What causes back pain after a c-section? 

There’s often not one cause of back pain after having a cesarean section, commonly known as a c-section.. Your body is intelligent. It’s always changing and adapting to your external and internal environment. Pregnancy is an incredible process that creates changes within your body. From hormone changes to musculoskeletal changes and many more. If you experience back pain after a c-section, it’s often the combination of a few different causes. Below focuses on each of these causes:


During pregnancy, your body increases the production of a hormone called relaxin. Relaxin  increases laxity in the ligaments throughout your body, primarily around the pelvis. This creates more room for a vaginal birth. (1) Your body creates this hormone upon conception, regardless of the type of birth you have. Loosened ligaments can create weakness, impacting your posture.


During pregnancy, your center of gravity changes. Combined with loosened ligaments and poor core engagement, this can lead to low back pain and postural changes. Postural changes can continue after giving birth for several reasons. 

During  a c-section, an incision is made through several layers of skin, nerves, tissue, and muscles. Although no abdominal muscles get cut, they are still affected by the procedure. (2) It’s common for women to have trouble activating their abdominal muscles post-c-section. On top of a weak core, you also have the lifestyle change of caring for your newborn. This includes carrying, lifting, breastfeeding your  child, and many other repetitive movements. These activities can all lead to poor posture and an increase in back pain post-c-section.

Procedural anesthesia 

A c-section begins with anesthesia injected into your lower back. This is a spinal block or epidural used to numb the lower half of your body. The needle is injected around the first vertebrae of your lumbar spine. This is a very sensitive area. It is common to feel discomfort around the injection site once the anesthesia wears off. The discomfort at the injection site should subside within a few days.

Is back pain after a c-section normal?

Some levels of back pain are common after delivering your baby through a c-section. Elective c-sections are associated with an increased risk of persistent low back and pelvic pain. (3) This pain can begin hours after the delivery when the anesthetic wears off. Pain can last anywhere from a couple of days to upwards of a couple of months. This discomfort can be due to one or more of the above causes of low back pain after a c-section.

Pain should not interfere with your day-to-day life. Below are ways to decrease pain and recover after a c-section. If your pain is severe or makes it hard to care for yourself and your baby, reach out to your healthcare provider.

How can you recover from back pain after a c-section? 

Take a hot bath

Taking a hot bath is a great way to ease tense muscles. Moist heat can increase circulation and reduce inflammation, providing relief for back pain. Avoid taking baths until cleared by your healthcare provider.

Practice proper sleep positioning

After having a c-section, the best sleeping position is on your back. This places the least amount of strain on your incision site. It also allows your spine to stay in a neutral position, helping relieve back pain. You can also place a rolled blanket or pillows underneath your knees to relieve pressure on your lower back. When sleeping on your back, make sure you take your time getting out of bed. Follow these tips below to safely transfer yourself out of bed:

  1. Roll onto your side facing the side of the bed where you would like to exit. Bend your knees. 
  2. Push down with your hands and use your arm strength to slowly push your body to a sitting position with your legs hanging off the side of the bed. 
  3. Pause in this seated position for a moment before standing.

Another position you can try is side sleeping. In this position, place a pillow between your stacked knees. This will help maintain neutral hip alignment and relieve pressure on your low back. You can also try hugging a pillow in front of you to keep your shoulders stacked. This will prevent compression in your front body.

Start a therapeutic program 

Your body underwent many physical changes throughout your pregnancy and c-section delivery. It’s important to rebuild your strength and mobility through an exercise program upon your doctor’s approval. Doctors’ approval typically takes place at your 6-12 week postnatal check-in appointment. When getting started, take things easy. Focus on very gentle activities such as breathingor core activation to allow your body to heal. Even after your doctor’s approval to begin exercise, avoid anything that puts excess pressure on your midsection. Movements that cause your belly to bulge, such as sit-ups or crunches, can interfere with healing. Once approved by your healthcare provider, try these exercises to begin strengthening your core:

Finding and contracting your TrA


Start: Lie on your back with your knees bent and your feet flat on the floor, hip-distance apart.

Step 1: Find neutral spine. Place a small rolled towel under your low back if needed to maintain this position.

Step 2: Place your hands on your lower belly with your fingertips just below your belly button. Gently press your fingers into your low belly.

Step 3: The TrA contracts when we cough or laugh, so gently laugh or cough until you feel muscle tension under your finger tip. This is your transverse abdominis or TrA

Step 4: To practice contracting this muscle, inhale, feeling your breath expand into your ribs, back, sides, and belly. As you exhale, draw your entire belly in and up. Try to imagine drawing your hip bones closer together. Make sure that your lower belly does not bulge with the contraction.

Step 5: Hold this contraction for a moment. Relax with your exhale.

Step 6: Repeat this several times. Practice this throughout the day

TRA bent knee fall out


Start: Lie on your back with your knees bent and your feet flat on the floor. Keep your knees and feet together.

Step 1: Find neutral spine. Place a small rolled towel under your low back if needed to maintain this position.

Step 2: Engage your core, drawing  your lower belly up and in.

Step 3: Keeping your feet together, slowly open one knee out to the side. Use your core to keep your hips stable. Do not let your hips or opposite knee move. Slowly return to starting position.

Step 4: Keeping your core engaged, repeat on the opposite side. 

Step 5: Continue alternating sides for 3 sets of 10 repetitions. 

Improve your post-c-section back pain today

Before you begin a new exercise regimen, please first consult your doctor. Pain and discomfort can negatively impact your postnatal journey. Targeting the root cause of your pain can improve your postpartum outcomes. For more information on how Orbit can help you decrease pain, manage stress, and improve your well-being, contact us today.


  1. CSPC. (2019, December 10). Effects of pregnancy on musculoskeletal system: CSPC Physiotherapy, Leeds. CSPC Physiotherapy. Retrieved September 14, 2022, from https://www.cspc.co.uk/complex-conditions/your-body-during-pregnancy/effects-of-pregnancy-on-musculoskeletal-system/
  2. https://americanpregnancy.org/healthy-pregnancy/labor-and-birth/cesarean-procedure/
  3. Mogren, I. M. (2006). Does caesarean section negatively influence the post-partum prognosis of low back pain and pelvic pain during pregnancy? European Spine Journal, 16(1), 115–121. https://doi.org/10.1007/s00586-006-0098-8
Share this post!