3 months postpartum body aches: Is Postpartum Causing My Aches And Pains?

Is Postpartum Causing My Aches And Pains?

Congratulations! You have brought a new life into the world. But don’t panic if there’s postpartum pain still nagging at you. It’s completely normal to feel postpartum aches and pains. Here’s what you need to know. 

As a mother, your life is about to change. There will be difficulties, challenges, and hurdles – but these all combine and bring so much joy and happiness.

Parenthood is something to cherish – if only you could get rid of that lingering pain… 

Of course, it’s normal to experience pain in your body after giving birth. The birthing process is one where your body goes through intense strain to accommodate the initial growth of your child, and a whole host of physical changes accompany impending motherhood. 

However, most pregnant women fully expect pregnancy-related pain to dissolve after birth has taken place.

Yet, it is perfectly normal and very common to experience pain in various parts of your body in the immediate stages of postpartum.  

This persisting pain comes from the burdens that your muscles and joints absorb throughout contractions. These contractions can be severe enough to create a lasting impact, causing aches and pains months post-delivery. 

Complaints about lower back pain are the most common, which won’t come as a surprise. Your lower back takes enormous extra pressure throughout pregnancy, and continues to take the strain throughout labor contractions. 

Headaches, knee pain, stiffness, shoulder pain, and discomfort in your hip, are also very common. Tingling sensations in your hands and wrists are often reported, too. 

But what about the less reported pain problems that accompany postpartum? 

Let’s take a look.

Before We Continue…

It is generally considered time to seek medical attention if your postpartum pains are still present after your sixth consecutive postpartum week. Should the pain still dictate your daily life by this point, your MD may prescribe prescription drugs or painkillers, but we wouldn’t suggest relying solely on these pills.  

No. There are other ways to help manage and control your discomfort, including Physical Therapy. 

That’s where we come in. 

As qualified and experienced physical therapists, we don’t just generalize your pain and jump in with the same treatments for everyone. We take the time to learn about your uniqueness (after all, we are all different!), alongside your situation, and craft a bespoke treatment package. All this effort ensures that you get back on your feet as quickly as possible. 

And, with that, let’s explore some of the aspects that we can help with relating to postpartum pain. 

Postpartum Breast Pain

One of the biggest changes that comes with the postpartum time frame involves your chest. 

After giving birth, your breasts may grow larger and become tender. According to various studies, new Moms usually experience onset lactation, engorgement (due to storage of excess milk), or ‘let down’ within a 24-72 hour period. 

Your breasts may increase cup size, develop a hardness and ‘feel warm’, alongside experiencing postpartum breast pain. Some women suffer a light fever during this time.

Once you begin to breastfeed your newborn, your breast pain should dwindle and become less swollen. The hardness will also lessen, and the engorgement will become less profound as breastfeeding continues. 

If you don’t breastfeed your baby very often, or choose not to engage with breastfeeding at all, then your breasts will remain engorged and hard. 

The solution? We’d recommend nursing on a regular basis. Breastfeeding doesn’t just benefit your newborn child, but it also provides relief for painful/engorged breasts – making them less swollen, and returning to their previous state. 

During the immediate postpartum, consider breastfeeding between every 3-4 hours. Women’s health specialists recommend nursing your baby somewhere near a dozen times a day. 

Should you opt not to breastfeed, you can apply cold/ice or heat packs to your breasts. Anti-inflammatory pills can prove useful, as can a well-fitting bra. 

As another option, consider using a breast pump to reduce the swelling and hardening of your breasts.  

Postpartum Abdominal & Pelvic Floor Pain 

Don’t panic if you feel what seems like contractions again! You don’t have anything untoward going on, and you are not a freak of nature. 

It’s perfectly normal to feel activity in your pelvic floor after giving birth, as the uterus works its way back to a pre-pregnancy state; medically referred to as ‘involution’. 

Strange as it may sound, breastfeeding can also bring about abdominal and pelvic floor pain. Intense contractions may occur while nursing due to a hormone known as oxytocin, which is released into the bloodstream. 

This hormone can cause contractions across muscles and assists in helping your uterus contract back into the pre-pregnancy state. 

