You did it! You brought a baby into the world, got through birth, are surviving sleepless nights... so why is the universe rewarding you with a sore back?
Lots of women experience back pain after pregnancy. Most studies suggest it affects more than 50% of new mothers [1] — lucky those bundles of joy are cute, right?
While we may not be able to sort out unlimited free osteo appointments for all our pregnant pals or new parents, we can help with learning more about postpartum back pain, what causes it, and how to manage it if it pops up.
Pull out your heat packs, grab a cuppa, and let's get to it.
Is postpartum back pain normal?
It's probably fair to say that most of us are prepared to experience some pain after giving birth. But just because we've normalised some of these things, it doesn't mean they're 'normal'.
Lower back pain is really common during pregnancy — we start to carry extra weight as the baby grows and the curve in the spine deepens [2].
Logically, you'd expect that after giving birth (when you're finished carrying around an entire human) the pressure on your back would ease up. Unfortunately, many women get the opposite of instant relief: persistent low back pain [3].
Even though more than half of women experience postpartum low back pain, it doesn't mean you should ignore it [4]. It's really important to address back pain as soon as possible, to prevent it from turning into chronic pain [5].
So, what should you look out for? Let's take a look at the risk factors for postpartum back pain, and how to know when to seek help.
What causes back pain in postpartum?
Most of the causes of postpartum back pain can be traced back to: changes that start happening during pregnancy, things associated with labour and giving birth, and lifestyle changes as a result of having a new baby to look after.
Some of these factors include:
Hormonal changes
If there's one thing pregnancy is famous for, it's hormones.
When you become pregnant, the body gets to work straight away — it releases hormones that help make room for a growing baby [3].
More specifically, hormones called progesterone and relaxin start ramping up. This prompts changes to the back and abdominal muscles and helps the spine curve to accommodate the baby. All of this can put pressure and strain on your lower back [3].
Structural changes
Following on from the hormonal changes above, the body literally starts to change its structure!
Think expanding uterus, changes to your pelvic floor muscles, your pelvis moving position (called pelvic tilts), changes to your abdominal muscles, and lots more [3].
When your body has released all of the hormones throughout pregnancy, it can also lead to joint instability and less muscle tone, both of which can lead to lower back pain [3].
Another thing that's often associated with lower back pain in pregnancy and postpartum is a condition called pelvic girdle pain or PGP [6].
Pregnancy also means the joints in your pelvis (called sacroiliac joints) start moving.
When they move unevenly, or when the baby's weight puts strain on your pelvis, this sometimes triggers pelvic pain. This pain can also radiate from the pelvic region to your hips, thighs or lower back.
PGP usually improves after birth, but some women might have ongoing pain [6].
Labour and delivery
We know that labour and giving birth can put a huge amount of strain on the body.
Sometimes there's a risk of injury during birth, and studies suggest the type of delivery can also be linked to postpartum back pain [4].
One example of this is an injured tailbone (coccyx).
The muscles around your tailbone are working super hard to push during labour, which can lead to straining and ongoing pain after birth.
You might be more at risk if you've had a difficult labour, if the baby was big or had trouble coming out, or if you needed forceps or other instruments used during delivery [6].
Side note: there used to be a myth floating around that postpartum back pain was caused by having an epidural and subsequently injuring yourself during birth — but studies have disproven this theory.
The same research also suggests that there was no difference in rates of postpartum back pain between those who had a vaginal birth vs women who delivered via C-section [4].
History of back pain and other health factors
This is a pretty straightforward one, but basically: if you were prone to back problems before you got pregnant, you're more likely to experience postpartum back pain.
Excessive weight gain during pregnancy can also increase the risk of postpartum back pain.
Lifestyle changes
We've talked a lot about pregnancy-related changes, but then there's everything that happens when the baby is here: maneuvering car seats and prams, carrying the baby around all day, breastfeeding in the same position for a long time... all of these can be a recipe for chronic back pain if we're not careful.
Babies are heavier than they look!
There's also evidence that lack of sleep or sleep disturbances during pregnancy and after birth might make back problems worse. Studies suggest that sleep problems are linked to higher inflammation, which is linked to higher pain levels [7].
How long does postpartum back pain last?
There's no one rule of thumb when it comes to how long postpartum back pain will hang around for.
This really depends on the individual, the underlying cause of the pain, and self-care measures you're using in your recovery [8].
Your body is still recovering from being pregnant, as well as the huge effort of giving birth — it can take a while for your back and abdominal muscles to get back to their pre-pregnant state. For some people, this might take a few weeks, and for others a few months or more [8].
The most important thing is to get proper advice about how to manage your pain.
Signs you should get immediate medical attention include:
- If your back pain was caused by an injury or trauma
- Persistent back pain, severe pain, pain that's getting worse, or feels sharper than usual
- If you feel numb, tingly, or lose feeling around your genital area/bum/groin
- If you lose feeling in your legs, feel weak, or lose your balance
- If you're having trouble urinating or having a bowel movement, or you become incontinent [9].
How to relieve back pain after pregnancy
All of this sounds really scary, we know — but the good news is there are lots of strategies that can help you cope with low back pain:
- Gentle exercise, especially exercises that focus on your pelvic floor muscles and abdominal muscles. Gentle walking is also great for recovery [2].
- Getting enough rest. Experts recommend lying flat for 30 minutes a day if you can, to take the weight off your back and pelvic muscles [10].
- Trying to maintain good posture. This could look like adjusting your position when bathing the baby/not hunching over, breastfeeding in a comfortable chair and not constantly looking down at the baby, or trying not to sit in the same position for more than 30 minutes [10].
- Avoiding extra strain on your back. Avoid heavy lifting, carrying your baby on one hip, stooping or bending or twisting too often, or standing for long periods of time. You can also reduce pain by sitting down to get dressed, and being careful when you get in and out of bed or your car [10].
- Support your muscles. Compression garments and support underwear can provide pain relief as they support your abdominal muscles. Something like a Belly Band can provide great support while your muscles literally knit themselves back together, and reduce the pressure on your back. They're also super discreet under clothing.
- Self-care and alternative treatments. Self-care is just as important as looking after your baby and will help your recovery in the long run. Looking after your overall health and eating well will give your muscles the fuel they need to recover.
Need more of a boost? You could consider a good quality postnatal vitamin to help your body recover and support you and your baby's health.
Kin's Postnatal does exactly that — it supports immune function, boosts your energy levels, and has many more benefits.
Alternative treatments might be trying out massage, acupuncture, or even just a warm bath when you need one.
But if the pain is sticking around, it's definitely time to talk to your healthcare provider. They may refer you to physical therapy, suggest specific exercises, or offer some medication options to get some pain relief.
If you've been struggling with postpartum back pain, please know that there are treatment options available — you don't have to grin and bear it. You deserve a pain-free life while enjoying your new addition, so make sure you reach out for help when you need it.
Image credit: Getty Images
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