Postnatal Back Pain: Causes and Physiotherapy Treatment

Why the back struggles after birth

The abdominal muscles have been stretched for months and take time to regain strength. The pelvic floor may be weakened. Ligaments remain softer for some time after birth. And then the daily tasks begin: lifting the baby dozens of times a day, feeding in awkward positions, bending over cots and changing tables, carrying car seats and pushing prams.

Add broken sleep, and the back has little chance to recover.

Common aggravating habits

Feeding posture. Hunching forward for long feeds strains the neck and upper back. Bringing the baby up to you with pillows, rather than bending down to the baby, makes a big difference.

Lifting from low surfaces. Bending from the waist to lift the baby from a low cot or floor strains the lower back. Squat or kneel instead.

Carrying on one hip. Shifting weight to one side for long periods strains the back and pelvis. Alternate sides or use a well-fitted carrier.

Car seats. Car seats are heavy and awkward. Keep them close to your body when lifting.

How physiotherapy helps

Assessment identifies the source of pain, checks for abdominal separation and pelvic floor problems, and looks at daily habits. Treatment usually includes:

• gentle hands-on treatment for muscle tension and stiffness
• progressive core and pelvic floor rehabilitation
• back strengthening
• advice on feeding, lifting and carrying positions

Our article on postpartum core rehabilitation covers the core side in more detail.

Simple exercises to start

Pelvic tilts, cat cow and gentle glute bridges are usually safe early on, progressing to more challenging core work. Our back exercises section has step-by-step guides.

Feeding positions that protect the back

Feeding a newborn can take many hours a day, and posture during feeds has a big effect on back and neck pain. Bringing the baby up to you, rather than leaning down, is the key principle.

Use pillows to support the baby at breast or bottle height. Sit in a chair with good back support, with feet flat on the floor or on a small stool. Support your arms with pillows or armrests so shoulders can relax.

Side-lying feeding can be a comfortable option, especially at night. Change positions between feeds when possible, and roll the shoulders and stretch the neck gently afterwards.

When to get checked

Back pain that's severe, getting worse, or accompanied by numbness, leg weakness, fever, or bladder and bowel changes needs prompt medical review.

For most women, postnatal back pain improves well with the right exercise and some changes to daily habits. If it's limiting you, our postnatal physiotherapy team can help.