Postpartum Back Pain & Tips for Relief

Postpartum back pain is pain in the upper and lower back and pelvis area that continues after childbirth.

It’s a common condition with around 72% of women reporting lower back pain postpartum months and even years after delivery.

The good news is that postpartum lower back pain is treatable and preventable, even if you have back pain after a c-section or back pain after the epidural.

Read on for tips on how to get relief if you’re one of the many women suffering from back pain after delivery.

Causes of postpartum back pain

There are a couple of main causes of back pain after pregnancy, a few less common causes, and a handful of additional things that can make the problem worse.

Hormones

During pregnancy, your body increases the production of estrogen, progesterone, and relaxin.

It’s this last one that especially causes back pain after giving birth because the hormone softens joints and tissues to allow them to stretch to make space for your growing baby.

Although hormone levels will drop after giving birth and quickly return to normal levels, it can take much longer (on average, 6-8 weeks) for your back, stomach, and pelvic muscles to heal and regain their pre-baby strength.

Diastasis recti

Diastasis recti is a common abdominal separation that occurs during pregnancy as your tummy expands to make room for the expanding uterus and the growing baby, causing core instability.

Although your abs will normally go back together on their own as the expanding uterus gets back to normal, or with exercise, it can take a few months of the postpartum period.

In the meantime, your core muscles will be weak, causing more strain on your back that results in postpartum back pain and pelvic pain, which makes the problems worse for new moms.

Although many times ab separation after pregnancy can heal naturally on its own, approximately 60% of women need to work at repairing their diastasis recti with exercise and breath work.

Posterior pelvic (pelvic girdle) pain

Although this is a rare cause, some pregnant women and new moms report persistent, dull lower back pain postpartum due to changes in their pelvic area during pregnancy, as well as pelvic floor issues during pregnancy.

This pelvic pain normally goes away after pregnancy and childbirth, but for some women, the pelvic pain can last even years after pregnancy.

In more extreme cases, women experience a sharp stabbing chronic pain in their lower back that might need to be treated by a physical therapist or chiropractor for pain relief.

Coccydynia (tailbone pain)

Even less common, but a contributor to back pain after birth, nonetheless, is a coccyx (tailbone) that has been bruised, fractured, or dislocated.

This can happen during a vaginal birth if the baby is large or there is some difficult labor that requires the use of instruments to assist delivery.

The tailbone can be pushed backward past its normal range of motion, causing it to lose feeling, as well as fracturing or bruising.

This can result in severe pain at the bottom of the spine, making the motion of sitting or standing extremely painful for new mothers.

Sacral stress fracture

Similar to coccydynia, the lower part of the spine in the pelvic region can also get fractured during childbirth.

This can cause severe lower back pain after birth, especially when putting any kind of weight on that area, such as when sitting.

Bending and lifting

Not necessarily a direct cause of postpartum low back pain, bending your back to lift your baby or objects that carry extra weight, such as bags, strollers, car seats, etc. can further damage already weak back muscles.

Arching your back with extra weight puts extra strain on your back muscles, and if your core is weak, it can’t support the weight of anything you pick up.

This can cause worse pain and, potentially, more serious and long-term issues.

Poor breastfeeding posture and weak abdominal muscles

When breastfeeding, it’s natural to want to look down at your beautiful baby.

However, the weight of your head in this body position puts strain on your back muscles, which puts you at higher risk for postpartum upper back pain.

Holding the full weight of your baby in your arms to raise it up while breastfeeding also puts tension on your neck and shoulders.

Lastly, leaning forward causes physical changes, such as your back and shoulders curving, which stretches already-strained muscles.

All of these things can exacerbate back pain after birth, causing it to get progressively worse the longer you repeat the motion.

Holding your baby on your hip

It’s a normal tendency to place your baby on one hip to help distribute the baby’s weight off your arms, putting strain on your hips.

However, this position puts your body out of alignment as it forces your back to curve to one side.

When your core and back muscles are strong, it’s usually not a big problem, but when your back and stomach muscles are weak or healing, it can cause or worsen back pain after delivery.

Weight gain and shifts in the center of gravity

As your pregnancy progresses, your body will need to compensate for the weight of the baby, your growing tummy, an increase in breast size, and your changing center of gravity.

Then, it will need to recalibrate after you deliver your baby.

All these changes can put a strain on your back, abdominal, and pelvic floor muscles as they start getting used in ways they’re not normally conditioned for.

Postpartum back pain after c section or epidural

After a cesarean birth, your abdominal muscles will need extra time to recover, preventing you from being able to bend and lift as much.

However, you still have a new baby to feed, burp, cuddle, and change diapers, so it’ll still require some lifting and movement.

