Pregnancy pain - Wokingham, Berkshire

1. Overview

Many women suffer from aches and pains during pregnancy — this is normal and extremely common. As the baby grows, it presses on surrounding structures, the uterus and abdominal wall stretch, and the increasing weight places sustained pressure on the back, hips and pelvis. Hormonal changes — particularly the relaxin hormone, which loosens the ligaments of the pelvis to prepare for birth — also destabilise the joints and contribute to pain. Low back pain and pelvic girdle pain affect between 45 and 77% of pregnant women, while headaches, sciatica, neck pain and muscle pain are also frequently reported throughout the three trimesters.

Managing pain safely in pregnancy is a significant clinical challenge. It is not advisable to take pain killers whilst pregnant — including paracetamol, which the NHS no longer recommends routinely in pregnancy as research has shown it can affect testosterone production in male babies, potentially causing undescended testicles. Strong analgesics, NSAIDs and opioids carry additional well-established risks for the developing baby. Acupuncture provides safe, drug-free pain relief throughout pregnancy, addressing the musculoskeletal causes of pain without any pharmacological risk to mother or baby. Multiple systematic reviews and meta-analyses confirm that acupuncture is a safe and effective therapy for pregnancy-related back and pelvic pain, with no significant increase in preterm delivery or adverse outcomes.

2. Types of pregnancy pain

Pregnancy produces a range of musculoskeletal and neurological pain conditions, many of which I routinely treat with acupuncture:

Pelvic girdle pain (PGP) — one of the most common and disabling pregnancy pain conditions; pain around the sacroiliac joints, pubic symphysis and posterior pelvis, caused by relaxin-induced ligament laxity and the altered biomechanics of the expanding uterus; can range from mild discomfort to severe, mobility-limiting pain that affects walking, turning in bed, climbing stairs and getting in and out of a car. Often called symphysis pubis dysfunction (SPD) when the pubic symphysis joint is specifically involved
Pregnancy-related back pain — low back pain is the most prevalent musculoskeletal complaint in pregnancy, affecting the majority of women at some point; the growing uterus shifts the centre of gravity forward, increasing lumbar lordosis and loading the lumbar spine, sacroiliac joints and surrounding muscles; typically begins around weeks 12–24 and reaches peak intensity between weeks 24 and 36
Sciatica in pregnancy — radiating pain from the lower back down the buttock and leg, caused by compression or irritation of the sciatic nerve by the expanding uterus, a bulging disc, or piriformis muscle spasm; pins and needles, numbness or weakness may accompany the pain down the leg
Headaches and migraines — particularly common in the first trimester due to hormonal changes; women with a history of migraines that were previously controlled with medication face a particular challenge as most migraine medications are contraindicated in pregnancy. Acupuncture is safe and effective for both pregnancy headaches and migraines without any drug risk
Paraesthesia and carpal tunnel syndrome — pins and needles, numbness and tingling in the hands and fingers are common from the second trimester onwards, driven by fluid retention that compresses the median nerve at the wrist (carpal tunnel syndrome); acupuncture effectively reduces the inflammation and nerve compression
Neck pain and upper back pain — increased breast weight and postural changes in pregnancy place additional loading on the cervical and thoracic spine; neck tension, upper back aching and shoulder pain are common throughout pregnancy
Rib pain and intercostal discomfort — in the third trimester, the expanding uterus displaces the diaphragm and lower ribs, causing rib pain, shortness of breath and intercostal discomfort, particularly when sitting for prolonged periods
Hip and gluteal pain — trochanteric bursitis, piriformis syndrome and lateral hip pain are common in pregnancy, related to the altered gait, increased ligament laxity and the changed mechanical loading of the hip joint

3. Causes

Pregnancy pain arises from a combination of hormonal, biomechanical and physiological changes:

Relaxin hormone — produced from early pregnancy, relaxin loosens the ligaments and joints of the pelvis and spine to allow the birth canal to expand; this ligament laxity reduces joint stability and allows excessive movement at the sacroiliac joints and pubic symphysis, producing the characteristic pelvic girdle pain of pregnancy
Postural changes and altered centre of gravity — the growing uterus progressively shifts the centre of gravity forward, increasing lumbar lordosis and placing sustained biomechanical loading on the lumbar spine, sacroiliac joints and hip musculature; the muscles of the lower back, pelvis and hips work harder to compensate, leading to fatigue, tension and pain
Uterine and abdominal wall stretching — as the uterus expands, it stretches the round ligaments (which suspend the uterus), producing sharp or aching pain in the lower abdomen and groin; it also displaces abdominal organs, increases intra-abdominal pressure and can compress nerves including the sciatic nerve
Hormonal changes — rising oestrogen and progesterone in the first trimester are closely linked to the onset of pregnancy headaches and migraines; hormonal fluctuations throughout pregnancy affect serotonin levels, vascular tone and pain sensitivity
Fluid retention and nerve compression — increased blood volume and fluid retention in pregnancy can compress peripheral nerves, particularly at the wrist (causing carpal tunnel syndrome) and, in some women, at other entrapment sites
Prior pain history — women with a history of back pain, migraines, fibromyalgia or other pain conditions before pregnancy often find that their symptoms worsen during pregnancy, particularly as medication options are restricted