To counteract this pain, you can increase the frequency in which you breastfeed, utilize breathing techniques to instigate relaxation, and ensure that there’s no pressure on your bladder – by frequently urinating. 

So when is this pain not normal? 

As we’ve mentioned previously in this article, these pains should not last longer than six weeks. If the pain doesn’t dissolve with rest, heat/ice packs, painkillers, and physical therapy sessions/advice, you must seek medical attention. 

If you experience any of these symptoms, get yourself seen to by a medical professional immediately: 

If your stomach pain or abdominal pain is severe, lasts longer than the first six weeks, or doesn’t get better with rest, heat therapy, and over-the-counter medications, it’s essential to get checked over by your doctor. And please seek immediate medical attention if you experience any of the following symptoms: 

• Sickness and vomiting
• Bright red, heavy vaginal bleeding 
• Chest pain or breathlessness
• Pain, redness, and inflammation around C-Section or Episiotomy scar
• Unusual discharge from your vagina or rectum

Perineal Tearing 

Ok. This is the part that most women panic about. 

Perineal tearing happens during a ‘normal’ (vaginal) birth, where soft tissue becomes lacerated between the vagina and the anus. These lacerations can vary in terms of severity, but the majority of cases are mild and don’t require much in the way of treatment. 

You just need to let your body recover! 

However, more serious cases can cause chronic pain that lasts an indefinite amount of time. You may need perineal stitching to help the recovery process on its way. 

Besides using heat/ice packs on the area of discomfort, we’d encourage you to wear loose-fitting clothing, and refraining from strenuous exercise and activities. 

Once you can move around more freely, physical therapy can help keep you away from undoing your progress and assist in your recovery.

Postpartum Joint Pain

Hormonal changes can bring about inflammation in your joints, and while joint pain is very, very common (almost inevitable) during pregnancy, postpartum joint pain symptoms can continue this theme and last for long stretches of time. 

Your knees are particularly susceptible. This is due to all that extra weight being carried around when pregnant, but could also be a sign of hyperthyroidism. If that knee pain simply isn’t going away, you should speak with your doctor. 

This joint pain (and associated inflammation) can be tackled with OTC (over-the-counter) anti-inflammatory medication and painkillers. 

If you are breastfeeding, consult with your doctor about the safest pain relief tactics. You don’t want to be mixing painkillers with nursing; for a whole range of health reasons!

How Physical Therapy Can Help 

If you are suffering from any of the issues mentioned in this article – especially joint and muscle pain – then consulting your physical therapist could bring huge benefits to your recovery plan. 

Firstly, you can work alongside a healthcare professional to gain the correct diagnosis for your pain. After all, you cannot target the source of pain if you don’t have that knowledge! 

Secondly, you will have access to advice from experienced physical therapists (PTs) who know all about postpartum pain management. After a physical evaluation and a detailed study of your medical history, your PT will be able to determine which activities and movements are best for you.  

This avoids injury. That’s incredibly important during the recovery of postpartum aches and pains!

When dealing with postpartum abdominal and pelvic floor pain, PTs can administer an exercise plan that starts with low-impact maneuvers aimed at strengthening the lower body and preventing further pain. This can include advice on how to alleviate breast pain. 

Get In Touch With Us! 

Intecore Physical Therapy is formed on two basic principles: Integrity of Care, and Core Rehabilitation values. 

These Core Rehabilitation values utilize the skills of the clinician, and a thorough and individualized rehabilitation program; instead of gadgets and passive treatments.

Our focus is through an extensive physical therapy evaluation, manual therapy techniques, therapeutic exercise, patient education and an individual focus on patient care to successfully return our patients to full function and enhance their quality of life. 

This includes those suffering from postpartum pain.  

Don’t suffer in silence, and don’t feel embarrassed about your issue. We do not judge, we are here to help! 

You can get in touch with us through our contact page, or visit one of our clinics. You can find more information on our clinics through our locations page. 

We look forward to helping your recovery. Motherhood is something to cherish and enjoy – let’s get you back to health for the full experience. 

