Postpartum back pain is a common complaint in new mothers. It is to be expected, but the pain can come as an unwelcome shock to some new parents.
Postpartum back pain is likely to last for a few months, although there is no specific timeline. On average, you should expect some level of back pain to last for about 6 months postpartum.
After this point, your hormone levels will begin to have evened out and your body should be returning to its pre-pregnancy state.
If you suffered from back pain prior to or during pregnancy, your risk of postpartum back pain is greatly increased.
There are many reasons for the development of this back pain and a lot of different home remedies to try out.
What causes postpartum back pain?
Change in your center of gravity
As your baby grows inside your belly, your center of gravity will begin to shift forwards. Your pelvis will naturally start to tip forwards, settling in a position known as an anterior pelvic tilt. This causes your lower back to arch. This can cause back pain and can even lead to sciatica. After you give birth, your center of gravity begins to return to its original location.
Gallstones
Gallstones are said to affect up to 12% of pregnant and postpartum women. They are small clumps of digestive fluid that have hardened and collected inside your gallbladder.
In the majority of cases, they are not that serious, do not present with any symptoms, and do not require medical intervention. If you do begin to exhibit symptoms, these will commonly be nausea, vomiting, central abdominal pain, central upper back pain, and right shoulder pain.
If you notice any of these symptoms in yourself, you should visit a doctor or qualified medical professional for further assistance.
This will commonly result in a surgical procedure known as a cholecystectomy – where the gallbladder is removed.
Complications of an epidural
An epidural is the pain relief that is administered via a spinal injection to relieve the pain of childbirth.
They are highly effective as a pain management strategy, but the after-effects can cause back pain. This will commonly last for less than one week. The epidural will not cause long lasting complications or back pain, as the discomfort will dissipate quickly.
Short term pain relief methods such as heat pads, ice packs, and over the counter analgesics will help you to cope with the pain.
Breast growth
Every woman knows that the bigger your breasts, the more back pain you experience.
The weight can change the curvature of your spine and cause your shoulders to be pulled forwards. This completely changes your posture and can cause significant levels of pain.
Hormones
During pregnancy, it is no surprise that your hormone levels are thrown out of whack. Your body will release an excessive amount of a hormone known as relaxin to prepare itself for childbirth.
This hormone is known to loosen joints and ligaments in the body. This can make it easier to push the baby out but can cause issues with other joints. Regardless of whether you have a vaginal birth or a Caesarean section, relaxin is released into your body.
This means that you should take care during the latter half of your pregnancy and the postpartum period to avoid dislocating any joints or injuring yourself.
Over time, as the hormone levels deplete, your body will return to its original state.
Labor or Caesarean section
Childbirth is said to be one of the most difficult life experiences a mother can go through.
Cesarean sections involve your abdominal muscles being cut open and your baby being pulled out. Vaginal birth comes with its own set of problems, such as muscle overuse and strains. Either way, birth takes an enormous toll on your body. Unsurprisingly, many mothers are in pain for days or even weeks postpartum.
Your body has gone through a huge amount of trauma and it will need time to recover.
Weight gain
Any level of weight gain will put an increased strain on all parts of your body. It is harder to move a heavier body about and will require more effort from your joints and muscles.
This is particularly true for your knees, hips, lower back, and abdominal muscles. Do not try to lose weight rapidly during the postpartum period. Many influential celebrities will slip back into their pre-baby bodies almost immediately and this can lead to a lot of stress for new mothers.
There are many other important things for new mothers to pay attention to, and weight loss should not be at the forefront of your mind.
With a healthy diet and regular exercise, your baby weight will melt off with little effort required on your behalf.
Muscle weakness and joint instability
Over the duration of your pregnancy, you are likely to lose a considerable amount of muscle tone.
This is particularly likely if you have a strong exercise regime as you will not be able to keep this up through the later stages of pregnancy. You will lose strength in your muscles and this can cause some back pain. Your joints are also likely to be more unstable during the postpartum period. This is because the hormones known as relaxin, progesterone, and estrogen rise in the body.
