Postpartum back pain: why your back hurts after having a baby and what actually helps

Why does my back hurt after having a baby?

Nobody warns you about how much your back ends up doing after you’ve had your baby. By the end of the day, it has worked through the feed that went much longer than expected, the awkward lift from the floor, the car seat carried out at arm’s length and the endless bending over the change table, all while you’re still healing from pregnancy and birth.

A position that used to feel fine can become painful when you’re in it several times a day. Maybe it’s leaning over the crib to put the baby down and feeling a catch across your low back. Or finishing a feed with one shoulder hitched up and an ache spreading through the back of your pelvis, because that was the only position that got your baby to settle.

It makes sense to think that this is just part of recovery. There is already so much to keep track of, and you may have heard that everything will feel better with more sleep, a stronger core, better posture or once you’re done breastfeeding. Sometimes the pain does ease as the demands of the day shift. But when it keeps affecting how you feed, carry, walk or settle into bed, it deserves a closer look, not another reason to wait it out.

Postpartum back pain is often less about one specific problem and more about how much your body is being asked to manage each day. Pregnancy, birth and caring for a baby can change how your spine, pelvis, abdominal wall and pelvic floor share the load. Once we understand where that extra strain is coming from, we can work out what needs extra support and gradually help you feel more comfortable moving through your day.

Is postpartum back pain normal, and how long does it usually last?

Back and pelvic pain during pregnancy is remarkably common, and it doesn’t always disappear once the baby is born. Research suggests that around 45 percent of pregnancies involve low back pain, pelvic girdle pain or both – this is by far the most common thing we see in our clinics at Oona. For roughly one in four people, that pain continues after birth, while about 7 percent describe it as serious. More recent research found pelvic girdle pain in 27 percent of participants at 14 weeks postpartum, which is right around the time that many people are starting to wonder why they aren’t fully recovered from pregnancy and birth.

For some, things gradually improve over the first three to six months postpartum as the body recovers and strength returns. However, pain that remains unchanged, keeps interrupting daily life or continues to make movement or rest difficult deserves more than reassurance that it will eventually pass. Research has found that some people continue to experience pelvic girdle pain years after pregnancy. Remember: just because something is common doesn’t mean it’s normal.

Pay attention to the way things are moving. Postpartum recovery is rarely a straight line. We expect you to feel better with time, but it can definitely be a bit of a moving target. A plateau in your recovery, increasing difficulty with feeding or carrying, or pain that is still present around six weeks postpartum without a proper assessment is a good reason to ask for help. There is truly no need to wait until it becomes unbearable before bringing it up.

Low back pain and pelvic girdle pain are not the same thing

This is probably the single most useful thing to understand, because the two are treated quite differently and they’re constantly lumped together as “back pain.”

The explanations you have probably been given, and what the research actually says

There are so many possible reasons that you might be suffering from postpartum back pain. However, the actual reason for it is usually more nuanced than you might have been led to believe. “It must be relaxin.” Relaxin is often blamed for making the joints unstable, along with the advice to wait until the hormone has cleared before expecting things to feel better. Hormonal changes do affect the body, but research has not found a consistent relationship between relaxin levels and pregnancy-related pelvic girdle pain. Waiting for a hormone to disappear also doesn’t explain why some people recover comfortably while others continue to struggle.

“My abdominal separation is causing my back pain.” Diastasis recti is common after pregnancy and often improves over time. One study found a widening in the linea alba in 60 percent of participants at six weeks postpartum, 45 percent at six months and 33 percent at one year. The same research found no difference in low back or pelvic pain between those with and without a separation. A gap may be part of the picture, but its width doesn’t tell us how well your body is managing movement and load. Breathing, abdominal wall function and pelvic floor coordination are usually considerably more useful, diagnostically.

“The epidural caused this.” If you had an epidural and you have lasting back pain, it does sound reasonable to wonder if the epidural may have caused it. However, research comparing people who had an epidural with those who didn’t found no difference in long-term back pain, disability or movement restriction.