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Andrew Vertson

Physical Therapist at Intecore Physical Therapy

Andrew received his Bachelor’s Degree in Exercise Science from California State University, Fresno in 1991. He then earned his Master’s degree of Physical Therapy in 1996 and his Doctorate degree of Physical Therapy in 2002 from Loma Linda University. In 1996 he also earned his Certification as an Athletic Trainer. He has also completed extensive post-graduate course work in orthopedic manual therapy through Kaiser-West Los Angeles and the Ola Grimsby Institute.

Latest posts by Andrew Vertson (see all)

Warning signs of postpartum health problems

Your body goes through many changes after having a baby, so it needs time to recover. In the weeks after childbirth, you can expect to feel certain discomforts, like belly cramps or fatigue, that are a normal part of the healing process. But some women have postpartum complications that can cause serious, life-threatening health problems. If you ever experience pain or discomfort that doesn’t seem “normal,” call your doctor. If you think your life is in danger, call 911 or go to the emergency room. 

Why postpartum care is important

All women need postpartum care after having a baby. Even if you’re feeling fine, go to all your postpartum checkups so your doctor can make sure you’re recovering well from labor and delivery. New moms are at risk of serious and sometimes, life-threatening complications after childbirth, so it’s important to get checked out. Too many new moms die from health problems that could have been prevented by getting the right postpartum care.

Three ways to take an active role in your postpartum health:

1. Go to all your postpartum checkups.
2. Take note of any warning signs or unusual symptoms.
3. Call your doctor right away—or go to the emergency room          

Know the warning signs

Is it a normal part of healing or something else? When you’re busy taking care of a new baby, you might miss the warning signs. Pay attention to the signs below that indicate something could be wrong, as well as signs and symptoms that point to specific health conditions.

Warning signs to look for after giving birth

• Chest pain
• Trouble breathing
• Heavy bleeding
• Extreme pain

Signs and symptoms of infection

• Fever higher than 100.4 F. When you get a fever, it means your body is trying to kill the virus or bacteria that caused an infection.

• Discharge, pain or redness around an incision site that doesn’t go away or gets worse. This includes around a cesarean birth incision, episiotomy or perineal tear. Cesarean birth (also called a C-section) is a surgery in which your baby is born through a cut your doctor makes in your belly and uterus (womb). An episiotomy is a cut made at the opening of the vagina to help let the baby out during birth. A perineal tear is a tear in the perineum, which is the area between the vagina and the rectum. Your perineum may tear naturally during vaginal birth.

• Pain/burning when you pee, increased urination or pain in your lower back or side. You may have a urinary tract infection (also called UTI), including a bladder infection (cystitis) or a kidney infection (pyelonephritis).

• Red streaks or new, painful lumps in your breasts. You may have a breast infection called mastitis. This can happen when you have a plugged duct, you miss or delay breastfeeding or your breasts become engorged (swollen and full of milk).

• Severe pain in your lower belly. You may have endometritis. This is inflammation (redness or swelling) in the lining of the uterus.

• Vaginal discharge with an odor. You may have endometritis or an infection called bacterial vaginosis (also called BV). BV happens when there’s too much of a certain bacteria in the vagina.

Signs and symptoms of sepsis

Sometimes the body has an extreme response to infection (called sepsis). Sepsis can lead to tissue damage, organ failure and even death. Alert your doctor if you experience any of the signs and symptoms below. 

• Chills or feeling very cold
• Clammy or sweaty skin
• Fast breathing
• Fast heart rate
• Feeling confused
• Fever
• Having extreme pain or discomfort

Signs and symptoms of other health conditions

Treatment depends on how severe your preeclampsia is and how far along you are in your pregnancy. Most women with mild preeclampsia after 37 weeks of pregnancy don’t have serious health problems. If you have mild preeclampsia before 37 weeks, you need treatment to make sure it doesn’t get worse.

• Bleeding that’s heavier than a normal period or bleeding that gets worse over time. You may have postpartum hemorrhage (also called PPH). PPH is when a woman has heavy bleeding after giving birth. It’s a serious, but rare condition that can happen up to 12 weeks after having a baby.

