but an investment for the comfort and health of mothers during pregnancy.