Back pain after hysterectomy: causes, treatments, exercises
Learn what causes back pain after a hysterectomy and how movement, physical therapy, and gentle exercises can help relieve discomfort.
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Recovering from any surgery, but especially one as big as a hysterectomy, can feel physically and emotionally overwhelming. Between fatigue, soreness, and adjusting to temporary movement restrictions, know that your body is already going through a lot. So when back pain shows up, you might think, “What else is going to happen?”
Back pain after a hysterectomy is common, especially in the first several weeks of recovery. “Your body goes through a lot of changes after surgery, both structurally and functionally,” says Maria Fernandez Cuadrado, PT, DPT, a pelvic health physical therapist with Hinge Health. “Your muscles, posture, and movement patterns all adapt during healing, and that can contribute to back pain.”
Back pain after a hysterectomy usually improves with time and gentle movement. Light physical activity, targeted exercises, and a gradual return to daily activities can help reduce muscle tension, rebuild strength, and support recovery.
Here’s what to know about back pain after hysterectomy, including common causes, symptoms, treatments, and exercises recommended by Hinge Health physical therapists.
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Causes of back pain after a hysterectomy
Back pain after a hysterectomy can occur for several reasons. The surgery impacts the abdominal and pelvic muscles, and during recovery people often move differently, become less active, or compensate with other muscle groups. This can place additional strain on the lower back and may also increase muscle tension and sensitivity temporarily as the body heals.
Some of the most common causes include:
Weakened core and pelvic floor. Your core muscles, back muscles, diaphragm, and pelvic floor all work together to support and stabilize your spine and pelvis. “When you have abdominal or pelvic surgery, those muscles can temporarily weaken or become less coordinated,” explains Dr. Fernandez Cuadrado. As a result, your back muscles may work harder to support your spine and pelvis, which can lead to tension and discomfort in this area.
Changes in posture and movement. It’s natural to move differently after surgery. Many people round their shoulders, avoid twisting, or limit certain movements to protect the affected area while healing. “Those altered movement patterns can place extra strain on the hips and lower back,” says Dr. Fernandez Cuadrado. Muscle guarding — when muscles tighten to protect an injured or healing area — can also contribute to stiffness and pain.
Nerve irritation. Surgery can sometimes irritate nerves in the pelvis or lower abdomen. This may contribute to aching, burning, or radiating discomfort that’s felt in the lower back.
Scar tissue and adhesions. As your body heals, it naturally forms scar tissue. Internal scar tissue, called adhesions, can occasionally pull on nearby tissues or organs, contributing to tightness or discomfort in the pelvis and back.
Pre-existing back pain. If you had lower back pain before surgery, you may be more likely to experience it during recovery as your body adapts to post-surgical changes and temporary activity limitations.
Abrupt hormone changes. If your ovaries are removed during a hysterectomy, estrogen levels drop suddenly. “Hormonal changes can affect pain sensitivity, sleep, energy levels, and muscle recovery,” says Dr. Fernandez Cuadrado. All of these factors can affect how pain feels after surgery.
Symptoms of back pain after hysterectomy
Back pain after a hysterectomy can range from mild stiffness to sharper or more persistent discomfort. Symptoms vary depending on the cause, but may include:
Persistent stiffness anywhere from the base of the neck to the tailbone
Dull aching or sharp pain in the lower back
Pain that worsens with bending, twisting, lifting, or prolonged standing
Sensitivity around the incision or abdominal area
Discomfort during bowel movements or urination
Back pain and pelvic pain can sometimes feel similar because of how close and connected they are to one another, but pelvic pain tends to feel deeper in the lower abdomen or pelvis and may radiate into the groin, vagina, or pelvic floor. Pelvic symptoms may include:
Pressure or heaviness in the pelvic region
How movement can help back pain after hysterectomy
After surgery, it’s normal to worry that movement might worsen pain or slow healing. But gentle movement is actually one of the most important parts of recovery.
“Movement helps improve circulation, reduce stiffness, and gradually restore strength and coordination to the muscles that support your spine and pelvis,” says Dr. Fernandez Cuadrado.