• Pain, swelling, redness, warmth or tenderness in your legs, especially your calves. You may have deep vein thrombosis (also called DVT). This happens when a blood clot forms deep in the body, usually in the lower leg or thigh.

 • Vision changes, severe headache, pain in the upper right belly or shoulder, trouble breathing, sudden weight gain or swelling in the legs, hands or face. You may have postpartum preeclampsia. This is a serious condition that can develop in women after giving birth. It is marked by high blood pressure and signs that some organs—like the kidneys and liver—may not be working normally.

• Chest pain, coughing or gasping for air. You may have a pulmonary embolism (also called PE). This is when a blood clot moves from where it originally formed to a lung. PE is an emergency that needs immediate attention.

• Feeling sad or hopeless for more than 10 days after giving birth. You may have postpartum depression (also called PPD), which is a form of depression that can develop after having a baby. PPD is marked by strong feelings of sadness, anxiety (worry), fatigue and harmful thoughts. PPD can make it hard for you to take care of yourself and your baby. PPD needs treatment to get better, so talk to your doctor right away.

• Feeling sick to your stomach or throwing up. You may have PPH or cardiovascular disease (also called heart disease). Heart disease includes conditions that affect the heart and blood vessels. They often affect the heart muscle or involve narrowed or blocked blood vessels that can lead to a heart attack or stroke.

If you think your life is in danger, call 911 or go to the emergency room.

what happens to the body after childbirth

A woman’s body does not rejuvenate during pregnancy and after the birth of a child. We tell you what cardinal changes in the body lead to and what to do about it.

Pregnancy and childbirth are, without exaggeration, the most amazing stages in the life of every woman. Waiting for and meeting a new person can be both very easy and difficult. Everything is individual and often unpredictable. Being aware of what happens “after” will help to cope with possible difficulties, fears and excitement.

After childbirth, the body will not be the same, all women know about it. But, as a rule, most often they mean stretch marks, excess weight, a flabby stomach, severe hair loss during breastfeeding and the consequences after episiotomy (surgical dissection of the perineum and posterior wall of the vagina) during natural childbirth. Less common are brittle teeth, an increase in the size of the foot, a change in the structure of the hair (wavy can become straight and vice versa), and a decrease in vision. Few people talk about urinary incontinence, umbilical hernia, severe dryness of intimate organs and pain in the chest.

So that this does not become a cause for concern and one of the triggers for the development of postpartum depression, it makes sense to understand the physiology of pregnancy and study rehabilitation techniques.

Pregnancy is the strongest restructuring of the body and worldview.

Firstly, you should not worry, because pregnancy is the strongest restructuring of both the body and the worldview. And secondly, the notorious “get in shape after childbirth” is most often inappropriate in any of the situations. The main thing is to give yourself time and help the body recover calmly.

Why do some women recover easily and quickly after childbirth, while others face such serious problems as urinary incontinence, diastasis, hernias, posture disorders, varicose veins, hemorrhoids, dry mucous membranes and loss of vaginal sensitivity? All these consequences of pregnancy are associated with undifferentiated connective tissue dysplasia (CTD).

Candidate of Medical Sciences, obstetrician-gynecologist Inna Kondrashova says that DST is a genetic and autoimmune disorder of collagen synthesis. There are about 20 signs of CTD: tall stature and narrow shoulders, changes in posture and early signs of osteochondrosis, O- or X-shaped deformity of the lower extremities and flat feet, chronic migraines and frequent headaches, asthenia and a low hairline on the forehead, vascular diseases and visual disturbances, a tendency to allergies, and clear, thin, dry skin.

If a woman has more than five signs, then most likely she has undifferentiated CTD, and it is important to take this into account when preparing for and managing pregnancy. Timely diagnosis will help to avoid complications. It is important to start prevention in time, for example, taking the right vitamins (it is especially important to normalize iron levels), a balanced diet (a sufficient amount of protein is needed for the synthesis of collagen and elastin), the use of prenatal and postnatal bandage, exercises to strengthen the muscular frame.

