"Ever since I had my baby, my pelvis feels uneven when I walk, and turning over, getting out of bed and putting on trousers all hurt..." In our consultation room at Ever-Health, many new mothers describe similar experiences. Older relatives may say "back ache after giving birth is normal; it'll be fine in a few months", and for some it does gradually improve. But if the pain persists or affects caring for your baby, it is worth getting assessed early.
This article explains the common causes of postnatal back and pelvic pain, common myths, which situations need extra care, how it is usually managed, and when to see a doctor. It is health education and cannot replace an in-person consultation with a registered clinician. We do not promise "recovery in a few sessions".
What Is Postnatal Back and Pelvic Pain?
The pelvis is joined at the front by the pubic symphysis and at the back by the two sacroiliac joints. During pregnancy, hormones (such as relaxin) make the ligaments looser, and with the baby's weight and changes in posture, the load on the joints and muscles around the pelvis increases. This can lead to "pelvic girdle pain".
In the first few months after birth, carrying the baby day and night, hunching over during feeds, lack of sleep, and abdominal and pelvic floor muscles that have not yet recovered can all keep the pain going. Some people also have diastasis recti (separated tummy muscles) or a weaker pelvic floor at the same time.
Common Symptoms
- Pain at the pubic bone: especially when walking, on the stairs or standing on one leg (for example, putting on trousers).
- Pain in the lower back and buttocks: pain on one or both sides of the lower back or buttock, sometimes spreading to the back of the thigh.
- Difficulty turning over and getting out of bed: pain when turning in bed or going from sitting to standing.
- A "stuck" or unstable feeling in the pelvis: some people feel walking is not smooth, or feel a "click".
Note: "uneven" does not mean "misaligned"
The pelvic joints only move very slightly. The pain is mostly linked to sensitive tissue around the joints, muscle control and load, not necessarily bones "out of place". The real cause can only be found through a professional assessment.
*Note: the above is not a self-diagnosis tool.
Two Common Myths
Myth 1: "A misaligned pelvis has to be pushed back into place?"
"Misaligned" is a popular term, but postnatal pelvic pain is mostly not caused by bones visibly shifting. Treatment usually focuses on reducing load on the joints and improving muscle control and everyday posture, rather than relying on one or two manipulations to "push it straight".
Myth 2: "The tighter you bind your belly, the faster your pelvis closes?"
A suitable pelvic belt or abdominal binder can give short-term support and make moving more comfortable for some people, but it cannot replace muscle recovery. Binding too tightly or for too long may be uncomfortable or affect your breathing. Ask a professional how to use one and for how long.
When to Be Extra Careful
The following should not be treated as ordinary back ache; see a doctor promptly or go to A&E as appropriate:
- Fever, or a wound (caesarean or perineal) that is red, swollen, oozing pus or very painful.
- Heavy bleeding or large clots.
- Pain and swelling in one calf or warmth there, or sudden breathlessness or chest pain.
- Numbness or weakness in the legs, or loss of bladder or bowel control.
- Pubic pain so severe that you cannot walk at all.
Take extra care: don't twist your back or push your pelvis forcefully yourself
After birth, the tissues around the joints are still recovering, and forceful twisting or hard pressure without an assessment may not be suitable. Be assessed by a professional first, then decide on a suitable method and pressure.
How It Is Usually Managed / What Clinics Commonly Do
At Ever-Health (Luen Wo Hui, Fanling), we first look at how you gave birth, how many weeks it has been, where the pain is and the movements you make caring for your baby. A physical examination then helps us understand the joints and muscles around the pelvis. If you have any of the warning signs above, we will advise you to see a doctor first. Below is the step-by-step approach commonly used at the clinic (results vary from person to person and are not guaranteed):
1. Find the source of pain first, then discuss the plan
Pubic pain, sacroiliac joint pain, lower-back pain and muscle strain each need a different focus. A clear assessment helps choose the right approach.
2. Physiotherapy support (depending on the individual)
A registered physiotherapist may provide gentle manual therapy, core and buttock strengthening, pelvic floor training, advice on using a pelvic belt, and adjustments to everyday movements such as feeding, carrying the baby and getting out of bed; based on the assessment, equipment may also be used to ease local discomfort.
3. Chinese medicine and acupuncture (depending on the individual)
Chinese medicine says that "after childbirth there is often deficiency and stasis". A registered Chinese medicine practitioner may, according to the pattern, use acupuncture to ease lower-back and sacral pain, and prescribe Chinese herbs where needed. If you are breastfeeding, please say so before any medicine is prescribed.
4. Sensible Things You Can Do Day to Day
- Sit upright to feed, use a pillow to bring the baby up to chest height, support your back and keep your feet flat on the floor.
- Bend your knees before picking up your baby and hold them close to your body; avoid bending and twisting.
- Keep your knees together when turning over in bed; sit down to put on trousers so you stand on one leg less.
- Build up pelvic floor and core exercises gradually as guided, and don't rush into strenuous exercise.
When to See a Doctor
If postnatal back and pelvic pain has not improved after several weeks, is affecting caring for your baby and sleep, or you have any of the warning signs above, arrange a professional assessment promptly. At your postnatal check, you can also tell the doctor about back and pelvic pain or leaking urine.
Remember: while caring for your baby, look after yourself too. Individual cases should be judged at an in-person consultation.
Frequently Asked Questions
Will postnatal back and pelvic pain go away on its own?
For some people it improves gradually over a few weeks to a few months after birth, but if the pain persists, affects daily life or comes with warning signs, get assessed early rather than just waiting.
Can the pelvis really be "misaligned"?
Postnatal pelvic pain is mostly not caused by bones visibly shifting, but by sensitive tissues around the joints, muscle control and load. Treatment usually focuses on reducing load and training the muscles.
Can I bind my belly?
A suitable pelvic belt or abdominal binder can give support for short periods, but it cannot replace muscle recovery, and binding too tightly or for too long may not be suitable. Ask a professional first.
Can I have acupuncture or Chinese herbs while breastfeeding?
Tell a registered Chinese medicine practitioner that you are breastfeeding, and they will judge whether it is suitable and how to adjust treatment.
Postnatal back and pelvic pain: you don't have to put up with it
If back ache or pubic pain after birth is affecting caring for your baby, visit Ever-Health in Luen Wo Hui, Fanling. Our team will carry out a detailed assessment first, then discuss whether physiotherapy, acupuncture or another option is suitable. This article is for reference only; individual cases should be judged at an in-person consultation.