Back pain after childbirth: What to do?

lumbago and back pain stiffness

Throughout the pregnancy, women's bodies are put to the test. The majority of them think that all the inconveniences linked to this delicate period will disappear directly after childbirth… Alas, this is very rarely the case!

Indeed, during a pregnancy, the maternal organism needs time to recover and gradually return to its initial state.

For many women, this recovery period can be disrupted by the onset or worsening of back pain.

 

So what are the causes of this back pain after childbirth ? What to do to relieve it effectively? These are the questions we will answer in this article.

Back Pain After Childbirth: Possible Causes

The pregnancy-related back pain can have the same causes as any other back pain, as well as causes more specific to this physiological condition.

In the following section, we will list the mechanisms behind the appearance of back pain in pregnant women. Because in the majority of cases, the back pain after childbirth is only a persistence of pain developed during pregnancy.

Loosening of ligaments

During pregnancy, especially during the few weeks before delivery, a hormone called « relaxin » is secreted by the ovaries, breast tissue and placenta.

This hormone causes a ligament loosening in order to increase flexibility and facilitate movement of the pelvis during childbirth (increased pelvic mobility).

Recent studies have shown that pregnant women with back pain have a increased pelvic mobility.

This increase in mobility could therefore contribute to the appearance of lower back and pelvic pain during pregnancy and in the peripartum (period surrounding childbirth).

The increase in weight

Throughout pregnancy, the weight of the baby and its appendages (mainly the placenta and amniotic fluid) increases and leads to a postural disorder in the mother-to-be due to the displacement of her center of gravity forwards, which can induce a composite lumbar hyperlordosis.

 

Hyperlordosis is a spinal deformity characterized by accentuation of lumbar lordosis (exaggeration of the natural lumbar arch).

This compensatory lumbar hyperlordosis during pregnancy promotes tensions muscle and the phenomena ofvertebral osteoarthritis, which results in lower back pain that may persist for several months after childbirth.

 

Insufficiency of abdominal muscles

The muscles of the abdomen play an important role in maintaining the structures of the lower spine.

During pregnancy, distention and weakening of the abdominal strap increase stress on the back, particularly in the lumbar region. This greatly contributes to the development of lower back pain in pregnant women.

This abdominal insufficiency persists for a few weeks/months after childbirth, even going as far as abdominal diastasis. The pain could gradually decrease with the strengthening of the abdominal strap.

Now we move on to the causes of back pain specific to childbirth and after childbirth:

 

Mode of delivery

Studies show that severe lumbo-pelvic pain observed within six months of childbirth was more common in women who gave birth Caesarean (high way).

These lumbar and pelvic pains are probably exacerbated by the surgical scar from the cesarean section. Indeed, the weakening of the abdominal wall interferes with the distribution of mechanical stresses in the spine.

To compensate for abdominal insufficiency, the lower spine is particularly stressed. Results : vicious attitudes et painful muscle tension.

 

Displacement of the sacrum and/or coccyx

During vaginal delivery (normal delivery), the sacred and pedal coccygeal have to step aside to let the baby pass.

After birth, they may remain stuck in this posterior position. This results in a tensioning of ligaments and muscles attached to it, which can limit movement of the pelvis and lead to pain in the lower back.

The epidural in question?

Early studies have suggested that obstetric analgesia, primarily the epidural, could be the cause of an increase in the frequency of low back pain after childbirth.

According to these studies, vaginal delivery without pain would promote brutal and traumatic movements during the expulsion of the baby.

But recent studies, of much better quality, have shown thatthere was no link between epidural analgesia during childbirth and prolonged postpartum low back pain.

 

This information must be provided to all women wishing to benefit from a painless childbirth so that they can decide calmly and in full knowledge of the circumstances of their childbirth.

Carrying the baby

Often, back pain is secondary to bad postures when the mother carries her baby, especially when she gives him the breast or his bottle.

Indeed, the relaxation of the abdominal muscles and the fear of traumatizing the baby (dropping it, hurting it, etc.) are a source of twitching de wrong position: tensioning of the shoulders and upper limbs, hunched back, increased stress on the back… All these positions promote pain throughout the back.

Psychological origin

In some cases, factors psychological play a major role in causing or worsening back pain after childbirth.

Among the situations that are sources of psychological suffering during pregnancy, we can cite:

  • Poor socio-economic conditions,
  • Fear of failing as a parent,
  • Difficult family background...

How to relieve back pain after childbirth?

After childbirth, the woman's body gradually returns to its original state. the back pain should gradually subside grace :

  • When relaxin levels decrease, the ligaments and other connective tissues regain their tone.
  • Weight loss following the evacuation of amniotic fluid and the expulsion of the placenta and the baby, thus reducing stress on the various structures of the back.
  • Gradual recovery of the tone of the abdominal muscles.

In addition, for relieve back pain after childbirth, many solutions exist:

Abdominal rehabilitation

During the postnatal medical visit, the doctor can prescribe to the woman sessions of re-education abdominal et perineal (the first 10 sessions are fully reimbursed by social security).

La re-education abdominal should only be started after having stabilized the perineal region, i.e. 6 to 8 weeks after childbirth (much earlier thanks to the rehabilitation of the perineum).

It aims to strengthen the abdominal muscles for (among others) relieve the back, and this, thanks to gentle and adapted exercises: abdominal breathing exercises, massages... The woman will be able, after a few sessions, to perform classic abdominal strengthening exercises, both in the physiotherapist than at home.

Improved posture

To reduce back pain after childbirth, it is important to maintain a correct posture in all circumstances. Especially when carrying the baby for a long time.

Here are some adjustments to make when carrying your baby:

  • Use a baby carrier (dorsal or ventral) and keep your baby always in contact with your body, as close as possible to your center of gravity, in order to distribute his weight evenly on your spine.
  • Avoid twisting movements of the spine. When you want to turn to pick up your baby, turn your whole body.
  • Avoid bending your back when lifting your baby. Bend your knees while keeping your back straight, contracting your abdominal muscles and squeezing your glutes.
  • Adjust the height of the stroller cuffs to avoid bending over when taking your baby out.
  • Make yourself comfortable and support your lower back with a pillow when breastfeeding your baby.

Osteopathy sessions

The osteopath could help unblock the pelvic bones (the sacrum and the coccyx remained in posterior position following childbirth) and relieve lower back pain.

For more solutions against back pain, do not hesitate to consult our article: relieve back pain.

References

[1] V. Charlier, G. Brichant, P.-Y. Dewandre, J.-M. Foidart, and J.-F. Brichant, “Obstetric epidural analgesia and postpartum low back pain: a causal link? », Medical Review of Liège, flight. 67, no 1, Jan. 2012, Accessed: June 2, 2022. [Online]. Available at: https://orbi.uliege.be/handle/2268/112672

[2] V. Foltz and S. Rozenberg, “Lumbago and pregnancy”, Journal of Rheumatism Monographs, flight. 88, no 1, p. 34-40, 2021.

[3] C. Rempp, "Lumbago and lumbosciatalgia in pregnant women: about 150 cases", ACUPUNCTURE AND MOXIBUSTION, flight. 4, no 4, p. 298, 2005.

[4] M. Batonat, “Small ailments of pregnancy: study of low back pain”, 2010.

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