Organ prolapse and urinary incontinence

During pregnancy, the load on the pelvic organs and kidneys increases due to the constant growth of the fetus and the pressure of the enlarged uterus. That is why urination becomes more frequent. Going to the toilet every two hours is not a cause for concern.

Stretched pelvic floor muscles during pregnancy can lead to pelvic organ prolapse, symptoms of which may include urinary incontinence, leakage when coughing or sneezing, pain during intercourse, a feeling of something foreign in the vagina, and as if the bladder is not emptying completely. These features may be slightly more common in women who have given birth vaginally.

As a self-help exercise, pelvic floor exercises work well. Although most women do them incorrectly, straining the auxiliary muscles, abs or buttocks. The easiest way is to imagine that you are stopping the process of urination. Repeat this exercise for several minutes, tensing and then relaxing the muscles.

Elena Lyubimkina, obstetrician-gynecologist, ultrasound and integrative medicine doctor:

“During pregnancy, you need to be especially attentive to yourself if a woman has illnesses, the result of which is constantly increased pressure inside the abdomen. Most often, these are chronic diseases of the digestive system with persistent constipation or the respiratory system, accompanied by a constant cough.

Obesity significantly increases the load on the pelvic floor muscles. Also, prolapse of the pelvic organs can occur in case of complicated childbirth: large fetus, rapid labor, episiotomy, use of obstetric forceps, vacuum.

Diastasis and umbilical hernia

Another common problem that is not so easy to diagnose. Immediately after childbirth, as a rule, a woman’s belly remains soft, like a pillow, about the size of the fourth or fifth month of pregnancy (although everything is individual). There may also be a protruding navel.

During pregnancy, the abdominal muscles and connective tissues stretch due to the expanding uterus. Diastasis is the separation of the rectus abdominis muscles. According to a 2015 study, 100% of women who gave birth have this pathology.

A month or two after childbirth, you can do a test: lie on your back, bending your knees, and lift your upper body, placing your fingers on your navel. If the fingers fall inward a little, into a line along the abdomen, then this is diastasis. The width of the dip up to two and a half centimeters is the norm. Moreover, there is no need to hurry with the exercises, because, as a rule, the muscles converge on their own after six months.

With diastasis, in no case should you pump the press! It is necessary to use the oblique muscles of the abdomen: do side and reverse planks, pull-ups on all fours – and not earlier than two months after childbirth and a mandatory consultation with a doctor. You can get rid of severe diastasis with the help of abdominoplasty, that is, surgically.

“Do breathing exercises, abdominal massage, Kegel exercises and glute bridge already in the postpartum ward. Be sure to wear a bandage and be careful when lifting heavy weights, no more than four to five kilograms for six to eight weeks. It is also important to maintain an adequate drinking regimen and balance the diet with fiber to prevent constipation,” recommends Elena Lyubimkina.

Stoop and pain in chest

During pregnancy, the center of gravity shifts, a deflection occurs in the lumbar region, because of this, the spine in the chest area is rounded, that is, kyphosis is formed. In the last stages of pregnancy, it can pull the lower back, and after childbirth, pain in the spine in the chest area is possible. In addition, many women feed the baby at first, hunched over, bending over him. It is better to use a special pillow and lean back to relax as much as possible.

Daily exercise with an emphasis on the upper body, swimming and massage can significantly improve the condition.

Severe dryness of intimate organs

After natural childbirth, the vagina can be traumatized, enlarged and torn. This goes on for a month. However, then there may be a feeling of severe dryness, burning and even tingling during washing, which is associated with a drop in estrogen levels due to lactation.

As soon as a woman stops breastfeeding and the menstrual cycle resumes, estrogen levels return to normal. Before that, in case of discomfort during sex, you need to use a water-based lubricant, a condom with a sufficient amount of lubricant. In some cases, using a moisturizing gel throughout the day may help.

Postpartum examinations

Afanasenkov Andrey Alexandrovich

Anesthesiologist-resuscitator

Lapino-1 Clinical Hospital “Mother and Child”

doctor at the maternity hospital
If the birth went without complications, then the mother is discharged from the maternity hospital on the third or fourth day. But before that, it must be examined by an obstetrician-gynecologist of the postpartum department. It is not necessary that this will be an examination on a gynecological chair, the doctor will be able to assess how the uterus has contracted, the nature of the discharge from the vagina, and what the seams look like at the site of the rupture without it.

