Back pain after C-section: causes, tips, and exercises to feel better

Back pain after a C-section delivery? While it’s common to have back pain during pregnancy, many people are surprised when it lingers after giving birth by cesarean. Physical changes from pregnancy and recovery from major abdominal surgery can both put extra strain on your back, which can lead to pain that lasts after delivery.

Back pain after C-section is common — research shows that 70% of women who give birth via cesarean experience back pain. But just because it’s common doesn’t mean you have to put up with it. There are many things you can do to ease your back pain and start feeling better. 

Here, learn more about what causes back pain after C-section, and how to prevent and treat it — especially with some gentle and safe exercises from Hinge Health physical therapists.

Is back pain normal after C-section? 7 possible causes

During pregnancy, your body changes in ways that can contribute to lower back pain. While these changes are normal, the effects don’t go away right after you give birth. You may also experience upper back pain in the weeks following delivery.

Common causes of back pain after C-section include:

1. Hormone changes during pregnancy. Pregnancy hormones help loosen supportive ligaments in your lower back and pelvis (the sacroiliac joints) to prepare for birth. These changes are normal, but they can strain the muscles and joints in your back and cause pain.

2. Weaker abdominal muscles. Your abdominal muscles stretch, lengthen, and sometimes even separate (a condition called diastasis recti) to make room for your expanding uterus during pregnancy. This reduces support for your pelvis and spine, which can lead to back and pelvic pain.

3. Shifts in posture. As your baby grows, your center of gravity shifts forward. This can lead to subtle changes in posture that increase stress on your back during pregnancy. It can take time to shift back to your pre-pregnant posture after delivery.

4. Recovery from surgery. A C-section is major surgery that requires incisions in your abdomen and uterus. It’s normal for your abdominal muscles to need time to recover, and this can sometimes put a little extra strain on your back, says Holly Tipp, PT, DPT, a Hinge Health physical therapist. Mild discomfort and tightness near your incision are also common as your body heals, notes Dr. Tipp. During this recovery period, you might shift your posture or avoid certain movements, which can affect your hips and back and sometimes lead to lower back pain, she explains.

5. Stress. Adjusting to parenthood can be exhausting and stressful. This can lead to tension in your back muscles, contributing to pain and muscle spasms.

6. Newborn care. Caring for a newborn is physically demanding: lifting and carrying your baby, bending for diaper changes and baths, carrying car seats, and leaning over when you breastfeed or bottle feed. All these activities can put extra strain on your back and neck.

7. Pre-existing back pain. If you had back pain before pregnancy, you might be at higher risk during and after pregnancy.

“You might notice it’s harder to stand up fully straight in the early days after a C-section — tightness along your incision can make you feel hunched over,” says Dr. Tipp. “Leaning forward or compensating for this tightness can put extra strain on your lower back and hip flexors, which may worsen back pain. In some cases, scar tightness can also affect your pelvic floor muscles, which may play role in lower back pain symptoms, adds Dr. Tipp.  back discomfort after surgery.”

Some people wonder if having an epidural during childbirth can cause back pain after a C-section. The research isn’t clear, and different studies show different results. Most experts agree that back pain after a C-section is common, but it’s still uncertain whether epidural anesthesia plays a role. People who have epidurals with vaginal births may have similar questions, and it’s still not clear if epidurals contribute to back pain.

What about back spasms after C-section?

A back spasm is a sudden tightening or cramping of the muscles in your back. It can feel like a sharp pain or a strong, uncontrollable muscle contraction, and it may make it hard to move your back or find a comfortable position. Back spasms can happen after a C-section for many of the same reasons as general back pain, such as changes in posture or muscle strain. Gentle movement and physical activity can help with both back pain and back spasms. 

When to see a doctor 

Back pain after C-section is usually not a sign of a serious condition. But there are some situations when you should see a provider. Talk to your doctor if your back pain is severe, interferes with your daily activities, or:

• Starts abruptly

• Worsens or does not improve with gentle stretching or rest

• Occurs with numbness or tingling in your lower body

• Occurs with changes to normal bladder or bowel function

Exercise and physical therapy for back pain after C-section

After a C-section, you’ll likely have movement limitations as your body heals from surgery. Many people are advised to avoid strenuous exercise or heavy lifting for several weeks, until their healthcare provider gives them clearance to resume activity. (Always check with your provider before beginning or restarting exercise after C-section.)

Still, gentle movement is important for recovery and can help ease back pain after a C-section. Walking, in particular, is often recommended as a safe and effective way to promote healing and reduce discomfort, as long as you feel up to it and have your provider’s approval. Once your provider clears you for more strenuous exercise, you can begin to gradually ease into other physical activities — such as core strengthening or low-impact aerobic exercises — that may further help relieve back pain and build strength.