Walking is often one of the first and best activities after a hysterectomy because it promotes healthy blood flow to healing areas without putting too much strain on your body. As recovery progresses and your healthcare provider clears you for more activity, strengthening exercises can help rebuild core and pelvic stability to further reduce load on your back muscles and neighboring structures.
Movement can also help calm muscle guarding and reduce fear around activity after surgery. “Too much rest can sometimes make back pain worse,” says Dr. Fernandez Cuadrado. “Gentle, gradual activity helps your body regain confidence in movement.” Consider seeing a pelvic floor physical therapist (PT) to learn how to get started.
Exercises for back pain after hysterectomy
Want expert care? Check if you're covered for our free program →- Diaphragmatic breathing
- Pelvic tilt
- Cat cow
- Figure four stretch
- Abdominal bracing
Together, these exercises help gently restore strength, flexibility, and coordination to the muscles that support your back, pelvis, and core after surgery. Diaphragmatic breathing can help reduce tension and muscle guarding, while strengthening and stretching movements improve stability and mobility, reducing strain on your lower back over time.
The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.
Pelvic floor physical therapy is more than just kegel exercises. Various exercises tailored to your symptoms and needs are key to getting relief. Pelvic floor PT can relieve many different pelvic issues, such as pelvic pain, painful sex, and urinary incontinence.
Members of the Hinge Health pelvic health program experience an average 67% reduction in pelvic pain and 54% reduction in urinary incontinence within the first 12 weeks. Learn more*.
Treatment for back pain after hysterectomy
Back pain after hysterectomy can be managed with a combination of gentle activity, targeted exercises, heat or ice therapy, and pain medications, depending on the severity of your symptoms. Here’s a closer look at ways to relieve back pain after a hysterectomy:
Try physical therapy and targeted exercises. Targeted exercises, such as the ones above, can help alleviate muscle tension, address posture-related changes, and rebuild strength in your core and pelvic floor muscles. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit. Always check with your healthcare provider before starting any new exercise routine or resuming activities after hysterectomy.
Stay consistent with gentle activity. Most people need to avoid heavy lifting and strenuous activity for several weeks after surgery, but light movement is encouraged. Short walks throughout the day can help reduce stiffness and improve circulation while supporting healing. Always follow your surgeon’s recommendations about activity restrictions and timelines for returning to exercise.
Apply heat or ice. Heating pads, warm showers, or hot water bottles can relax tense muscles and improve blood flow to the back. Some people prefer ice to reduce inflammation or soothe soreness. You can try both and use whichever feels best for your symptoms.
Try over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can help ease pain so you can do your targeted exercises and stay active when you have back pain. Other options are topical NSAIDs or pain relief creams. If you have a medical condition or take other medications, check in with your provider to make sure these OTC options are safe to take.
Consider complementary treatments. Talk to your provider if you’re interested in trying alternative treatments for back pain relief, such as massage, acupuncture, or chiropractic care.
Ask about TENS therapy. TENS, or transcutaneous electrical nerve stimulation, uses gentle pulses to quiet your pain response and help reduce back pain. One option is the wearable device Enso, available through Hinge Health. It’s small, wireless, and portable. Talk to your provider about whether it’s right for you after a hysterectomy.
Physical therapy for back pain after hysterectomy
Physical therapy after hysterectomy focuses on restoring strength, mobility, and coordination to the muscles that support your abdomen, pelvis, hips, and back.
“After surgery, your body sometimes loses some of the natural coordination between the core, pelvic floor, and back muscles,” says Dr. Fernandez Cuadrado. “Physical therapy helps reconnect those systems.”
A PT may guide you through:
Gentle core strengthening
Pelvic floor coordination exercises
Breathing exercises
Stretching for tight hips and back muscles
Postural retraining
Movement modifications for daily activities
Your PT can also help you safely return to activities like lifting, exercise, household chores, and work tasks while minimizing strain on your healing body. Recommendations may also include ergonomic tips or relaxation techniques.
You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.
Check with your healthcare provider before starting any new exercise routine or resuming activities after a hysterectomy.
Tips to manage back pain after hysterectomy
Back pain after hysterectomy generally improves over time after surgery. But there are several simple lifestyle and self-care strategies — such as managing constipation, engaging your core when you lift, bracing your abdomen when you cough or sneeze, and practicing relaxation techniques — that can help ease discomfort after surgery.
