Postpartum Back Pain: Tips and Exercises for Back Pain After Pregnancy

Of course your back aches during pregnancy — that growing bundle in your belly can get heavy. And of course you expect your back to feel better after pregnancy when the baby is out. But — rude surprise — sometimes postpartum back pain can linger for weeks or even months after you deliver. That’s because some of the changes that caused your back aches in pregnancy may still contribute to postpartum back pain. Plus, a new baby can bring new stressors to your back muscles. (Hunch over while breastfeeding much?)

Postpartum back pain is common. But there are steps you can take to help ease the aches. Read on to learn gentle exercises, healthy body mechanics, and self-care strategies for back pain relief.

Causes of Postpartum Back Pain

Your body experienced many changes over the course of nine months of pregnancy — some of which contributed to your lower back pain during pregnancy. The effects of those changes don’t resolve immediately after delivery. Moreover, your upper back may also ache postpartum or you may experience soreness in your tailbone from labor.

Common causes of postpartum back pain may include:

• Hormone changes during pregnancy. Pregnancy hormones help loosen supportive ligaments in your lower back and pelvis (the sacroiliac joints) to prepare for birth. It’s a normal part of pregnancy, but it can strain the muscles and joints in your back and cause pain.

• Weaker abdominal muscles. To make room for your expanding uterus during pregnancy, your abdominal muscles stretch, lengthen, and sometimes even separate (a condition called diastasis recti). This reduces support for your pelvis and spine, which can lead to back and pelvic pain.

• Shifts in posture. As your baby grows, your center of gravity shifts forward to compensate for the additional weight. This can lead to subtle changes in posture that increase stress on joints, nerves, and muscles in your back during pregnancy. It can take time to shift back to your pre-pregnant posture after delivery.

• Stress. Adjusting to parenthood can be equal parts exhausting and stressful. This can make your back muscles tense, leading to pain and muscle spasms.

• Newborn care. You lift your little one out of the crib, lean over for diaper changes and baths, and lug car seats. You may also hunch over when you breastfeed or bottle feed — all of which can put extra strain on your back and neck muscles. 

• Pre-existing back pain. If you had back pain before pregnancy, you might be at higher risk during and after pregnancy.

Postpartum back pain usually doesn’t indicate a serious condition. But there are some situations when you should see a provider. Talk to your doctor if your back pain:

• Starts abruptly

• Is severe

• Occurs mainly at night

• Worsens or does not improve with gentle stretching or exercise

• Occurs with numbness or tingling in your lower body

Tips to Relieve Postpartum Back Pain

Postpartum back pain generally improves over time. But you can ease some of the ache by making small changes to your daily habits and modifying how you perform childcare activities. An ob-gyn or physical therapist (PT) can help. They can recommend everyday pain management strategies that are safe and appropriate for you and help you determine if you need additional care.  

Some tips for postpartum back pain relief include:

• Engage your core when lifting your baby. Also important: Exhale during the lift and keep your baby close to your body. Take a moment to find a stance that decreases strain on your lower back before lifting your baby from the crib. You might rest one foot on a footstool, for example, or stagger your legs (like you’re doing a mini lunge).

• Use carrying devices. Resting your baby on your hip shifts your weight to one side of your body, which can strain muscles, cause an imbalance, and lead to pain. Instead, use a hip holster to help evenly distribute your baby’s weight or a multi-position carrier for a quick errand or short stroll. On longer walks, use a stroller appropriate for your child’s age.

• Alternate feeding positions. Most newborns eat every two to three hours — that’s eight to 12 times per day. Uncomfortable feeding sessions can strain your muscles. Even if you’re in a back-friendly position, feeding your baby the same way every time can lead to tightness, achiness, and pain in your upper and lower back. Varying your position with each feeding session can help ease discomforts.

• Elevate diaper changes. Instead of changing diapers on the floor and leaning forward, use a changing station at hip or waist height whenever possible. Keep diapers, wipes, creams, and clothing within easy reach.

• Bathe your newborn in a countertop tub. A kitchen sink also works to help avoid you crouching over the edge of your tub. If you use a regular bathtub, try a bath kneeler and elbow resting pads for support.

• Consider a car seat adapter for your stroller. An adapter lets you securely attach your car seat to a stroller frame so you can push your baby instead of carrying them.

• Sleep with support pillows. If you’re a back sleeper, place a pillow under your knees. For side sleepers, position pillows between your knees and feet. 

Bed sharing (sleeping in the same bed with your infant) can cause poor positioning during sleep. The American Academy of Pediatrics advises against bed sharing for safety reasons. Return your baby to their own sleep space after you bring them into your bed for feeding or comforting.

• Make time for self-care. Self-care might not seem realistic when you're adjusting to the ups and downs of newborn parenthood. But try to focus on care that makes your back feel better and is doable for your schedule. It could be a short warm bath (get clearance from your ob-gyn first), using a heating pad or massage gun, or doing a short stretching session (like a Hinge Health playlist). Talk to your healthcare provider or PT to find the best low back pain self-care therapies for you.

Physical Therapy for Postpartum Back Pain

When your back aches, you might not feel like moving. But moving more may be just what your back needs to feel better. Gentle physical activity and exercises, like walking and yoga, can help ease postpartum back pain. Before you begin any postpartum exercise, get clearance from your healthcare provider. Once you get the OK, a physical therapist can help tailor a postpartum exercise program that is safe and appropriate for you. A PT may recommend stretches to help prevent stiffness and tightness as well as exercises to strengthen your core, pelvic floor, and mid-back and upper back muscles. Pelvic floor physical therapy is a comprehensive treatment that also includes exercise, education, and behavioral and lifestyle strategies. 

You can see a physical therapist in person or use a program like Hinge Health to access a PT who specializes in pelvic health via telehealth video visit.