Low back pain
Low back pain is the most common issue experienced by many new mothers, typically arising from the physical stresses of pregnancy, childbirth, and the postpartum period. This pain can affect lumbar spine joints as well as sacroiliac joints due to several exacerbating factors: body changes, hormonal fluctuations, childbirth recovery, and physical demands of child care. It is crucial to recognize these symptoms, find support and interventions, and educate yourself on proper body mechanics and postpartum exercises to alleviate pain and promote recovery.
Body changes
Women experience many changes in their body throughout pregnancy and postpartum. It is a slow and steady pace of change during the 40 weeks of pregnancy; however, it is the sudden change after the birth of the baby with a healing time of only 4-8 weeks that leave women with residual lifelong symptoms.
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During pregnancy, women typically gain an average of 25-35 pounds for single birth and 50-62 pounds when carrying multiples. Right after delivery, the weight suddenly drops 10-13 pounds, averaging another 5 pounds after excess fluid and lochia discharges. These sudden fluctuations in weight can cause stress on the spine and sacroiliac joints.
The weight and position of the baby during pregnancy shifts the center of gravity forward, causing the lower back to arch more to maintain balance. This posture is called lumbar lordosis. It goes hand in hand with anterior pelvic tilt. It can become habitual and can persist into postpartum. With weakened abdominal muscles and an exaggerated lumbar curve, the lower back muscles work harder to stabilize the spine. If this posture persists, it can lead to increased pressure on intervertebral discs, nerve impingement, joint instability, and muscle spasms.
Hormonal Fluctuations
During pregnancy, the body produces hormones like relaxin which loosen the ligaments and joints, especially in the pelvic area, to prepare for childbirth. These changes can persist postpartum, leading to sacroiliac joint instability and pain. In addition, decreases in estrogen and progesterone, and increases in cortisol levels increases inflammation in spine and sacroiliac joints leading to discomfort and pain.
Childbirth Recovery
In addition to weight fluctuations, growing a baby causes the abdominal and pelvic floor musculature to stretch, some muscles up to twenty-five times its original size, which weakens the anterior abdominal wall. A common postpartum concern is diastasis recti. Diastatis recti is a condition where the rectus abdominis muscles separate down the middle of the abdomen. This can reduce trunk support and cause compensatory use of low back musculature, hence increasing the strain on this area.
physical demands
Now that your body is done growing and birthing the baby, your body is gearing up to take care of the baby. From feedings every 2-3 hours to carrying and holding the baby at all hours of the day, the everyday routine starts to take a toll on a mom’s body. The body that is still healing from the residual symptoms of childbirth now has little time to rest and recover, causing aches and pains in low back joints.
what can you do?
binder & braces
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Abdominal binder: It offers support to abdominal muscles and pelvic floor by reducing downward pressure, holding the abdominal muscles in optimal position to assist in healing, and offering gentle compression that can aid in pain relief.
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Lumbar Support: Using lumbar support cushions while sitting can help maintain a neutral lumbar spine position and reduce lower back strain
Pelvic Floor/ Abdominal Exercises
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Kegel Exercises: Kegels can strengthen pelvic floor muscles, which can become weakened during childbirth
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Lower abdominal exercises: Transverse abdominis muscle retraining can help reduce muscle imbalances, improve pelvic tilt to reduce lumbar lordosis, help with diastasis recti healing, and over improve tolerance for functional activities.
Rest & Nutrition
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Adequate Rest: Sleep is crucial in regulating the body and aiding in healing. Resting in between feedings and routine for the first 4-6 weeks will allow the body to heal from the pregnancy changes and postpartum trauma
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Balanced Diet: Diet rich in vitamins, minerals, and proteins support recovery. Staying hydrated and consuming high-fiber foods can also help prevent constipation. In addition, reducing intake of sugary foods can have a rapid and positive effect on weight reduction
Staying Active
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Walking: Consistency of walking and performing activities of daily living will help mobilize your joints and muscles, which may also help with decreasing inflammation as well as kick start weight loss.
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Low Impact Activities: Activities like jogging, swimming, or cycling at low impact and once cleared by your provider will improve hormonal imbalances, weight, and aid in healing
Medical Intervention
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Pain Management: Over-the-counter pain relievers like acetaminophen or ibuprofen can help manage pain. Consult with your doctor before taking any medications. For more severe pain, consult with a healthcare provider to learn about your options
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Analgesic Agents: Apply an ointment or gel with analgesic properties to the painful sites. Be sure to avoid any incisions or open wounds. For more questions, ask your provide
Support
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Support: Whether it’s through a support system or support groups, having the right people by your side to help you cope with your postpartum feelings can be highly effective in pain reduction
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Medical interventions: consulting with obstetrician or endocrinologists to monitor hormone levels is recommended. They can prescribe hormone replacement therapy or medications to manage pain symptoms if needed.