Postpartum Back Pain: Why It Sometimes Lingers

You'd be forgiven for assuming the back pain ends with the pregnancy. The bump is gone, the weight has shifted, and yet — six weeks in, eight weeks in, sometimes still at six months — the lower back hasn't quite forgiven you. There are real reasons, and most of them are addressable.

Why Postpartum Back Pain Outlasts Pregnancy

Four things are usually at play. First, relaxin lingers — the hormone that loosened your ligaments during pregnancy doesn't disappear at birth; it remains elevated for about five months, longer if you're breastfeeding. Your joints are still more mobile than they were pre-pregnancy. Second, your abdominal muscles need to be re-engaged — they were stretched, often separated (diastasis recti), and don't simply snap back. Without core engagement, the lumbar spine bears load it shouldn't. Third, sleep deprivation delays recovery; tissue repair happens during deep sleep, which is in short supply with a newborn. Fourth, and most underestimated: there are new repetitive postures that didn't exist before — feeding, lifting, carrying, settling — and they tend to be one-sided and held for hours.

The Specific Postures That Don't Help

• Hunched feeding — looking down at the baby for 30 to 60 minutes at a stretch, multiple times a day. Cumulative neck and upper-back strain.
• Always carrying baby on the same hip — usually the non-dominant side, which sets up an asymmetric pelvic tilt and lumbar shift. Eight months of this and the spine adapts.
• Lifting a car seat from awkward angles — reaching across the back seat, twisting, lifting at arm's length. The car seat alone weighs 4 to 5 kg before the baby's in it.
• Stooping over change tables — tables set too low force the spine into flexion several times a day. Multiply by every nappy change.

What You Can Change in the First Six Months

1. Nurse with pillow support — bring the baby to the breast, not the breast to the baby. A nursing pillow lifts the baby to the right height and lets your shoulders drop.
2. Alternate sides for everything — feeding, carrying, hip-balancing. If the baby is always on your left hip, your spine knows.
3. Use a deadlift-style baby pickup — feet wider than hips, hinge at the hips, keep the back flat, lift with your legs. Sounds like overkill; isn't.
4. Use a posture-friendly carrier — one that distributes weight across both shoulders and the hips, with the baby high enough to kiss. Skip the lower-slung carriers that pull on your lumbar spine.
5. Re-engage the core gently from week 6 onwards if cleared — pelvic tilts, transverse abdominis breathing, gentle bridging. No crunches until diastasis is checked. A pelvic-floor physiotherapist is the gold standard for this assessment.

When It's Worth Getting Checked

If postpartum back pain has hung around past 8 to 12 weeks, or if it's getting worse rather than better, the pelvis may not have returned to its pre-pregnancy alignment. That's not unusual — five months of relaxin and asymmetric load is a lot for a pelvis to self-correct from. A Gonstead postnatal assessment is gentle, uses postnatal-appropriate force, and identifies whether the SI joints, sacrum, or lumbar spine are the source. Addressing it early is significantly easier than addressing it five years later, when compensations have set in. Our pregnancy and postnatal care page covers the postnatal side, and our back pain page explains the structural component.

We see new mothers regularly across Sunway Geo, Sri Petaling, and Kota Damansara. WhatsApp the branch closest to you and bring the baby — they're welcome.