4. Pregnancy pain in Chinese medicine

In traditional Chinese medicine (TCM), pregnancy is a state in which the Ren (Conception Vessel) and Chong (Penetrating Vessel) channels are engaged in nourishing the growing fetus, directing Blood and Qi to the uterus and away from other channels. This physiological redistribution of Qi and Blood, combined with the increasing weight and the constitutional demands of pregnancy, creates a specific vulnerability to channel obstruction and deficiency patterns in the lumbar spine, pelvis and lower limbs. The most common TCM patterns in pregnancy pain are:

Kidney deficiency with inadequate channel nourishment — the most important pattern in pregnancy musculoskeletal pain; the Kidney governs the bones, the lumbar spine (“the lumbar region is the domain of the Kidneys” in classical TCM) and the pelvic structures; when Kidney Qi and Yin are insufficient to support both the mother’s constitution and the growing fetus, the lumbar spine, sacroiliac joints and pelvis lose their constitutional nourishment and support, producing the aching, weakness-type back and pelvic pain of pregnancy. The increasing demands of pregnancy progressively deplete the mother’s Kidney reserves. Treatment gently tonifies Kidney Qi and Yin using carefully selected pregnancy-safe points such as BL23 (Shenshu), KI3 (Taixi) and SP6 (Sanyinjiao), combined with local points on the lower back and sacrum
Qi and Blood stagnation in the Belt channel (Dai Mai) and lumbar channels — the Belt channel (Dai Mai) encircles the waist and connects the Chong, Ren and Du channels; when the growing uterus and increasing abdominal weight obstruct the Belt channel, Qi and Blood stagnate in the lumbar and pelvic channels, producing the fixed, aching or sharp pelvic girdle and sacroiliac pain characteristic of pregnancy PGP. The stagnation pattern produces pain that is worse with sustained postures and better with gentle movement. Treatment moves Qi and Blood in the Belt channel and opens the lumbar and pelvic channels
Liver Blood deficiency with channel undernourishment — the Liver stores Blood and nourishes the sinews and tendons; during pregnancy, the Liver Blood is directed to the Chong channel to nourish the fetus, leaving less available to nourish the sinews; this produces muscle cramps, leg pain, rib discomfort, tight muscles and a general aching of the sinews that increases as pregnancy progresses. Treatment nourishes Liver Blood and relaxes the sinews
Wind-Cold invasion of the weakened channels — pregnancy creates a state of constitutional vulnerability in which external pathogenic factors can more easily invade the channels; acute onset neck pain, upper back stiffness or sciatic-type pain triggered by cold exposure or poor posture reflects Wind-Cold obstruction of the Bladder and Gallbladder channels. Treatment expels Wind-Cold, warms the channels and opens the collaterals using distal points on the legs and feet without any abdominal needling
Liver Yang rising with pregnancy headaches — pregnancy headaches and migraines often reflect the Liver Yang rising pattern, where the Liver Blood directed to the uterus depletes the Liver Yin that normally anchors Yang, allowing it to rise upward into the head. Treatment gently calms Liver Yang and nourishes Yin using safe distal points

5. Acupuncture for pregnancy pain

Traditional acupuncture is very safe to have whilst pregnant and relieves pain by regulating the flow of Qi and Blood through the channels, addressing the specific TCM patterns driving the pain. Specific acupoints that are contraindicated in pregnancy are avoided — in particular, points on the abdomen are not used, so there is no risk of disturbing the baby. The ancient Chinese have used acupuncture for thousands of years to treat pregnancy-related problems, and acupuncture has been used safely in obstetric care across many cultures throughout history.