These hormones cause your joints to relax and become less stable. Once you have delivered your baby, the levels of these hormones will begin to drop again.
After 6 to 8 weeks the levels will have returned to the pre-pregnancy quantities and your joints will be more stable once more.
Pregnancy and lactation associated osteoporosis (PLO)
This is a relatively rare form of osteoporosis that commonly appears in the third trimester of pregnancy or the postpartum period. It only occurs in around 0.4 in every 100,000 pregnancies. Osteoporosis is a disease that results in very weak and brittle bones. The symptoms of PLO include intense lower back pain, hip pain, vertebral fractures, and a loss of height.
You should immediately contact a doctor if you suspect PLO is an issue for you. They will likely ask you to take Vitamin D and calcium supplements in conjunction with pain reducing analgesics and physical therapy.
Diastasis recti
This is when the rectus abdominis muscle separates during delivery. This muscle is sometimes called the six-pack muscle and is what is found running down the center of your abdominals.
It holds the six-pack together, and can very commonly separate during pregnancy and labor due to the rapid enlargement of the uterus to accommodate for the growing fetus. The muscles are forced to stretch a lot and eventually, this causes the muscle tone to deteriorate. If you have weak abdominal muscles to begin with, you are at a higher risk of this happening during pregnancy.
Diastasis recti can compromise your posture and cause you to have pelvic and generalized lower back pain.
Loose pelvic floor
Your pelvic floor muscles are found at the base of the pelvis and support the bladder, bowel, and uterus. A weak or loose pelvic floor can cause problems with urinary and bowel incontinence.
Some women are lucky and do not find their pelvic floor changes much postpartum. For other women, the impacts of pregnancy and birth on their pelvic floor can last for years. As well as the weakening of the muscles, you can also suffer from posterior pelvic pain (also known as pelvic girdle pain). This causes a dull and constant pain in the lower back. This can also present as stabbing, sharp pains.
Coccydynia
This is the medical name for tailbone (coccyx) pain. This is commonly seen in women who had a very difficult delivery.
Generally, if the child is too large to be delivered vaginally, the mother has gained a lot of pregnancy weight, or the birth is assisted through the use of forceps. There is a section at the base of your spine known as the coccygeal segment. This is the part impacted during childbirth.
It can be overextended backward during childbirth, past its normal range of motion. This is a medical condition that can fix itself, although it will take a few weeks to a few months.
The pain is likely to be relatively debilitating during the recovery period, making it hard to perform simple activities such as standing up.
Sacral stress fracture
Your spinal column is made of many different vertebrae that are fused together. The spinal vertebrae in your pelvic region are known as the sacral spine.
These vertebrae can experience a stress fracture during childbirth, like coccydynia. Sacral stress fractures can also be caused due to hypermobility or extended curvature in your lower spine.
If you develop osteoporosis during pregnancy or take blood thinners like warfarin or heparin, you will have an increased risk of developing a sacral stress fracture. If you have one, you will find sitting very uncomfortable.
Over exhaustion
You should not try to push yourself back into exercise immediately postpartum.
Being a new mother is exhausting and there are much better ways to use your energy than working out. There is a real risk of mental, physical, and emotional burnout. You should be careful to ensure you have a good balance in your life. When you are tired or burnt out, your body is more receptive to pain. This means that any postpartum back pain is likely to be exacerbated by tiredness.
While you cannot ensure you get enough sleep, try to limit the amount of stress and activity you do. This will help to reduce the mental and physical load of being a new parent and will help you to feel better overall.
Posture
Poor posture is one of the leading causes of back pain in new mothers. The life of a mother is filled with constant bending over to pick up babies and toys, twisting, and stretching in all directions.
The average mother will breastfeed around 12 times a day, for about 15 minutes each time. This means that mothers of newborns will spend around 3 hours a day breastfeeding.
If you have poor posture while feeding, this can quickly lead to serious back pain. Babies are not that heavy, but over time carrying them with improper form can cause strains and tears. You should take care to lift them up in a way that adequately supports your muscles.
