Clinically reviewed by What is back pain after delivery
Back pain after delivery is pain across the lower back, the pelvis or between the shoulder blades that starts or carries on once the baby arrives. It is extremely common and it is not something you have to put up with.
In Urdu it is simply delivery ke baad kamar dard. Two things are usually happening together. The muscles that support your spine, the deep abdominals and the pelvic floor, have been stretched and are weak. At the same time you are feeding, lifting and carrying more than you ever have, often in poor positions.
Weak support plus heavy demand equals pain.
Symptoms you might have
- Aching across the lower back, worse by the end of the day
- Pain between the shoulder blades and in the neck, from feeding positions
- Pain on standing up from a low chair, and on bending to pick the baby up
- Leaking urine on coughing, sneezing or lifting, which points to a weak pelvic floor
- A soft gap or doming along the middle of your abdomen when you sit up, which is a separation of the abdominal muscles
Why it happens
- Deep abdominal muscles stretched during pregnancy and now too weak to support the spine
- A weak pelvic floor, which works with the deep abdominals to hold the trunk steady
- Pelvic ligaments that stay soft for some months after delivery
- Hours of feeding with the back rounded and the head dropped forward
- Lifting the baby, the car seat and the pram with a bent and twisted back
- Carrying the baby on one hip all day
- Broken sleep, which lowers pain tolerance and slows recovery
When you should see a physiotherapist
Come in once you have had your postnatal check. Get your doctor's clearance before you begin any exercise programme, and do not skip it after a caesarean or a difficult delivery. Six weeks is the usual point, sooner for gentle breathing, posture and pelvic floor work if your doctor agrees.
Earlier than that, we can still go through feeding positions, lifting technique and how to get in and out of bed.
Go to a hospital the same day if you have heavy bleeding, fever, a hot and swollen calf, chest pain or breathlessness, a severe headache with blurred vision or swelling of the face and hands, or any loss of bladder or bowel control with numbness around the groin.
Al-Shama Physiotherapy Clinic
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How it is treated
Treatment starts by testing what is actually weak. The pelvic floor, the deep abdominals and the hip muscles are checked, along with the gap between the abdominal muscles, before any exercise is given.
- Exercise therapy, the main treatment. Pelvic floor and deep abdominal retraining first, then hip and back strengthening, progressed as you cope
- Manual therapy to the lower back, pelvis, ribs and neck, to free stiff joints and settle tight muscles
- Feeding and carrying retraining, worked out with your own chair, your own bed and your own baby's size
- Abdominal wall and scar work after a caesarean, once the wound has healed and your doctor has cleared it
- TENS over the back muscles where pain is limiting what you can do
- Dry needling or hijama for the upper back muscles, once you are past the early weeks
Surgery has no part in ordinary back pain after delivery. A wide abdominal separation that has not closed after many months of proper training is the only time a surgical opinion comes up, and that is a surgeon's decision.
Exercises, and what to avoid
What helps
- Pelvic floor squeezes, little and often, built into feeding times so you remember them
- Deep abdominal activation, drawing the lower abdomen gently in on an out breath, without holding your breath
- Bridges, side lying clams and sit to stand practice, for the hips and legs
- Walking, starting at ten minutes and building up
What to avoid
- Sit ups, crunches and planks in the early months, especially with an abdominal separation. They push the gap wider
- Running and jumping before the pelvic floor is working, because leaking usually follows
- Lifting with a rounded back, including carrying the car seat with the baby in it on one arm
- Pushing through pain to get your old shape back quickly. Strength returns in order, not all at once
What you can do at home
Bring the baby up to you for feeding, instead of bending down to the baby. Back supported, a pillow or two under the baby, feet flat on the floor or on a low stool. Side lying feeding gives your back a complete rest.
Put the car seat down on a seat or the floor and get close before lifting it. Bend your knees, hold it near your body, and do not twist.
Keep what you need most at waist height, so you are not bending to the floor twenty times a day.
Heat suits this better than ice. A warm pack for 15 to 20 minutes on the lower back or between the shoulder blades, but not over a caesarean scar that is still healing.
How long it takes
With consistent work, most back pain after delivery improves noticeably within four to six weeks and settles over eight to twelve weeks.
The ligament softening of pregnancy takes roughly three to six months to reverse, so the pelvis feels more solid as that happens.
An abdominal separation narrows a great deal on its own in the first eight weeks. After that, further closing comes from training, and it keeps improving over months.
It takes longer if you had a caesarean, if you are carrying a toddler as well as a newborn, or if a leaking pelvic floor is being ignored. Pain still present at a year is usually a strength problem that was never addressed, not damage.
Urdu / Roman Urdu
Choose your reading script / اپنی پسند کا رسم الخط منتخب کریں
اردوUrdu script
زچگی کے بعد کمر درد بہت عام ہے۔ پیٹ کے اندر کے گوشت اور پیڑو کے پٹھے کمزور ہو جاتے ہیں، اور اسی وقت بچے کو اٹھانا اور جھکنا بڑھ جاتا ہے۔
دودھ پلانا کے وقت کمر کو سہارا دیں، بچے کے نیچے تکیہ رکھیں، اور پیروں کو زمین پر رکھیں۔ گردن جھکا کر گھنٹوں تک نہ بیٹھیں۔
بچے یا گاڑی نشست کو گھٹنے موڑ کر، بوجھ جسم کے قریب رکھ کر اٹھائیں۔ ایک ہی کولہے پر بچے کو سارا دن نہ اٹھائیں۔
ورزش شروع کرنے سے پہلے ڈاکٹر سے اجازت لینا ضروری ہے، خاص طور پر سی-سیکشن کے بعد۔
اگر زیادہ خون آئے، بخار ہو، ٹانگ میں سوجن اور درد ہو، سانس پھولے، یا پیشاب پاخانے پر کنٹرول نہ رہے تو فوراً ہسپتال جائیں۔
Roman Urdu
Delivery ke baad kamar dard bohat aam hai. Pet ke andar ke gosht aur pelvic floor kamzor ho jate hain, aur usi waqt bachay ko uthana aur jhukna barh jata hai.
Feeding ke waqt kamar ko sahara den, bachay ke neeche takiya rakhen, aur pairon ko zameen par rakhen. Gardan jhuka kar ghanton tak na baithen.
Bachay ya car seat ko ghutne mor kar, bojh jism ke qareeb rakh kar uthayen. Ek hi kolhe par bachay ko sara din na uthayen.
Warzish shuru karne se pehle doctor se clearance lena zaroori hai, khas tor par C-section ke baad.
Agar zyada khoon aaye, bukhar ho, taang mein sujan aur dard ho, saans phoole, ya peshab pakhane par control na rahe to foran hospital jayen.
Treatment at the clinic, and online
INFORMATION → INDIVIDUAL CARE
A plan built around you.
Talk with Dr. Zahra Fatima, DPT. Understand your next steps, with guidance for your own symptoms and daily routine.
Talk it through
Discuss your symptoms, what you find difficult and what you want to get back to.
Understand your next steps
Use the consultation to discuss which care and exercises fit your situation.
Take your plan with you
Your online consultation includes a written plan you can refer to afterwards.
Questions people ask
When can I start exercising after delivery?
Is my back pain because of the epidural?
Why do I leak urine when I cough?
What is the gap in my stomach muscles?
Is this the same as back pain in pregnancy?
Related conditions
- Pelvic floor weakness and exercises
- Back pain in pregnancy
- Diastasis recti treatment
- Lower back pain in women
- Recovery after a C-section