Postpartum back pain is a 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 back pain is treatable and preventable, even if you have back pain after c section or back pain after 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.
During pregnancy, your body increases the production of estrogen, progesterone, and relaxin. It’s this last one that especially causes back pain after pregnancy 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 childbirth 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 is a common separation of the abdominal muscles that occurs during pregnancy as your tummy expands from the growing baby. Although your abs will normally go back together on their own, or with exercise, it can take several weeks or months. In the meantime, your core muscles will be weak, causing more strain on your back that results in postpartum back pain.
Posterior pelvic (pelvic girdle) pain
Although not as common, some women report persistent, dull lower back pain postpartum due to changes in their pelvic area during pregnancy. It normally goes away after childbirth, but for some women, the pain can last even years. In more extreme cases, women experience a sharp stabbing pain in their lower back that might need to be treated by a physical therapist or chiropractor.
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 delivery if the baby is large or there is some difficulty that requires the use of instruments to assist delivery. The tailbone can be pushed backward past its normal range of motion, causing fracturing or bruising. This can result in severe pain at the bottom of the spine, making the motion of sitting or standing extremely painful.
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 back pain, bending your back to lift your baby or objects like bags, strollers, car seats, etc. can further damage already weak back muscles. Arching your back 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
When breastfeeding, it’s natural to want to look down at your beautiful baby. However, the weight of your head puts strain on your back muscles, which can cause 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 your back and shoulders to curve, which stretches already-strained muscles. All of these things can exacerbate back pain after birth.
Holding your baby on your hip
It’s a normal tendency to place your baby on one hip to help distribute the weight of your baby off of your arms. 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 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 to treat and relieve postpartum back pain ranging from exercise to relaxation therapies to even nutrition. Try any or all to see what works best for you and gives you the most relief. 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 feeding posture
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 back and abdominal muscles.
Get off your feet
Avoid standing for long periods as this puts extra strain on your back and core muscles, which can exacerbate lower back pain postpartum. Take frequent breaks, and when you sit down, prop your feet up on pillows or a stool to reduce any pressure on your back.
Take a bath
If you have a tub, soak in a warm bath to relax your muscles. 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.
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 postpartum 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. 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 (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 exercise and stretching
Start with some gentle stretching, and slowly start doing some very simple exercises like kegels or exercises that help heal diastasis recti as they also gently heal and strengthen core muscles. You can also try the following postpartum exercises that help relieve postpartum back pain and gently strengthen your back muscles.
- Heel slides
Lie on the floor on your back with your knees raised and feet flat on the floor.
Lightly tighten your stomach and pelvic muscles, and slowly slide one foot out until your leg is straight against the floor.
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.
Lie flat on your back on the floor or on your bed or sofa with your legs fully extended.
Place a pillow behind your knees, and raise yourself up onto your elbows.
Then gently exhale and pull your belly button toward your spine. (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.)
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 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?
- 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.
- 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.
- 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 common and normal, and it usually goes away on its own after a few weeks. However, 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 doctor in case of something more serious.
Otherwise, try out the remedies and exercises we suggested, and if you have some tips or remedies that worked for you, we’d love to know about them in the comments.