Postpartum Low Back Pain and Postpartum Pelvic Pain

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How Pregnancy Causes Lower Back And Pelvic Pain

While you’re pregnant, your pelvis supports a lot of extra weight. It also becomes more flexible. The hormones produced during pregnancy help the joints and ligaments become more mobile. A movable pelvis helps your baby navigate its way out of the birth canal. It can also throw off your spinal alignment, leading to low back pain and postpartum pelvic pain.

The Structure Of Your Lower Back And Pelvis

The hip bones, pubic bone and sacrum form the pelvic structure. At the base of the sacrum is your tailbone. The top of your sacrum transitions into your spine. All of these bones work together to help you move.

The muscles that surround this area provide added support. Your abdominal muscles normally work to stabilize the spine, but they become weaker during pregnancy. All women experience physical changes to the pelvis and lower back during pregnancy. They do not all have pain, however.

After the baby is born, your muscles and ligaments harden again. At this point, some women who have not had problems begin to feel pain.

Symptoms Of Lower Back And Pelvic Pain

As the body changes during pregnancy, your posture adapts. You hold your weight on your heels instead of the center of your feet, you may hyperextend your knees and more pressure is put on the joints in the lower back and sacrum.

After birth, women may experience pain:

  • In the front of the pelvis
  • In the sacroiliac joint
  • In the buttocks
  • During intercourse
  • In the thighs

If the muscles or ligaments around the pelvic area have been damaged, incontinence may be a problem.

How To Diagnose Lower Back And Pelvic Problems After Childbirth

A healthcare professional that specializes in postpartum physical therapy can help you determine the cause of your pelvic pain. An examination can help the medical professional determine whether your pain is caused by hormones, nerve damage, bone damage, postural adaptations or adhesions in the muscles and ligaments.

At NYDNRehab we are proficient at special methods of diagnostic ultrasonography (RUSI) for pelvic pain, diastasis recti and postpartum core dysfunction.


How Likely Are You To Experience Postpartum Pelvic Or Back Pain?

Researchers have found that up to 56 percent of mothers experience pain in their backs while pregnant. Other research confirms that about half of women have lingering back pain after they give birth.

What Can Make Your Pelvic Problems Worse?

Some females experience more severe back and pelvic pain than others. One study reported that mothers who have been physically active for more years before they become pregnant are less likely to experience lower back and pelvic pain.

Other factors that make you more likely to have back pain after pregnancy are:

  • A history of discomfort in the back
  • Younger age at conception
  • Short stature
  • Elevated maternal weight

Some things that have not been found to increase the risk of postpartum back pain are:

  • The placement of the epidural
  • The baby’s weight
  • The method of delivery
  • The length of the pushing stage

How Can You Treat Postpartum Low Back Pain And Pelvic Pain?

Many women become more physically active after childbirth in an attempt to alleviate postpartum pelvic pain. However, doing the right kinds of exercises is important for reducing pain.

To help stabilize the pelvis, avoid doing activities that require you to put weight on only one side of your body. Distribute your weight uniformly while you’re standing. Focus on standing on both feet without shifting your hips.

When you’re holding the baby, you might be tempted to extend one hip for added support. Wearing the baby in a carrier that spreads out the baby’s weight evenly can prevent this from happening. If you do wear your infant in a carrier, ensure that the baby’s head is close to yours. If you wear the baby too low, you may aggravate your pain.

It may also help to take shorter strides when you’re walking. Avoid running and jumping while you’re in pain.

Repeating the same motions can intensify the condition. If you’re constantly stooping and twisting to take care of your baby, consider taking changes to make your movements less stressful on the body. When you’re turning in bed, keep your legs together and engage your core.

Wear a sacroiliac belt to support the pelvic area throughout the day. If you do not own one, you may simply tie a scarf around your hips and pelvis. This will stabilize the joints, providing a better foundation for your spine.

Can You Prevent Lower Back Pain After Childbirth?

You can try to prevent Postpartum low back pain and pelvic pain, but your attempts may not always work. Maintaining proper posture throughout the day can help. Remaining moderately physically active throughout your pregnancy is also beneficial. After your postpartum recovery period, pelvic floor physical therapy can be beneficial to restore your pelvic muscle tone.

Yoga has helped many women prevent or manage pain caused by pregnancy or childbirth. Practicing prenatal yoga can help stretch the muscles and ligaments that will be affected during labor. After birth, yoga can help your body realign as the hormones become balanced again.

Research at NYDNRehab

Conference: the 12th World Congress of the International Society of Physical and Rehabilitation Medicine (ISPRM 2018) At: Paris, France

In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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