For pregnancy musculoskeletal pain, needles are typically inserted on the legs, lower back, buttocks and upper back, depending on the nature and location of the pain. Specific mechanisms by which acupuncture relieves pregnancy pain include:

Releasing muscle tension and spasm in the paraspinal, gluteal, piriformis and hip muscles that are overloaded by the biomechanical changes of pregnancy, directly relieving back, pelvic and sciatic pain
Modulating the descending pain inhibitory system through endorphin, enkephalin and serotonin release, providing drug-free analgesia that is safe for both mother and baby
Reducing local inflammation and oedema around compressed nerves and joints, addressing the nerve compression contributing to sciatica and carpal tunnel syndrome
Stabilising the sacroiliac joints and pelvic girdle by improving the neuromuscular control and tonus of the stabilising muscles, addressing the joint laxity component of PGP
Balancing hormonal fluctuations and reducing the vascular and neurochemical changes that drive pregnancy headaches and migraines
Reducing co-morbid anxiety, sleep disturbance and emotional distress that amplify pain perception in pregnancy, through calming the Shen and regulating the autonomic nervous system

Research evidence

A systematic review and meta-analysis by Zhang et al. (2024), published in Acupuncture and Herbal Medicine, searched 6 databases from 2000 to August 2023 and included 12 RCTs involving 1,641 pregnant women (16–34 weeks gestation) with low back and pelvic girdle pain, confirming that acupuncture is an effective and safe therapy for pregnancy-related LBPGP. A systematic review and meta-analysis by Li et al. (2023), published in Heliyon, searched 8 databases through January 2022 and included 12 RCTs involving 1,302 patients; acupuncture significantly decreased VAS pain scores, and acupuncture plus other therapies produced a significantly increased effective rate (OR: 6.92; 95% CI: 2.44–19.67) compared with other therapies; importantly, no significant difference was found in preterm delivery rate, confirming the safety of acupuncture in pregnancy. A multidimensional clinical assessment by Martins (2018) further confirmed acupuncture’s effectiveness for low back pain in pregnant women.

6. Safety in pregnancy

Acupuncture is safe throughout pregnancy when performed by a qualified, experienced practitioner. Several important safety principles are followed at this clinic:

No abdominal needling — acupoints on the abdomen are never used during pregnancy, so the treatment does not disturb the baby; points on the legs, lower back, buttocks, arms and upper body are used instead to treat back, pelvic and other pregnancy pain
Contraindicated points avoided — a number of acupoints that have traditionally been associated with stimulating uterine contractions (such as SP6/Sanyinjiao, GB21/Jianjing, LI4/Hegu and BL60/Kunlun when used with strong stimulation) are either avoided or used only in specific, appropriate clinical contexts by an experienced practitioner; this conservative approach ensures treatment is safe at all stages of pregnancy
Trimester-specific adaptations — treatment is adapted for each stage of pregnancy; in the first trimester, gentle, minimal stimulation is used; positioning is adjusted as pregnancy progresses so that the woman is never lying flat on her back (which can compress the vena cava) — side-lying, semi-reclined or seated positions are used instead
Practitioner qualifications matter — it is always advisable to have acupuncture from a member of the British Acupuncture Council (BAcC) and from a practitioner who specialises in fertility and pregnancy-related problems. I am a BAcC member and specialise in treating women with fertility and pregnancy-related conditions

The systematic review evidence confirms that acupuncture has a good safety profile in pregnancy, with no significant increase in preterm delivery, miscarriage or other adverse outcomes when performed correctly by a qualified practitioner.

7. Other pregnancy conditions

In addition to pain management, acupuncture and TCM can support a range of other common pregnancy complaints. I specialise in treating women throughout their pregnancy journey:

Nausea and vomiting (morning sickness) — acupuncture and acupressure at PC6 (Neiguan) are well-evidenced treatments for pregnancy nausea and vomiting at all levels of severity, including hyperemesis gravidarum
Fatigue and tiredness — particularly prominent in the first trimester; acupuncture supports Qi and Blood to reduce pregnancy fatigue and improve energy
Baby brain (poor memory and concentration) — cognitive changes in pregnancy reflect the redistribution of Blood and Qi to nourish the fetus; acupuncture supports Heart Blood and calms the Shen to improve mental clarity
Sleep disturbance — insomnia and disrupted sleep are common in pregnancy; acupuncture improves sleep quality by calming the Heart-Mind and addressing the underlying patterns contributing to waking
Anxiety and mood changes — hormonal changes and the psychological demands of pregnancy can produce significant anxiety and mood disturbance; acupuncture regulates the nervous system and supports emotional balance
Prebirth preparation — from week 36, prebirth acupuncture prepares the body for labour, ripening the cervix and optimising the baby’s position
Breech baby — moxibustion at BL67 (Zhiyin) at 33–36 weeks is used to encourage a breech baby to turn to the head-down position
Labour induction — acupuncture can support natural labour induction when pregnancy goes beyond the expected date

8. Self-care tips

The following self-care measures complement acupuncture treatment for pregnancy pain:

