Baby Ergonomics and Managing Postpartum Back Pain
Had back pain during pregnancy? You might expect it to get better once you’re no longer expecting. While back pain generally improves after giving birth, many people continue to deal with it in the postpartum period. Here’s what to know about what’s aggravating your back and tips to reduce it.
What’s Causing My Back Pain?
Many people with postpartum back pain also had it during pregnancy because of factors such as:
Hormonal changes. Pregnancy hormones loosen ligaments in your low back and pelvis (the sacroiliac joints) to prepare for birth. This can strain the muscles and joints and cause pain.
Shifting center of gravity. As your baby grows, your center of gravity shifts forward to compensate. This can lead to subtle changes in your posture that increase stress on joints, nerves, and muscles in your back.
Weaker abdominal muscles. Your expanding uterus causes abdominal muscles to separate (called diastasis recti). This reduces support for your pelvis and spine and can cause back pain.
After your baby arrives, additional issues may come into play:
Stress. The normal stress of adjusting to parenthood can make your back muscles tense, leading to pain and muscle spasms.
Pre-existing back pain. If you had back pain before pregnancy you might be at higher risk during and after pregnancy.
Childcare tasks. From hunching over to feed your baby to carrying a heavy car seat, caring for a baby has a lot of repetitive motion tasks that can trigger back pain.
Modifying Daily Activities
You can decrease postpartum back pain by paying attention to your posture during activities, trying different positions, and using supportive props or pillows. Here are a few additional tips:
Lifting baby in and out the crib: Activate your core muscles, exhale during the lift, and keep your baby close to your body. Try different positions for your legs to decrease strain on your lower back, like resting one foot on a footstool or staggering your legs (like doing a mini lunge).
Carrying or wearing your baby: Try not to carry your baby on your hip, which can shift your weight too much to one side. This can cause muscle imbalance, overworked tissue, and pain. Use a hip holster or a multi-position carrier instead. However, don’t use a carrier for walks and long errands. Instead, use a stroller appropriate for your child’s age.
Diapering and changing clothes: Use a changing station at hip or waist height. Try not to change your baby on the floor. Keep diapers, wipes, creams, and clothing within easy reach.
Bathing: Try a countertop bathtub or bathe baby in a sink so you don’t need to bend over a bathtub. If using a regular bathtub, try bathing your baby less often and doing sponge baths in between. Use a bathtub elbow and knee pad set to reduce pain from being crouched over.
Breast or bottle feeding:
Sitting: Sit in a firm upright chair to support your back (avoid soft couches). Bring your baby higher up with supports like a nursing pillow or stack of pillows. Don’t lean or hunch over. Alternate sides while feeding, whether by bottle or breast.
Sidelying: This position is helpful if you’re tired or have soreness at a surgical site. If you have low back pain, try placing a rolled towel roll under your waist. If you have pelvic or hip pain, put a pillow between your knees and feet.
Standing: If you have upper body pain or fatigue, you can try using an infant carrier to help feed your baby while standing. Sometimes a postural brace or posture bra can help decrease upper back pain while feeding. If your neck and shoulders get fatigued, try some shoulder rolls or neck stretches to reduce the strain.
Getting the car seat and stroller in and out of the car: Try to avoid carrying the baby in the car seat when you can, especially as they get heavier. Use a stroller adapter for your car seat so your baby can stay in their car seat and be strolled at the same time. When getting the infant carrier or stroller in or out of the car, activate your deep core muscles and exhale as you lift.
Sleeping positions: If sleeping is uncomfortable, a pillow support can help decrease pain. If you like to sleep on your back, place a pillow underneath your knees. For side sleepers, try placing pillows between your knees and your feet.
Co-sleeping with your baby can cause poor positioning during sleep. The American Academy of Pediatrics also advises against co-sleeping for safety reasons, stating that you should only bring your baby into your bed to feed or comfort, then return them to their own sleep space.
Postural and back bracing may help decrease pain and remind you to activate your core muscles when performing childcare activities to decrease muscle strain. Alternative therapies, such as massage therapy and acupuncture or acupressure, may be beneficial as well. We recommend talking to your physical therapist or provider about these therapies to find the right one for you.
Movement Is Medicine for Postpartum Back Pain
Once you get clearance from your provider, slowly begin to exercise to strengthen your core, pelvic floor, and mid-upper back muscles. This helps decrease pain and improve overall quality of life. Activities like walking, Pilates, and yoga are great ways to ease into exercise again.
Talk to your Hinge Health physical therapist or coach to further tailor your treatment plan. It’s a good idea to include pelvic floor exercises, as they are an important part of postpartum exercise rehabilitation and may help improve your back pain as well.
When Should I Talk to My Doctor?
Postpartum back pain generally is not a sign of a serious condition. If your pain starts abruptly, is severe, occurs mainly at night, worsens, or does not improve with gentle stretching/exercise, or if you have numbness or tingling in your lower body, talk to your doctor.
Back pain related to pregnancy, birth, and childcare is common but usually isn’t serious.
Modifying how you perform childcare activities can help reduce your pain.
Movement is medicine for back pain. Engage in regular activities like walking, yoga, and Pilates and do core and postural strengthening exercises to help improve your postpartum back pain.
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