If you are experiencing a lot of pain, you could consider wearing a belt to support your back.
Poor exercise plan
There are many issues when it comes to restarting an exercise regime for new mothers. You are likely to be experiencing problems with your pelvic floor, abdominal separation, and chronic back pain.
These can all cause issues with performing specific exercises and you should adapt your regime to account for this. It is not ideal to do Kegels, which are hailed as a miracle cure. They are a good exercise, but on their own, they will not do much to help you and your pelvic floor to recover.
Crunches are also not advised as they can cause further harm to your body. Good exercises to do for back pain include Pilates and yoga. They are relatively gentle and can be incredibly useful to build back up your strength. That being said, they can cause issues if you are not careful.
If your abdominal muscles and pelvic floor are weak and have not been strengthened, you may need to undergo a re-strengthening program before you start yoga sessions once more.
How can you get relief?
Pay attention to your lifting form
A common reason that new mothers suffer from back pain is due to improper lifting form.
As with weightlifting in the gym, an incorrect lifting form can cause you to strain, pull, or even tear muscles. It may not seem like it, but your baby is heavy and can injure you.
When you lift them, take care to start the movement from your knees to prevent overloading your back muscles. Try to keep your spine as straight as possible, as this is the optimal position for reducing injuries. When you lift your child, you should get very close to them and keep your back straight as you bend towards them.
Lift the baby and hold them tightly to your chest. At the same time, tense your pelvic floor muscles and exhale. Keep your back straight and stand up.
Focus on your breastfeeding posture
Carrying children about all day can cause your spine to be jolted out of alignment. If left unchecked, this can cause severe back pain over time.
Another leading cause of poor posture amongst new mothers is a poor breastfeeding posture. Try to keep your back as straight as possible when carrying kids and when breastfeeding. Hold your baby across your lap, with their belly touching yours. Their head should be in the crease of your elbow and their back should run along the length of your arm.
Place a pillow underneath them to support their weight. This reduces the strain on your arms and back and should allow your baby’s head to be at nipple level. You should place a second pillow behind the middle of your back. This will help to keep it straight and stop you from slouching.
Place a footstool under your feet. This will ensure there is an angle between your thigh and back that is less than 90 degrees. Do not cross your legs as you sit.
Pay attention to your pelvic positioning
Pelvic positioning has a massive impact on back pain. You should try to remain conscious of the position of your pelvis as you sit and stand. Try to untuck your butt and stack your ribs directly over your hips. As you are sitting, place a pillow or rolled up towel underneath your bum and hips to elevate them. This will force your pelvis into a more optimal position and help with your posture.
Focus on your sleeping position
If you sleep on your front, it is a good idea to place a pillow or rolled up towel underneath your hips. If you sleep on your side, do not pull your knees to your chest as this curves the spine.
Try to place a pillow in between your knees as this will align your hips and spine. If you sleep on your back, support the arch or your lower back or underneath your knees with a small pillow.
Warm baths
The gentle heat provided by a warm bath will be incredibly soothing to your aching muscles. If you have had a Caesarean section then you should consult your doctor to ensure it is safe for you to bathe. We recommend adding some Epsom salts or magnesium to your bath water. This will help to further reduce muscle tension and inflammation.
Warm baths have also been shown to increase blood flow to your perineal area, helping to promote a faster recovery process and dissipation of swelling.
Pain management techniques
It is a good idea to consult with your doctor or obstetrician-gynecologist before you begin to take any kind of pain relief medication. This will ensure you are taking the correct dosage and will not cause problems for you or your baby. You can also utilize ice packs or heat pads for localized pain relief. Heat pads improve the blood flow and overall circulation to a specific area of your body.
The warmth can also improve your muscle flexibility. Ice packs work by reducing the blood flow to a certain area, reducing the inflammation and swelling. TENS machines are well loved in the postpartum and chronic pain communities. These machines use a process known as transcutaneous electrical nerve stimulation to send electrical impulses through the skin.