Manage constipation. Constipation is common after surgery and can increase pressure and discomfort in the pelvis and lower back. Staying hydrated and eating fiber-rich foods like fruits, vegetables, beans, and whole grains can help keep digestion moving.
Engage your core when lifting. You’ll likely need to avoid heavy lifting for several weeks after surgery. But when lifting light objects, gently engage your abdominal muscles, bend your knees, and keep your back straight. “Exhale during effort instead of holding your breath,” says Dr. Fernandez Cuadrado.
Brace yourself for a cough or sneeze. Holding a pillow firmly against your abdomen can help support your incision and reduce pressure on your back during coughing or sneezing.
Practice relaxation techniques. Deep breathing, meditation, and progressive muscle relaxation can help calm the nervous system and reduce muscle guarding that contributes to pain and tension.
Focus on sleep. Sleep is when your body does its repair work and poor sleep can actually make pain feel more intense. Try sleeping on your back with a pillow under your knees, or on your side with a pillow between your legs, to reduce strain on your lower back.
When to see a doctor
For most people, hysterectomy-related back pain will improve over time after the procedure, says Dr. Fernandez Cuadrado. See a healthcare provider if your back pain lasts longer than six weeks, or if you experience any of the following:
Severe or worsening back pain
Fever, or pus, swelling, or redness around the incision site (signs of infection)
Pain radiates down your legs (possible nerve issue)
Difficulty or inability to urinate or control bowel movements
New numbness, tingling, or weakness in your legs
PT tip: Remember, movement is medicine
“It’s normal to feel cautious about movement after surgery,” says Dr. Fernandez Cuadrado. “But gentle activity is an important part of the healing process.”
Too much rest can sometimes increase muscle stiffness and tension, which may worsen back pain. Start small with gentle walking and light movement, then gradually build strength and activity as your body heals. “Your recovery doesn’t have to be perfect,” says Dr. Fernandez Cuadrado. “Consistent, gradual movement can go a long way toward helping you feel better.
How Hinge Health can help you
If you have pelvic pain, bladder, bowel, or other pelvic symptoms that are affecting your quality of life, you can get the relief you've been looking for with Hinge Health’s online exercise therapy program.
The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.
See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.
This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.
References
Aghamkar, J., Perita, C. J., Yangad, S., Jamadar, K., Sabde, S., Dhir, S., & Arokiaswamy, S. T. (2025). A Study to Evaluate the Effect of Back Muscle Strengthening Exercises on Pain Among Post-Hysterectomy Women Admitted in Tertiary Care Hospitals. Journal of Pharmacy & Bioallied Sciences, 17(Suppl 3), S2551–S2553. doi:10.4103/jpbs.jpbs_874_25
NHS website. (2018, May). Recovery. Nhs.uk.https://www.nhs.uk/tests-and-treatments/hysterectomy/recovery/#
Song, J.-Y., Chae, M., Lee, H., & Moon, Y.-E. (2022). Relationship between Preoperative Lower Back Pain and Severe Postoperative Pain after Gynecologic Laparoscopy: A Prospective Observational Study. Journal of Clinical Medicine, 11(15), 4295. doi:10.3390/jcm11154295
Zhang, Y., Chen, X., Yang, X., Wang, S., Tian, Y., Yuan, S., Liu, X., & Wang, L. (2024). Hysterectomy—a possible risk factor for operative intervention in female patients for degenerative lumbar spine conditions: a case control and cohort study. The Spine Journal, 24(11), 2066–2077. doi:10.1016/j.spinee.2024.06.019
Aghamkar, J., Perita, C. J., Yangad, S., Jamadar, K., Sabde, S., Dhir, S., & Arokiaswamy, S. T. (2025). A Study to Evaluate the Effect of Back Muscle Strengthening Exercises on Pain Among Post-Hysterectomy Women Admitted in Tertiary Care Hospitals. Journal of Pharmacy & Bioallied Sciences, 17(Suppl 3), S2551–S2553. doi:10.4103/jpbs.jpbs_874_25