There’s a good chance you’ve been dealing with back pain during your pregnancy. After all, the weight gain, hormonal changes, and general inability to really get comfortable can take a toll on your body, including your back.

And while you likely expected some discomfort during pregnancy, you might not have expected postpartum back pain after your C-section.

Back pain is something that some mothers experience after birth, with pain starting within hours after delivery and continuing for days, weeks, or months postpartum.

Here’s a look at the possible causes of back pain after a cesarean delivery, commonly known as a C-section, as well as what you can do to relieve some of the discomfort.

Back pain after giving birth can be nerve-racking, especially when you’re still recovering from surgery. You probably expected to feel some discomfort from the incision, but now you’re aching in more places than you thought possible.

There isn’t a single possible cause of pain, but rather several plausible explanations for aches, which you might feel in your upper or lower back.

1. Hormonal changes

Being pregnant not only increases the size of your stomach but also results in much less visible changes, some of which may contribute to back pain after delivery.

During pregnancy, the body releases the pregnancy hormone relaxin in preparation for giving birth. This hormone loosens ligaments and joints so that it’s easier to push out the baby.

The body releases this hormones regardless of whether you have a vaginal delivery or a C-section.

Since it’s easier to strain your back when joints and ligaments are loose, the slightest activity might cause lower or mid-back pain.

The good news is that your joints, muscles, and ligaments will gradually strengthen in the months following pregnancy.

2. Weight gain

Carrying extra body weight is another contributing factor to back pain.

It’s normal for your size to increase during pregnancy. After all, you’re growing a whole new person. But the extra weight and a shifting center of balance due to carrying so much of it in front could put stress on your back and spine, leading to back pain.

3. Lifting and carrying a new baby

Your baby might only be six or seven pounds, which doesn’t seem like a lot, but that’s extra weight that you’re now carrying in your arms every day.

Also, you’re constantly bending over and lifting your baby from the crib, car seat, and stroller. These extra movements and reaching can affect your posture and cause neck and/or back pain.

Being more aware of your posture when handling your baby may bring some relief. Instead of bending over, keep your back as straight and upright as possible when lifting your baby and use your legs.

Consider how you’ve placed your car seat and whether sitting in the car to access the seat will decrease the need for awkward positioning while lifting your baby in and out. The same goes for the crib. Consider whether it’s positioned for optimal reach for you to use (as well as for baby’s safety!) and make adjustments as needed.

4. Breastfeeding

Breastfeeding is an excellent way to bond with your baby, and during each feeding, you may stare lovingly into your baby’s eyes.

Unfortunately, maintaining this position for too long can strain your neck, causing neck pain that radiates to your back. Bad posture while breastfeeding can also cause back pain, particularly if you shrug your shoulders toward your baby.

To reduce pain, keep your shoulders relaxed and place a pillow underneath your elbow to support your arm. While it’s OK to look down during feedings, break your gaze occasionally and look straight to avoid straining your neck.

5. Effects of anesthesia

The type of anesthesia you receive before a C-section can also cause pain in the days or weeks following delivery. You might receive an epidural or spinal block to numb the area in preparation for surgery.

With an epidural, the doctor injects anesthesia into the area surrounding your spinal cord. Meanwhile, with a spinal block, they inject anesthesia closer to your spinal cord. Spinal blocks work faster, whereas it can take up to 20 minutes for an epidural to numb the abdomen, so the method of delivery can influence which type was used.

One problem with an epidural or spinal block is that they can cause muscle spasms near the spinal cord after delivery. These spasms can continue for weeks or months after delivery.

Back pain after a C-section is often temporary, with pain intensity gradually decreasing over the days, weeks, and months following delivery. In the meantime, here’s a look at several ways to help your back feel better.

Try not to bend over when lifting and picking up your baby

Be conscious of your posture. Keep your back straight and bend with your knees. If you’re feeling achy, ask your partner or someone else to put baby in the crib, stroller, or car seat.

Keep your back straight while breastfeeding

This can ease pressure on your spine and neck, preventing back pain and easing existing pain. Finding a comfortable spot for feedings can make a world of difference.

Take a hot bath

A hot bath can relieve muscle tension and muscle spasms in your back. Plus, moist heat helps increase blood circulation, reducing inflammation and back pain. Since a C-section is surgery, don’t take a bath until your healthcare provider gives you the clear. If you don’t have time for a bath, stand in the shower and let the hot water run down your back, or use a heating pad.

Choose gentle exercises

Once your healthcare provider gives the green light, start with simple, easy exercises like Pilates or yoga. This helps strengthen your abdominal muscles and releases muscle tension in your back. In addition, going for a light walk can improve blood circulation. This may ease inflammation and spasms in your back.

Allow yourself to rest

Moving around too much could worsen back pain. So stay off your feet as much as possible, especially if you’re achy. Give your back a chance to rest and heal. Being overly active could prolong pain. Also, take naps whenever possible. Sleep is how your body repairs itself, and caring for a new baby often means you aren’t getting all the sleep you need.

Get a massage

Getting a back massage can also help you feel better. Massages can relieve muscle tension and improve blood circulation. Ask your partner to give you a massage, or get a professional postpartum massage.

Take pain medication to ease spasms

Also, ask your doctor about safe medications to take, particularly if you’re breastfeeding. Typically, it’s OK to take acetaminophen and ibuprofen while breastfeeding. Just make sure you don’t exceed the maximum daily dosage as instructed on the label.

Although back pain after a C-section is common, don’t ignore severe pain. This includes pain that prevents you from sleeping at night or makes it difficult to move or hold your baby.

Your doctor might need to prescribe a stronger pain medication. Depending on the severity of pain, you may need to work with a physical therapist to strengthen your abdominal or back muscles and relieve pain.

It’s also important to see a healthcare provider when a fever or numbness accompanies back pain. This could be a sign of neurological complications from anesthesia.

Whether a cesarean delivery is planned or unexpected, it often comes with a longer recovery time, and you’re also likely to have some back pain.

Pain is usually temporary, and sometimes reversible by improving your posture and making other adjustments. If the pain doesn’t improve after a couple of months or interferes with your daily life, talk with your doctor to discuss other options for relief.