Postpartum back pain is more than an inconvenience; it can be an agonizing and even debilitating condition that negatively impacts quality of life. The good news is that, with proper treatment, you can reduce or eliminate postpartum back pain. Here are doctor-recommended tips to relieve postpartum back pain after childbirth.
- Postpartum back pain: Quick overview
- What is postpartum back pain?
- How to alleviate postpartum back pain
- When to see a doctor
Postpartum back pain: Quick overview
- Caused by multiple factors, including ligament laxity from the relaxin hormone, poor posture, the physical stress of pregnancy and caring for newborns
- Can last 3 to 6 months or more
- Try natural remedies first, including chiropractic care, posture correctors, physical therapy, exercises, stretches, yoga, and massage
- Avoid over-the-counter medications if you're nursing
Postpartum back pain statistics
- More than 67% of women experience back pain after delivery; some estimates put that figure as high as 80%
- 37% of women still have back pain at their follow-up exam
- Women who perform physically heavy work are more likely to experience postpartum back pain for more than 12 months
- There is an association between childbirth and chronic back pain later in life. Women who have given birth are at higher risk than those who have not (85% versus 77%)
- Women who have cesarean sections are more likely to experience back pain than women who deliver naturally
What is postpartum back pain?
Postpartum back pain is back pain experienced after childbirth. It’s often felt in the lower back, but it can also present in the mid- and upper-back, and it can occur after both natural and C-section deliveries.
“Postpartum back pain is most commonly felt in the lumbar spine and pelvis, but can affect the upper back and even the neck,” says Dr. Gregg Rubinstein, a Webster certified chiropractor and founder of 57th Street Chiropractic, which has focused on maternity, pediatric and family care for over 30 years in New York City.
Women can experience postpartum back pain and associated spasms while sitting, standing, lying at rest or during activities such as walking, running, working or exercising at the gym.
Postpartum back pain can last up to three to six months – and even years, in some cases, though this is unusual.
What causes postpartum back pain?
“There are many contributing factors to the aches and pains the new mom experiences, and it is almost always multifactorial,” says Dr. Rubinstein.
Postpartum back pain causes include:
- Ligament laxity
- Postural misalignment
- Nerve irritation
- Physical stress
- Weakened pelvic floor muscles and stretched abdominal muscles
- Heightened pain acuity due to increased adrenaline and cortisol
- Strain from carrying the baby, diaper bag, stroller, nursing, etc.
- Loss of muscle tone and joint instability
- Poor posture caused by pregnancy, often hyperlordosis
- Trauma during delivery
- Weight gain during pregnancy
- Preexisting conditions
Dr. Rubinstein explains that the most common cause of postpartum back pain is related to ligament laxity due to high levels of relaxin in the body. Relaxin is the hormone that relaxes the pelvic girdle and ligaments to allow the baby’s passage through the birth canal.
This ligamentous laxity occurs when your ligaments are too loose to hold your joints in the proper position. Relaxin levels stay high for several weeks after delivery, creating a snowball effect in which joint instability causes your muscles to compensate, usually by tightening, which in turn causes pain.
“But that is just the tip of the iceberg,” says Dr. Rubinstein. “For several months prior, the expecting mom was carrying an ‘extra’ 20 to 30 pounds, and her center of gravity slowly shifted forward by two to three inches, which loads the lumbar spine differently and affects the facet joints that guide the motion of the spine.”
The additional stress causes misalignments in the spine – what chiropractors term “vertebral subluxations.” These subluxations inhibit vertebral range of motion, and when the bones of the spine are misaligned, they can irritate the same nerves they’re designed to protect. That nerve irritation also contributes to tightness and increased tension in the muscles of the lower back and pelvic girdle.
“Couple that with the actual physical stress of the delivery and now you have to care for your new bundle of joy, which always requires forward leaning, bending, lifting and carrying. You don’t walk out of your home now without a baby in tow, a diaper bag and assorted other accoutrements you need to care for your newborn,” Dr. Rubinstein says.
Altered sleep patterns can also contribute to postpartum back pain, as new mothers often wake for multiple feeding sessions. When mothers look down at their newborns during nursing, they place strain on their necks and upper backs – similar to tech neck. In addition, most women cannot sleep on their stomachs during pregnancy.
“The birth process itself can be a little traumatic on the mom and then all the responsibilities and new postures one assumes in caring for their newborn, like constantly being flexed forward – looking at the baby, changing the baby, and lifting the little ones as they grow and develop,” says Dr. Rubinstein.
Another contributing factor is the weakening of the pelvic floor and stretching of the abdominal muscles as the baby slowly moves anterior during pregnancy.
“After five to six months of pregnancy, mom was carrying extra weight and her center of gravity moved interior two to three inches, loading the lumbar spine in a different way and putting additional stress on the facet joints that guide the motion of the lumbar spine,” says Dr. Rubinstein.
Stress, anxiety, and preexisting conditions
The stress of pregnancy, delivery, and caring for a newborn can increase adrenaline and cortisol levels, which can contribute to postpartum back pain. In addition, pregnancy and post-pregnancy can exacerbate preexisting conditions.
“There’s also some stress and anxiety for new parents, which can also put mom into sympathetic ‘overdrive’ with increased levels of adrenaline and cortisol, which increase pain acuity and slow down the body’s ability to heal because the body thinks it’s in fight or flight,” says Dr. Rubinstein. “If the mom had back or neck issues prior to pregnancy, the pregnancy and all the stresses and strain can amplify a preexisting condition to continue postpartum.”