“A caesarean must be why my back hurts.” In the early weeks after a caesarean birth, your abdominal wall and surrounding tissues (your core muscles) are recovering, which can certainly contribute to back pain. However, we don’t have fabulous data on whether this actually contributes to longer-term back pain. We recommend assessing your scar, abdominal wall, breathing and overall movement patterns instead.

“I am only noticing it because I am exhausted.” Sleep loss can make pain feel more intense. Broken nights affect how the nervous system responds to the demands of your daily life. Sleep may change how much the pain bothers you, but it definitely doesn’t mean you have to ignore it.

The everyday loads that keep your back irritated

Most patients aren’t able to pinpoint a single specific event that caused their postpartum back pain. More often, the pain builds through the day-to-day activities involved in caring for a baby. These activities are repeated so many times throughout the day that the body doesn’t get any recovery time between one activity and the next.

Feeding can be part of it. You may notice that a position felt totally fine during an earlier feed but suddenly it’s uncomfortable after hours spent sitting with the head forward, the shoulders rounded and the low back unsupported. Carrying your baby on one hip can also contribute to your back pain, especially since most of us tend to favour one side over the other, and we need that other free hand to get things done. Lifting and carrying a car seat can certainly also contribute.

Add the crib, the change table, the floor, the stroller and the toddler who suddenly needs to be picked up, and it becomes easier to understand why the back is struggling. None of these things are things you shouldn’t be doing – they’re definitely a part of being a new parent and completely unavoidable. We all need to do these things just to get through the day! They’re just things that all have to happen at a time when your body is still healing, and that’s what makes them tricky.

Feeding and breastfeeding posture

There is no perfect feeding position; we all have to choose the position that works best for us and our babies. Adding a bit of back support can definitely make it a bit easier on your back. Bringing the baby toward you instead of hunching forward (the dreaded “feeding hunchback”), putting a pillow behind your back, making sure your elbows are resting on something, and supporting the baby’s weight with more pillows can reduce how much work your shoulders and spine are doing.

A position doesn’t have to feel painful before you switch it up. Moving between a few comfortable positions, making sure to shift your weight from time to time, and noticing whether you’re hunching over your baby for an entire feed can all help reduce the strain that will inevitably build up over time.

Carrying on one side

Most people have a preferred side for carrying their baby. It’s usually the side that feels familiar, the one that leaves a hand available for you to use to do something else, and often the one the baby settles against most easily. Carrying your baby that way definitely isn’t wrong. Staying in one position for an extended period may just ask one side of your body to do too much work. Switching sides from time to time, using a carrier if it feels comfortable and putting the baby down before your back screams at you can definitely help. A carrier isn’t automatically the better option, just as carrying your baby in your arms isn’t automatically a problem. What matters most is finding a way to carry your baby that doesn’t hurt over time.

The car seat and the change table

Car seats are difficult objects to lift. They’re heavy, awkward, and usually picked up from a low position, often with the arm held away from the body. This is honestly a bit of a recipe for pain. Try bringing the seat closer before lifting, turning with your feet instead of twisting through the low back, and setting it down on a raised surface whenever you safely can.

Change tables are their own beast. Leaning forward for a minute or two at a time may not feel like much, but given how many times you do this throughout the day, it’s a bit of a repeated assault on your back. Keep your changing table supplies close by, adjusting the height of the table to suit you if you can, and do your best to move out of a hunching position before you feel pain. These changes aren’t necessarily a cure-all, but they can make daily life more manageable while you work out what kind of support would be most useful.

What postpartum back pain can feel like

“Back pain” can mean an ache across the lumbar spine, a sharp catch when standing up, a pulling sensation on one side or discomfort around the back of the pelvis. Pain may travel into the buttock or thigh, become worse after sitting or increase with walking. Rolling in bed, climbing stairs, standing on one leg or lifting the baby from the floor can point to a pattern that isn’t as obvious at rest.

That pattern helps guide an assessment. Pain that settles when you change position may need a different approach from pain that appears whenever one leg takes more of the load. Pressure, heaviness, leaking, constipation, or pain during sex are also relevant, since they may indicate that the pelvic floor and abdominal wall should be part of the conversation.