The problem is that it’s natural for your body to use your back muscles to compensate for healing abdominal muscles.

This can cause further strain and injury to already weak back muscles, causing back pain after the c-section.

In addition, when you have an epidural, the lack of feeling in your lower body prevents you from knowing how much you’re pushing or straining.

Back, pelvis, and tailbone injuries can occur when there’s a lack of a pain signal to warn you that something is being torn or fractured.

It’s not until feeling returns that you realize that further damage may have been done.

If you have severe back pain after an epidural, be sure to tell your doctor that you had an epidural so they can take it into account when examining, diagnosing, and treating your pain.

Treatment and relief for postpartum back pain

Thankfully, there are a number of ways and self-care measures to help with pain management, as well as treat and relieve persistent low back pain ranging from exercise, relaxation therapies, and physical therapy to even nutrition and alternative treatments.

Try any or all to see what works best for you and gives you the most relief and pain management.

Sometimes it’s a matter of experimenting until you find a treatment that works, but if at any point the back pain after birth becomes unbearable, you should consult a doctor, chiropractor, or physical therapist.

Avoid bending to lift

When you go to pick up your baby or other children, instead of bending your back and then lifting, squat down or drop to one knee, then use your legs to lift while keeping your back straight.

This includes checking your baby while in the crib. Instead of bending over the side rail, drop the rail to give yourself easier access to your baby inside the crib.

Use good posture for breastfeeding pattern

Place a pillow under your baby to elevate it to your breasts.

This will help keep your back and shoulders straight so you don’t have to hunch over to reach your baby.

Avoid dropping your head to look down at your baby for too long, as well.

If you’ve had a c-section or have diastasis recti, it might even be best to breastfeed while lying on your side to prevent strain on the back and abdominal muscles.

Bring baby to you – Always remember to ‘bring your baby to YOU’ for breastfeeding or bottle feeding, versus YOU to the baby. What this means is don’t bend over to feed your baby.

Instead, keep your posture intact and bring your newborn to you instead.

Many mothers develop that “nursing slouch” which can affect them for years to come and may become hard to correct.

It’s also a good idea to learn and try different positions as this will also allow you to alternate holds throughout your day – mix things up!

A laid-back feeding position, or an underarm (‘football hold’), cradle hold, or lying-down method may take the pressure off the most painful areas of your breast, as well as your back.

The more you lean back (aka the ‘laid-back approach’), the more gravity helps hold your baby, and in turn, creates less strain on your arms and back.

Get off your feet

Avoid standing for long periods, which puts extra strain on your back and core muscles, which can exacerbate postpartum lower back pain.

Take frequent breaks, and when you sit down, prop your feet up on pillows or a stool to reduce any pressure on your back.

You can also still wear compression socks long after delivery.

These are great for blood circulation and feel amazing.

Take a bath

If you have a tub, a warm bath will provide pain relief and relaxation to your muscles and soft tissues, and it will ease chronic back pain.

You can add a few drops of pain-relieving essential oils such as lavender, basil, peppermint, eucalyptus, frankincense, ginger, or marjoram.

Epsom salt sprinkled in the water also helps soothe painful muscles.

If you’ve had a c-section, be sure to ask your doctor first if it’s okay to take a bath as you may need to wait for some time until your sutures are healed.

Apply heat

If you don’t have a tub or aren’t able to take a bath, use a heat compress on your back.

Moist heat is always best, such as the rice-filled compresses that you can heat in the microwave, but a heating pad will also ease back pain.

Just be sure to not make it too hot, and always put a towel or cloth between the compress or the heating pad and your skin to prevent burns.

Also, limit heating time to no more than 15 minutes at a time.

Get a specialized postpartum back pain massage

Although any kind of massage feels great, try to find a postpartum massage therapist as they will be familiar with the specific causes of persistent low back pain and how to treat it.

They will also know what to do and not to do while massaging and may have some tips for you on stretches you can do at home to further alleviate the pain.

Focus on nutrition and hydration

Make sure to drink ample amounts of water as that will help reduce postpartum swelling caused by fluids that might contribute to back pain after pregnancy.

If water isn’t cutting it for hydration, look at other fluids such as coconut water, electrolyte solutions, nut milks, and herbal (non-caffeine) teas.

In addition, eat foods rich in antioxidants (fresh fruits and vegetables, fish, olive oil, and whole grains) as they have a natural anti-inflammatory effect.

Foods rich in omega-3s and vitamin D (fish and nuts) also help reduce inflammation.

Ask your doctor about other natural anti-inflammatory and pain-relieving supplements like ginger, turmeric, and white willow bark, especially if you’re breastfeeding.