Ultimately, postpartum back pain has many different causes (though epidurals usually aren’t one of them).
“The ligament laxity, the stress and strain of the pregnancy and delivery, and then the newfound postures that a new mom finds all combine to create the perfect storm of postpartum, lower back and pelvic pain,” says Dr. Rubinstein.
How to relieve postpartum back pain
Fortunately, you can alleviate and even eliminate back pain after childbirth with the following tips.
1. Chiropractic care
A chiropractor can evaluate your postpartum back pain and prescribe a treatment regimen designed to deliver relief.
“For decades, chiropractic has been an extremely useful tool for moms during pregnancy and after,” says Dr. Rubinstein. “The best thing about chiropractic is we use no drugs or surgical procedures. We don’t put anything into the body, and we don’t take anything out.”
Chiropractic care for postpartum back pain might include adjustments, physical therapy, exercises and stretches. In some cases, doctors may recommend co-treatment with pelvic floor specialists.
“We enhance the body’s inherent recuperative power by checking for vertebral subluxations, essentially misalignments of the spine that put pressure on the delicate spinal nerves as they exit between adjacent vertebrae,” says Dr. Rubinstein. “That irritation to the nerves can cause pain, discomfort, and hypertonic muscles. This coupled with the fact that there is still some ligament laxity creating additional and increased probability that the vertebrae will subluxate or misalign. Consult a chiropractor and have them do a complete examination and take a detailed history about your pregnancy and of your overall spinal health. The chiropractor will determine what needs to be done.”
2. Posture correctors
“Posture plays a huge role in everything, and our postures change when we’re a new parent,” explains Dr. Rubinstein. “We’re constantly looking down while we’re breastfeeding the new infant. We’re constantly bending forward, changing, lifting, carrying and bending. I would venture to say that postpartum, there’s more stress on the spine than there was during the pregnancy.”
Posture correctors gently align the spine and can help retrain new mothers to maintain proper posture post-pregnancy. With posture correctors, the ultimate goal is to remind you what proper posture is and strengthen postural muscles so, eventually, you can sit and stand with good posture without needing the corrector.
“Sometimes posture correctors help because it’s a constant reminder of us to assume a more natural, neutral posture,” says Dr. Rubinstein. “We don’t like people to be 100% dependent on posture correctors, but if it serves as a good gentle reminder to keep their posture upright, straight and tall, then they can be an effective tool.”
Proper posture also offers aesthetic benefits to new mothers, including reducing potbellies and lending a taller, slimmer appearance that inspires confidence. Some posture correctors feature stylish designs that can be worn over clothes yet are lightweight and comfortable enough to be discreetly worn under clothing.
Posture correctors for women: Stylish posture braces that can be worn over or under clothing
3. Exercises, stretches and yoga
Exercises, stretches and yoga can help strengthen core muscles, promote flexibility, and reduce postpartum back pain. In many cases, mothers gradually adopt a hyperlordotic posture during pregnancy, and the following exercises, stretches and yoga positions can help fix lordosis (be sure to check with your doctor to make sure these are the appropriate exercises for your condition).
Prone head lifts
Supine head lifts
Isometric neck stretches
4. Physical therapy
A physical therapist can work with you to develop an exercise, stretch and yoga routine that alleviates postpartum back pain. PT’s often work alongside chiropractors and some even offer massages.
Massage can help alleviate postpartum back pain, especially if the cause is muscle tension and not misalignment or another underlying condition. Many physical therapists and chiropractors prescribe or even offer massage in their clinics.
6. Practice mindfulness
Mindfulness can go a long way toward alleviating postpartum back pain. Be mindful about your posture when you’re carrying and picking up the baby, when you return to work, when nursing, and when returning to your normal activities.
The more you practice proper posture, the easier it will be to maintain it, and the more likely your back pain will subside. A posture corrector can help you train your body to maintain proper posture throughout the day.
What about over-the-counter (OTC) pain relievers?
Though OTC pain relievers like Tylenol and ibuprofen are often indicated for back pain, they’re typically not recommended for new mothers.
“The use of over-the-counter painkillers and muscle relaxers is generally contraindicated in a nursing mom because those harmful chemicals can be transferred to the baby through the breastmilk,” says Dr. Rubinstein. “It’s always best to try the natural and lease invasive options first.”
If you’re considering OTC medicines or muscle relaxers, be sure to consult your doctor first.
When to see a doctor for postpartum back pain
It’s always best to see a doctor if you’re experiencing postpartum back pain to outline an appropriate and effective treatment plan.
“I tell my patients that pain is never normal. It’s a sign that something is wrong and not going right and needs to be addressed,” says Dr. Rubinstein. “A chiropractor is absolutely qualified to help you with your postpartum back pain and he or she is trained to recognize if there is something beyond the scope of chiropractic to refer to a medical doctor if necessary.”
Signs that there could be a more serious underlying issue that requires medical attention include:
- The pain is severe
- The pain lasts more than a few weeks
- The pain gets progressively worse
- Your legs, groin, or posterior go numb
For typical cases, however, chances are you can alleviate postpartum back pain through natural remedies such as chiropractic care, posture correction, exercises and stretches and mindfulness.
“I always encourage people to try the natural, noninvasive healing arts first before they resort to drugs and surgery,” says Dr. Rubinstein.