Pelvic girdle pain management — wear a pelvic support belt to stabilise the sacroiliac joints and reduce PGP pain during weight-bearing activities; avoid asymmetric loading of the pelvis (e.g. standing on one leg, crossing legs, carrying a heavy bag on one side); when getting in and out of bed or a car, keep the knees together and move symmetrically
Sleep positioning — sleeping on the left side with a pillow between the knees reduces pressure on the lumbar spine and sacroiliac joints; a full-length pregnancy pillow provides support to the abdomen, back and hips simultaneously and significantly reduces overnight discomfort
Gentle exercise — swimming and water exercise are particularly well tolerated in pregnancy as the buoyancy reduces spinal loading; prenatal yoga and Pilates, tailored to pregnancy, strengthen the core and pelvic floor muscles that support the lumbar spine and pelvis; avoid high-impact activities that jar the pelvis once PGP is present
Warm baths and heat — a warm (not hot) bath provides excellent temporary relief from back and pelvic pain in pregnancy; a heat pad on the lower back (on a low setting, not directly on the skin) is also soothing. Hot baths should be avoided as elevated core temperature is not recommended in pregnancy, particularly in the first trimester
Acupressure wristbands — for pregnancy nausea, travel sickness wristbands applying pressure to PC6 (Neiguan) on the inner wrist provide continuous anti-nausea relief between acupuncture sessions
Avoid prolonged static postures — prolonged sitting, standing or lying in one position worsens all forms of pregnancy back and pelvic pain; change positions frequently, use a lumbar support when sitting and take short gentle walks to keep the muscles and joints moving
Footwear — wear supportive, low-heeled footwear; high heels increase lumbar lordosis and pelvic tilt, worsening back and pelvic pain; flat unsupported shoes are equally problematic; a shoe with a small heel (2–3 cm) and good arch support is ideal

9. Treatment at my clinic

I treat pregnancy pain at my clinic in Wokingham, Berkshire. I specialise in treating women with fertility and pregnancy-related problems, including back pain, pelvic girdle pain, sciatica, headaches, migraines and other musculoskeletal pain throughout all three trimesters and postpartum. Treatment is tailored to the specific pain presentation, the trimester, and the woman’s overall pregnancy health and TCM pattern. I am a member of the British Acupuncture Council (BAcC) and all treatment follows the highest standards of safety for pregnant women.

Visit the prices page for treatment costs. Related pages include morning sickness, pregnancy acupuncture, prebirth acupuncture, back pain and sciatica.

10. Frequently asked questions

Is acupuncture safe during pregnancy?

Yes — acupuncture is safe during pregnancy when performed by a qualified, experienced practitioner. Research confirms that acupuncture does not significantly increase the risk of preterm delivery, miscarriage or other adverse outcomes. A systematic review and meta-analysis of 12 RCTs involving 1,302 pregnant women found no significant difference in preterm delivery rates between acupuncture and control groups, confirming the safety profile of acupuncture in pregnancy. Certain acupoints are avoided and no needling is performed on the abdomen.

Can acupuncture help with pelvic girdle pain in pregnancy?

Yes. Pelvic girdle pain is one of the conditions with the strongest evidence base for acupuncture in pregnancy. A 2024 systematic review and meta-analysis of 12 RCTs involving 1,641 pregnant women confirmed that acupuncture is effective and safe for pregnancy-related low back and pelvic girdle pain. Acupuncture releases the tight muscles around the sacroiliac joints, addresses the TCM Belt channel obstruction pattern driving PGP, and modulates the descending pain inhibitory system to reduce pain without any drug risk to the baby.

Can I take pain killers for pregnancy pain?

It is not advisable to take pain killers whilst pregnant. The NHS no longer recommends paracetamol routinely in pregnancy as research has shown it can affect testosterone production in male babies. NSAIDs (ibuprofen, aspirin) are contraindicated after 20 weeks and should be avoided throughout; strong analgesics and opioids carry well-established fetal risks. Acupuncture provides safe, effective, drug-free pain relief that addresses the musculoskeletal causes of pregnancy pain without any pharmacological risk.

What types of pregnancy pain does acupuncture treat?

Acupuncture is used to treat the full range of pregnancy-related musculoskeletal and neurological pain, including back pain, pelvic girdle pain and symphysis pubis dysfunction, sciatica, headaches and migraines, carpal tunnel syndrome (paraesthesia in the hands), neck and upper back pain, rib pain, hip and gluteal pain, and muscle cramps and tension. Women with a history of migraines or other pain conditions who can no longer take their regular medications during pregnancy particularly benefit from acupuncture as a safe alternative.

Where are the needles placed for pregnancy pain?

No needles are placed on the abdomen during pregnancy — so the treatment does not disturb or risk the baby. For back and pelvic pain, needles are typically placed on the lower back, sacrum, buttocks and legs. For headaches and migraines, points on the hands, arms and feet are used. For neck and upper back pain, points on the neck, upper back and arms are used. The specific points chosen depend on the TCM diagnosis and the trimester of pregnancy, with certain traditional points carefully avoided or modified throughout.