Before discharge, make a list of questions that interest you, such as how to handle the stitches in your particular case or what to do if the bleeding increases. Ask your doctor where you can go if you have any problems after giving birth.

Ultrasound in maternity hospital
Before discharge in the maternity hospital, they can do an ultrasound of the pelvic organs, but in reality this does not always happen. If the birth went well and then the mother is not bothered by anything, then ultrasound is often not done, but if there were complications, then they do it for sure. In fact, every woman after childbirth has the right to an ultrasound examination (this is recorded in the order of the Ministry of Health), so you can ask and insist on an ultrasound. What it gives: it will be seen how the uterus contracts, and most importantly, is there any part of the placenta and large blood clots left in it. If there are any remnants, then some time after the birth they can give bleeding or inflammation, so it’s better to make sure everything in advance.

By the way, if the birth was under a contract, then this study is always included in the terms of the contract.

Inspection after a month
Four to six weeks after giving birth, you must again go to an appointment with an obstetrician-gynecologist. What it will give: firstly, by this time the discharge from the uterus will end, it will return to its previous size, all tears and incisions will heal and it will become clear what and how is now with the internal and external female genital organs. If a mother feels that something is wrong with her, for example, she has a slight urinary incontinence or has discomfort during sex, or is still pulling the skin at the site of the stitches (yes, there can be a lot more), all this must be told doctor and decide how to eliminate the trouble. Secondly, mom learns everything about her health. If everything is fine with him, this will give her confidence and strength, if not, then she will be able to deal with him in time.

additional research
But the health of a mother after childbirth is not limited to gynecology alone. What else can be checked after the baby is born? Take a complete blood count and check the level of hemoglobin: anemia often occurs during pregnancy, and some amount of blood is always lost during childbirth. It would also be nice to see the content of iron and calcium in the body (they are looked at in a biochemical blood test): the baby “took” these trace elements during pregnancy, so now they may not be enough. Well, you can go to the rest of the specialists, depending on whether something worries you or not.

where to go
Where can a mother be examined after childbirth? You can go to the antenatal clinic for a gynecologist and a pelvic ultrasound, take a blood test there or in a regular city clinic. If the mother was observed at the CDC at the maternity hospital before the birth, you can go to an appointment with him, especially if the pregnancy was carried out there. The second option is paid medical clinics and centers: you won’t have to sit in queues there, and there’s just more comfort. In general, when choosing both a free and a paid clinic, you need to look so that they are not just consulted, but really able to help. It’s one thing when there are no complaints and you go for a regular check-up after childbirth (take tests, do an ultrasound), another thing is when there is some kind of problem. Therefore, if something is bothering you, go to a large multidisciplinary center, there will always be a doctor specializing in a specific problem.

By the way, if a woman gave birth under a contract, then she is often provided with observation by an obstetrician-gynecologist within one month after giving birth, and this opportunity must definitely be used.

urgent examination
There are situations when you need to see a doctor urgently, and even go to the hospital:

• If the bleeding from the vagina has increased, this usually happens if there are parts of the placenta left in the uterus.
• If the blood discharge from the vagina has an unpleasant odor, that is, it is clear that there is an inflammatory process.
• If there are pains in the lower abdomen and body temperature has risen (or there are pains in the abdomen and unpleasant discharge from the vagina).
• If there are any problems with the postoperative suture after caesarean section (it does not heal, its edges are inflamed, ichor or pus has appeared from it).
• If you are concerned about stitches in the area of ​​genital ruptures (swelling, severe pain, discharge from the stitches).
• If there are signs of mastitis – a painful red lump in the chest, plus a rise in body temperature.

There is no need to postpone the appeal to the doctor and be afraid that he will put him in the hospital and have to be separated from the baby. It is better to stay in the hospital for several days than several weeks (when complications begin), because each of these situations does not go away on its own and sooner or later you still have to go to the hospital.