Your back pain may improve over time as you recover from surgery and pregnancy-related changes. But if it lingers, makes everyday activities or caring for your baby difficult, and your doctor has cleared you for activity, consider seeing a physical therapist (PT). 

Physical therapy can help address postural changes through stretching, strengthening, and techniques to ease scar pain. Your physical therapist may recommend a set of gentle exercises that are safe after pregnancy and C-section, easy to do at home (even when you’re busy caring for a newborn), and designed to help reconnect your core and pelvic floor muscles, relieve tension, and rebuild strength. Together, these exercises can play a key role in managing back pain as you recover from surgery and adapt to new routines. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

Most providers recommend avoiding strenuous activity and not lifting anything heavier than your baby for the first 4–6 weeks after a C-section to protect your healing abdomen and incision. Avoid lifting from low surfaces for the first few weeks, and use extra caution after that point. When you do need to lift from low surfaces, bend your knees and keep your back straight to avoid straining your core or placing tension on the incision site. Ask for help with heavier or awkward objects, and talk to your healthcare provider if you have questions about lifting safely.

These exercises are designed to gently restore strength and flexibility to your core, back, and pelvic region. By improving muscle balance and mobility, they can help relieve back pain and support your recovery after a C-section. (Always check with your provider before beginning or restarting exercise after C-section.)

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

More ways to treat back pain after C-section

Back pain after C-section generally improves over time. But you can ease some of the discomfort by making small changes to your daily habits and modifying how you perform childcare activities.

• Engage your core when lifting your baby. Before lifting, gently tighten your stomach and back muscles. Breathe out as you lift and keep your baby close to your body. Try to stand in a way that reduces strain on your lower back, such as resting one foot on a stool or stepping one leg slightly forward, like a mini lunge, before picking up your baby from the crib.

• Use carrying devices. Carrying your baby in your arms can put extra weight on one side of your body, which may strain muscles and lead to pain or imbalances. Using a well-fitted baby carrier helps distribute your baby’s weight more evenly. Be cautious with slings, as they can sometimes cause uneven weight distribution — consider using them only for short periods, quick errands, or brief walks. For longer walks, choose a stroller that’s appropriate for your child’s age to reduce strain on your back. 

• Alternate feeding positions. Most newborns eat every two to three hours — that’s eight to 12 times per day. Uncomfortable feeding sessions can strain your back. Even if you’re in a back-friendly position, feeding your baby the same way every time can lead to tightness, achiness, and pain in your upper and lower back. Varying your position with each feeding session can help ease discomfort.

• Elevate diaper changes. Use a changing station at hip or waist height instead of changing diapers on the floor and leaning forward. Keep diapers, wipes, creams, and clothing within easy reach.

• Bathe your newborn in a countertop tub. Or use a kitchen sink to avoid bending over a bathroom tub. If you use a regular bathtub, try using a bath kneeler and elbow pads for extra support.

• Consider a car seat adapter for your stroller. An adapter securely attaches your car seat to a stroller frame so you can push your baby instead of carrying them. (It also lets you move your baby from the car to the stroller without disturbing them.)

• Prioritize sleep when you can. Getting good sleep with a new baby is challenging, but being sleep-deprived can actually make back pain feel worse. Try to rest when your baby naps, and give yourself permission to prioritize sleep whenever possible.

• Sleep with support pillows. If you’re a back sleeper, place a pillow under your knees. For side sleepers, position pillows between your knees and feet. Bed sharing (sleeping in the same bed with your infant) can cause poor positioning during sleep. The American Academy of Pediatrics advises against bed sharing for safety reasons. Return your baby to their own sleep space after you bring them into your bed for feeding or comforting.

• Consider over-the-counter pain medications. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for back pain. If you are breastfeeding, have a medical condition or take other medications, check with your provider to make sure these OTC options are ‌safe to take.

• Make time for self-care. Self-care might not seem realistic when you're adjusting to the ups and downs of newborn parenthood. But try to focus on small things that make your back feel better and are doable for your schedule. It could be a short warm bath (get clearance from your ob-gyn first), using a heating pad or massage gun, or doing a short stretching session.

PT tip: Massage your C-section scar

“Your C-section scar can become sensitive and painful, especially if you avoid touching it,” says Holly Tipp, PT, DPT, a Hinge Health physical therapist. But there are techniques you can use — including scar massage and desensitization therapy — to help it feel better. “Taking steps to address scar pain and sensitivity can help as you rebuild the connection between your core muscles, pelvic floor, and back muscles to improve your stability and improve your back pain.”

How Hinge Health can help you

If you have pelvic pain, bladder, bowel, or other pelvic symptoms that are affecting your quality of life, you can get the relief you've been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

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