Postpartum back pain

Postpartum back pain and self-management strategies

Congratulations, you’ve given birth! Next, you’re diving into the journey of parenthood, bonding with your adorable new baby, but there’s this niggling back pain which you thought was only going to be a problem during pregnancy. Postpartum back pain is very common and can last for weeks or months after the birth of your baby. In fact, many of the same physical and hormonal changes that lead to back pain during pregnancy could still be contributing to your discomfort now.

What are the causes of postpartum back pain?

1. Changes during pregnancy on your body

The body went through a significant transformation over 9 months to grow your baby, including hormonal changes, physical weight gain, changes in the centre of gravity and stretching of your abdominal muscles (to name a few). Even though you have now given birth, the effects of these changes won’t disappear overnight.

2. Pre-existing history of back pain prior to pregnancy

If you had pain prior to your pregnancy then you are more likely to experience discomfort during and afterwards.

3. Recovery from your birth

Your muscles may have worked very hard (and long) during labour and birth, which is why you can experience soreness immediately postpartum. This sort of discomfort should ease within a week or two of giving birth and is simply your body’s response to the marathon that was birth.

4. Hormonal changes postpartum

Hormonal fluctuations continue to occur well after pregnancy into the postpartum period, especially if you are breastfeeding/lactating. Hormones can lead to increased ligament laxity which means we are have higher likelihood of straining our muscles more easily

5. The new demands of looking after a baby:

You are now caring for a growing little human by lifting, bathing, feeding and carrying a heavy baby. Continuous heavy lifting, awkward positions, and prolonged postures are contributing factors to postpartum back pain.

How can I look after my back postpartum?

Practice good biomechanics

• Babies are heavy, and continue to grow heavier, so making sure you use good techniques is integral
• When lifting your baby, whether that be from the bassinet, change table or playmat, engage your deep core abdominals and your pelvic floor muscles, and keep your knees and elbows soft and bent (not locked)
• When lifting, try to push up through your leg muscles rather than hunching through your spine
• When carrying or lifting your baby, keep their weight close to your body rather than further away from you
• Where possible, lift your baby from a forward-facing position rather than a side or rotated one
• Try to carry your baby centrally, rather than on one hip. If you need to carry them on one side, try to alternate which side you hold them on
• Using a baby carrier like the range from Ergobaby is helpful when you’re out and about, and also means your hands are free

Watch your posture when feeding

• Whether you are breast or bottle feeding, it is important to maintain a good posture as often back pain can be due to sustained awkward postures
• Feeding is an activity you will do with your baby multiple times a day, for months, so optimising your posture is paramount
• If breastfeeding, try to change feeding positions. Find what works best for you and your baby. There are many options such as cradle, cross-cradle, side-lying and football hold
• When feeding make sure you aren’t hunched over, your back is well supported by the chair and that you aren’t looking down at your baby the entire feed (ouch, sore neck!)
• If you are bottle feeding, aim to switch which side you feed them from
• Use pillows to help support the weight of your baby’s body (a nursing pillow can be useful)

Use your village

• Ask for help and let others do the heavy lifting where possible (this might include washing, cleaning or looking after toddlers)
• Especially for the first 6 weeks post-delivery (no matter whether you deliver vaginally or via caesarean section) it is advised that you refrain from lifting anything heavier than the weight of your baby)

Practice self-care

• Horizontal rest is very beneficial for your pelvic floor, lower back and pelvis recovery
• For the first 6 weeks, it is advised to spend 30-60 minutes a day lying down (you can rest, read a book, watch tv or call a friend – this is your time).
• Pamper yourself: you deserve it! This might be getting a massage, a facial or having a warm bath
• Good nutrition aids physical recovery
• Using a heat or cooling pad (dependent on the type of pain you have) to relieve discomfort
• Using a garment such as postnatal shorts or abdominal tubing to support your recovery and offload the muscles
• Practice relaxation techniques such as deep breathing and mindfulness to reconnect with your diaphragm and pelvic floor muscles (both of which make up your ‘core’)

Exercise

• During the first 6 weeks, gentle exercise is encouraged and may include breath work, pelvic tilts, pelvic floor exercises and spinal stretches
• Gradually build up your walking starting with 5-10 minutes (x1-2 per day) in the first 1-2 weeks
• See your doctor and a Women’s Health Physiotherapist for a postpartum assessment at 6 weeks to assess your wound, pelvic floor, scar tissue and abdominal separation
• Your physiotherapist can guide you to return to your exercise and fitness goals
• Strengthening your muscles will build your back support, improve posture and prevent pain and injury
• Find a form of exercise you enjoy
• Aim to include both aerobic exercise (walking, swimming, running, spin class) and strengthening exercise (Pilates, weight training, resistance exercises) in your workout regime
• Remember that exercise should always be pain free

If you are concerned about your postpartum back pain or need further support, reach out to your local Women’s Health Physiotherapist. They can help relieve your discomfort and create an individualised exercise program.

Fiona Grouber is a Women’s & Pelvic Health Physiotherapist and a new mum to her 5-month-old daughter. She is passionate about supporting women through their pregnancy and postnatal journey and breaking taboos associated with pelvic health issues. Fiona enjoys educating and empowering her patients by guiding them to reach their health and wellness goals. She consults privately at her clinic Pelvic Wellness, and works on a maternity ward providing care to new mothers. You can connect with her on Instagram @pelvicwellnessphysio or visit her website www.pelvicwellness.com.au