Ease back into physical activity and stretching

Start with some gentle stretching, and slowly start doing some very simple postpartum exercises like Kegels or postpartum exercises that help heal diastasis recti as they also gently heal and strengthen core muscles.

You can also try the following exercises that help relieve postpartum back pain and gently get you your muscle tone back, just like it was before pregnancy.

Keep in mind that you will need to be careful with Kegels, because while they can be beneficial there is a risk of “overly tight pelvic muscles after delivering a baby”.

Women need to learn how to relax their pelvic floor just as much as also engaging it. The best way to activate your pelvic floor, transverse muscles, and diaphragm is through breathing.

Heel Slides

1. Lie on the floor on your back with your knees raised and feet flat on the floor.
2. Lightly tighten your stomach and pelvic muscles, and slowly slide one foot out until your leg is straight against the floor.
3. Slide the same foot back so it returns to the bent-knee position, then do the same with the other leg. Repeat a few times for each leg, but be sure to stop before your muscles feel tired.

*Always keep your head on the ground (or this will turn into a crunch).

Scooping

1. Lie flat on your back on the floor or on your bed or sofa with your legs fully extended.
2. Place a pillow behind your knees, and raise yourself up onto your elbows.
3. Then gently exhale and pull your belly button toward your spine. Imagine blowing out birthday candles. This exhale strengthens deep transverse muscles, critical to restoring your core. (Only do this if you can do it without pain. If you have diastasis recti or are recovering from a cesarean, your body might not be ready for this one.)

Belly Binding / Wrapping

Bengkung Belly Binding is a Malaysian belly wrapping technique used to bind the postpartum mother’s abdomen; from the hips to her breast-line.

This wonderfully therapeutic bodywork technique is usually done 3-10 days after a vaginal birth (after the heavy bleeding has stopped) and 3-4 weeks after a cesarean (once your scar has healed).

Belly binding works by supporting the natural healing process of closing after birth.

Along with supporting your back, belly binding brings in the hips, abdominal muscles, and rib cage and diminishes pelvic instability.

Supports your internal organs, joints, and connective tissues. Aids with digestion and bowel movements.

Prevention tips

Because postpartum back pain is primarily caused by a weakened core and muscles that have been loosened, stretched, and strained, you can only prevent it to a point.

The rest is up to your hormones, your body composition, and time.

The best prevention is to do core-strengthening exercises before and during pregnancy.

Women who maintain strong ab, pelvic floor, and back muscles are less likely to experience back pain after pregnancy.

However, it can still happen, and prevention exercises may only serve to make the pain less severe.

Therefore, the best prevention is to do exercises that involve stretching and engaging the core such as postpartum yoga, pilates, and Kegels.

During pregnancy, as your baby grows, you’ll need to be careful not to overdo exercises that might strain your back, but a number of exercises that prevent and heal diastasis recti can also help prevent postpartum back pain.

When to see a doctor and seek physical therapy about postpartum back pain

Postpartum back pain normally minimizes or completely abates within about six to eight weeks after delivery.

However, many women continue to have back pain after birth for months and even years.

So how do you know at what point you should see your doctor?

1. If the back pain persists or gets worse after you’ve tried other remedies such as massage, exercise, light stretching, warm baths and compresses, and giving your muscles a rest, then it would be a good idea to consult your doctor, physical therapist, or chiropractor. Postpartum back pain that continues untreated can easily turn into chronic back pain, so it’s best to be proactive about it.
2. If you experience sharp, shooting pain or numbness, or weakness in one or both legs, you should consult a doctor as soon as possible for diagnosis and treatment. These symptoms could indicate a more serious issue that puts you at risk of more permanent damage or future debilitation if left unchecked.
3. If the pain is unbearable and affects your daily life and routine, it’s best to talk to your doctor, especially before taking any kind of pain medication if you’re breastfeeding. Although postpartum back pain is common, it doesn’t mean you should suffer through pain that exceeds what you can handle. Your own sleep, rest, and recovery are crucial after having a baby, so if the pain is disrupting that, talk to your doctor.

Postpartum back pain is a common complaint among new mothers, which can sometimes be accompanied by pain under the left breast.

Proper posture, gentle exercises, and adequate rest can help alleviate the discomfort.

Conclusion

Postpartum back pain is common and normal, and it usually goes away on its own after a few weeks.

If you’re having severe or unbearable pain or pain and numbness that affects your ability to rest and conduct your daily routine, then it’s best to consult your healthcare provider in case of something more serious.

Your healthcare provider will be able to assess physical changes and provide medical attention and medical advice needed.