I thought the pain of pregnancy was over! Why do I have postpartum back pain?
Postpartum back pain is common and is not fun to deal with. You may have experienced low back pain throughout your pregnancy or during the third trimester. It may have gone away and now it’s back. Or maybe it never even left. What are you to do?
Why Postpartum Back Pain Occurs
There are several common explanations for back pain postpartum. One main cause of neck pain and lower back pain postpartum is using poor posture during daily activities. This is common with breastfeeding, and many moms try to make their babies comfortable by sacrificing their own comfort. You may sit in a slouched position on the couch that feels comfortable in the moment but may leave you feeling sore an hour or two later. Breastfeeding back pain is common in both the low back and the neck because many women tend to slouch and look down instead of using pillows to prop the baby close.
You may also find yourself repeating activities that your body isn’t used to, such as leaning over and picking your baby up from the floor or in and out of the crib/bassinet. Holding and rocking your baby is also something you were not doing while pregnant unless you have another young child. These repetitive movements may overload your back as your muscles did not have time to accommodate to this new routine. I know I found myself bouncing my baby a lot when she was young, and my back started aching after a while because I didn’t use good form. When I stopped leaning back with my shoulders and relied more on my legs than my back to do the bouncing, I had less back pain. Another change I made was to sit on an exercise ball instead of bouncing while standing, and this was a huge game-changer for me!
Another reason women experience postpartum back pain is because our core isn’t working the same way it used to. The muscles have been stretched and stressed as your baby and uterus grew. You must retrain these muscles before you can expect them to function like they did before. Holding your baby for long periods of time can put excess strain on your low back because your abdominal muscles aren’t doing their usual job to stabilize.
Our core is a pressure system like a can of pop, so when one part is weak or compromised, other areas struggle as well. If you take away stability in one area, the body tries to make up for it in another area. For this reason, diastasis recti is another cause of postpartum back pain. Diastasis recti is the separation of the abdominals. For more on this topic, see our previous blog post. The abdominals are not working to their full potential due to the separation of muscle, so the low back and pelvic floor often compensate. This can lead to tight and painful low back muscles.
Similarly, if the pelvic floor is compromised due to a tear during delivery or it is weakened from carrying a heavy uterus around for months, it can also lead to back pain. Again, the pressure system is not working properly so the muscles involved are no longer working efficiently. For more on the pelvic floor, click here.
How to treat postpartum back pain
If you use bad posture to pick up your baby, you increase your chances of having pain. Instead of bending at the low back, bend at the hips and use your knees to squat down. Then lift with your legs as you come back up instead of swinging yourself back up with your back muscles.
Another common posture issue is when women hold their baby to the side and pop one hip out. This puts more pressure on one side of the back and can cause pain. Try to stand up straight, even if you hold your baby to the side.
When sitting, try to use proper posture and sit in a good chair that has some lumbar support (hint-hint, not a couch).
Besides modifying daily activities, you can also try several stretches and exercises to decrease your back pain. Not all stretches are good for every type of back pain, so use discretion and never push your body into a stretch if it hurts or makes your pain worse. Several stretches and exercises to try are: knees to chest (one knee at a time or both knees together) with gentle rocking, cat-cow, lower trunk rotations, and gentle cobra. Strengthening the core is also very important, as weakness is often a big cause of postpartum back pain.
The best way to make sure you are on track toward healing and to make specific changes that will help with your postpartum back pain is to see a physical therapist, specifically a pelvic floor physical therapist. We evaluate you as an individual and give you exercises that will address your cause of back pain and give you tips on how to modify daily activities to avoid discomfort.
Takeaways:
Sit in a supportive, comfortable chair
Use pillows, Boppy, nursing pillow when breast or bottle feeding
Use a ball to bounce on instead of always standing to bounce/rock your baby
Watch your posture when doing activities like picking up, holding, and carrying your baby
Try some stretches
Work on your core and pelvic floor postpartum with a pelvic floor physical therapist!