A one-size-fits-all postpartum core exercise routine can’t account for those differences. An exercise that feels appropriate for one person may be too much for another, or simply aimed at the wrong thing. Understanding what brings on the pain is a better place to begin than choosing an exercise because it happens to be labelled postpartum.

What about diastasis recti, pelvic floor weakness and posture?

“Your core is weak” is rarely a complete, or even a useful, explanation.

Abdominal widening, or diastasis recti, is a normal and expected change during pregnancy and remains present in many people after birth. The size of the gap doesn’t tell us how much pain someone will have or how well they’ll move. One person may have a noticeable widening without any back pain, while another may have significant pain or discomfort because the abdominal wall, breathing muscles and pelvic floor are not yet sharing load comfortably.

Pelvic floor function is also about more than bladder and bowel control. Along with the diaphragm, abdominal wall and spine, it helps manage pressure when you lift, cough, carry, breathe and move. That doesn’t mean every person with postpartum back pain needs pelvic floor physiotherapy, or that weakness is always the issue. It does mean an assessment may be useful when back pain appears alongside heaviness, leaking, difficulty emptying the bladder or bowel, or pain with sex.

When it comes to posture, holding yourself rigidly upright all day isn’t necessary, and there isn’t a single position responsible for postpartum back pain. More often, feeding and caring for a baby leave very little opportunity to move out of one position. The goal should be to find more comfortable ways to get through your day, rather than a single posture rule for you to follow all the time.

How an assessment should help

A good assessment should leave you with a clearer explanation, not a longer list of things to worry about. Your practitioner may ask when the pain began, whether it changed after birth, what happens when you walk or turn over in bed, what positions you’re feeding and carrying in, and whether there are related concerns involving your pelvic floor. They may look at your breathing, abdominal wall, hip and spine movement, single-leg loading and the movements you actually find difficult at home.

We’re not looking to lay the blame on a single muscle or activity here. The goal is to understand how the different parts of your body are sharing the work and what your current capacity is. From there, care might include education, hands-on treatment, changes to a few daily positions, pelvic floor or whole body strengthening, and a plan for increasing activity without making the next day worse.

You should also be able to ask questions. What do you think is contributing to this? What should I keep doing? What should I change for now? How will we know whether the plan is helping? Those are reasonable questions at any stage of postpartum recovery, whether your baby is six weeks old or two years old.

Can postpartum back pain be treated if it has been there for months or years?

Pain that has been there for months or even years is still worth having assessed. A longer history of pain doesn’t mean you have missed your chance, and it also doesn’t mean that nothing can be done because you’ve “waited too long.” Waiting too long isn’t a thing. Over time, people often start avoiding certain movements, working around the discomfort or taking on more as their baby grows, without realising how much those changes have shaped the way they move.

Care may need to begin gradually, with a proper look at what has been happening and a few changes that make daily life easier. From there, strength and activity can build at a pace your body can manage. If your pain has continued long after birth, our guide to postpartum pain that continues long after birth explores what may be contributing and where to begin.

How the different Oona services may fit together

There is no single right place to begin when postpartum back pain is part of a larger recovery. What matters is what you’re feeling, which movements are difficult and whether anything else has changed since pregnancy or birth.

Pelvic floor physiotherapy may make sense when back or pelvic pain comes with heaviness, leaking, constipation, painful sex or difficulty returning to activity. Chiropractic care can be helpful when a particular area feels stiff, restricted or difficult to move. Osteopathic care offers another whole-body approach, while massage therapy may help with the muscular tension that builds through feeding, carrying and sleeping in whatever position is available.

Other parts of recovery can matter too. Low energy, poor sleep, nutrition, iron levels and mood can all affect how much physical strain feels manageable. Naturopathic care and mental health support can sit alongside physical treatment when those concerns are part of the picture. Following a caesarean birth, postpartum scar care or Dolphin Neurostim scar treatment may also be worth discussing.

None of this means you need to book several appointments at once. A conversation with us should give you enough room to understand what is connected and help you decide where to begin.