These impulses flood your central nervous system and reduce the ability to send pain signals to the brain and spinal cord, reducing your overall pain levels.
Minimize your time standing
Standing up places a lot of tension onto your lower back. It is a good idea to sit down where possible, or to place one foot on a low stool if standing is necessary. This will reduce the strain on your back.
Stretch
In a new mother’s day to day life, there is an exorbitant amount of bending over required. When this is combined with a reduced activity level and sleep deprivation, it can quickly begin to cause problems.
Strangely, tight hamstring muscles have been shown to link to lower back pain. You should pay attention to stretching out these muscles. Taking 5 or 10 minutes out of your day to stretch can do wonders for your mental and physical health.
Do not try to push your body too hard, but do try to fully stretch out all of your muscles. If you begin to feel pain anywhere, stop stretching. As we have mentioned already, your body will release a hormone called relaxin in the later stages of pregnancy.
In the first few weeks postpartum you will still have elevated levels of this in your body. This will allow your joints and soft tissue to be more supple and elastic, making stretching easier.
Massage
A massage can do wonders for pain and stress relief. You do not have to spend lots of money visiting a professional masseuse, you can simply ask your partner to do it for you.
However, if you have the money spare, a professional massage is a great postpartum treat. Massages force the tension and knots out of your muscles, alleviating pain greatly. This will go a long way to reducing your back pain.
Visit a chiropractor, osteopath, or physiotherapist
All three of these professions specialize in treating musculoskeletal pain but use slightly different methods.
Not everyone will respond in the same way to treatment, and you should opt for whichever practitioner makes you feel most comfortable and at ease.
All 3 professionals should be able to help treat your back pain by making a few small adjustments and this can make a real difference to your pain levels and recovery period. Chiropractors manipulate your joints by making small movements known as adjustments, often to the limbs and spine. This technique is very hands on and fast.
Osteopaths also use hands on techniques to realign your joints but tend to use more gentle techniques than making adjustments.
Physiotherapists use a combination of exercise, education, manual therapy, and advice to treat the problems that you are experiencing.
Eat a healthy and well-balanced diet
Staying hydrated and eating well is the most sure-fire way to maximize your recovery process.
Your diet should contain a lot of antioxidant rich foods as these will help to reduce inflammation. Good foods to include are fresh fruits and vegetables, fish, olive oil, and whole grains.
Try to reduce the amount of processed food in your diet as this can cause inflammation. Aim to drink 64 oz of water daily.
Exercises to reduce postpartum back pain
Gentle exercise
Daily gentle exercise is a great way to help alleviate symptoms of back pain. You should take care to clear it with your doctor before starting in order to prevent you from sustaining injuries.
Walking is a surprisingly underrated form of exercise. It is hugely beneficial and you can take your newborn out in a pram while you walk, allowing them to take in some fresh air. Walking increases your blood flow and circulation, and improves your cardiovascular health. It has also been shown to have positive effects on mental health and loosen your hip flexors.
Pelvic tilts
Pelvic tilts are very easy and highly effective exercises that are ideal for postpartum women.
Lie on your back on the ground and bend your knees so that the soles of your feet are flat on the ground. Engage your abdominal muscles and pull your belly button towards your spine. Tighten your gluteal muscles and picture your pelvic bone tilting towards your face, keeping your lower back on the ground.
You should hold this position for 5 seconds and then return to the starting position. You should try to do sets of 5 to 10 reps multiple times per day.
What to avoid
You should try to avoid any kind of strenuous exercise. You should gently ease yourself back into exercise. Going too hard to begin with can cause injuries and will set you back in your recovery journey. We do not recommend performing exercises such as crunches or sit ups. Yoga should also be avoided for a little while unless it has been specifically designed for postpartum women.
When should you seek medical advice?
You should visit a doctor if your pain does not subside within a few weeks, or if any of the pain management strategies are not working for you.
If you notice any new symptoms appearing, this is also a good indicator that you should visit a doctor. Particular symptoms to keep an eye out for include numbness or weakness in your legs.