Why Do Some People Have Pain During Pregnancy While Others Don't?

A closer look

Small shifts can change how you feel.

One of the most common questions I hear is, “Why am I having so much pain during pregnancy when someone else seems to have none?” The answer is not always straightforward. Every pregnancy is different, but one thing I often see is that pregnancy does not necessarily cause dysfunction. It often reveals dysfunction that has been there all along.

Before pregnancy, your body is incredibly good at compensating. You may have had mild weakness, limited mobility, or muscles that were not working as efficiently as they could, but your body found other ways to get the job done. You did not have pain because your body had plenty of options.

Pregnancy changes those options. As your baby grows, your abdominal muscles stretch and their ability to generate force changes. Your center of gravity shifts forward, often increasing the curve in your lower back and changing how your muscles work together. Your feet naturally flatten and widen, changing how forces travel through your legs and pelvis. Hormonal changes also make your ligaments more flexible, which means your muscles have to provide even more support.

For someone with good strength and coordination, these changes may not cause significant problems. But if there was already a weak link somewhere in the system, pregnancy often exposes it.

For example, your pelvic floor already has a much bigger job during pregnancy. If your hip muscles have been weak for years, your pelvic floor may have been quietly compensating. Once pregnancy increases the demands on both, that compensation may no longer be enough, leading to pelvic pain, back pain, or urinary leakage.

The opposite can happen, too. Maybe your hip muscles have been working overtime to support your pelvic floor. As pregnancy places greater demands on those hips during walking, standing, and climbing stairs, they can no longer keep up, and symptoms begin to appear.

Your body is remarkably adaptable. It will compensate for dysfunction until it no longer has the capacity to do so.

The good news is that pain during pregnancy is not something you simply have to accept. Physical therapy can identify where your body is compensating, improve strength and movement patterns, and help distribute the workload more efficiently. By addressing the root cause, not just the painful area, you can often move more comfortably, stay active throughout pregnancy, and better prepare your body for labor, delivery, and postpartum recovery.