What actually helps postpartum back pain

Treatment works best when it reflects your actual day rather than an idealised version of postpartum recovery. Your practitioner should consider how you’re feeding, carrying, lifting and moving, along with what your back or pelvis can comfortably manage at this stage.

Progressive strengthening. Research supports stabilising exercise for reducing postpartum pain and disability in the short term. Earlier research also found lasting benefits from individually tailored programmes for pelvic girdle pain. No single exercise is right for everyone. A useful program begins at the level your body can manage and changes as your strength and tolerance improve.

An assessment that includes your pelvic floor. The pelvic floor, diaphragm, abdominal wall and spine work together when you breathe, lift and carry. Pelvic floor physiotherapy may be particularly useful when back pain appears alongside heaviness, leaking, constipation or pain during sex. If pressure or heaviness is part of your experience, our guide to pelvic organ prolapse after birth may also be helpful.

Hands-on care. Postpartum chiropractic care and osteopathic care may help when an area feels stiff, sore or guarded. Hands-on treatment can make movement more comfortable, but it’s usually most useful when it forms part of a broader plan that includes rebuilding strength and changing the loads that keep aggravating the area.

Massage therapy. Evidence for massage in this specific population is less developed than the evidence for exercise. Many people still find registered massage therapy helpful for the neck, shoulders and upper back, particularly when feeding and carrying have created a constant muscular load.

Small changes to daily movements. Bringing the baby closer before lifting, supporting your arms during a feed, changing carrying sides, keeping change table supplies within reach and turning your whole body instead of twisting through the low back can all make the day easier. Small adjustments are not a replacement for assessment, but they may reduce how much pain you’re experiencing between appointments.

Support for recovery as a whole. Pain is harder to manage when sleep, energy, mood or nutrition are already stretched. Naturopathic care and mental health support may be useful alongside physical care, while postpartum scar treatment may be relevant after a caesarean birth.

When back pain after birth needs urgent attention

Most postpartum back pain can be assessed safely in a clinic, but certain changes need prompt medical attention.

Seek urgent care if back pain comes with a fever of 38 degrees Celsius or higher, new weakness or numbness in a leg, loss of bladder or bowel control, numbness around the saddle area, or severe swelling, redness or pain in a calf or thigh. A severe headache that doesn’t settle after an epidural or spinal also needs medical attention.

Sudden, severe back pain with very little provocation, particularly alongside a loss of height, should be assessed promptly as well. These concerns are uncommon, but they belong with a doctor or emergency department before a routine treatment appointment.

Where to start if your back has been hurting for a while

Pain that has continued for months deserves attention, even if you have become used to working around it. A proper assessment can help distinguish between pain coming mainly from the lumbar spine, the pelvic girdle, the pelvic floor, the way a load is being shared or a combination of several factors.

You can book directly with an Oona practitioner and no referral is needed. If you’re unsure where to begin, the free Care Navigator call can help you choose a first appointment. Oona has clinics in Toronto, Newmarket and Meadowvale, and babies are welcome at appointments. Direct insurance billing is also available where applicable.

For pain that has continued long after birth, read our guide to postpartum pain that doesn’t go away. You can also explore our broader guide to postpartum care at Oona. If you’re still pregnant, pregnancy chiropractic care and our guide to pregnancy sciatica may be more relevant. Pain from repeated feeding and carrying can also show up as postpartum wrist pain, so mention that during your assessment too.

Frequently asked questions about postpartum back pain

You do not have to wait until it gets worse

Back pain can start to feel like part of everything after a baby arrives: feeding, lifting, carrying, walking, getting comfortable in bed and trying to make it through the day. That doesn’t mean you’re expected to accept it as part of being a parent.

When pain keeps returning or begins to change what you do, an assessment can help make sense of it. You may need support for your back, your pelvis, your pelvic floor or the way your body is managing the physical demands of the day.

There is no need to wait until life becomes easier, sleep improves or your baby needs to be carried less. You can ask for help while recovery is still happening and while you’re still in the middle of it.