Low Back Pain that Started after the Birth of a Child

I would like to tell you the story of a young mom who was suffering from severe lower back pain. When we met her child was 1 year old but she had been suffering from increasing back pain since birth. Her medical doctor referred her to see us in the Physical Therapy department with the hope that we could figure out the root cause underlying the unrelenting low back pain from which she was suffering.

She had suffered some lower back pain during her pregnancy but instead of resolving after the birth of her child, it worsened progressively. X-rays were taken previously but they appeared completely normal.

Pregnancy Dramatically Weakened the Abdominal Muscles

There is a common situation that can occur after pregnancy called diastasis recti. Don’t even worry about pronouncing it! The point is the central vertical line of the abdominal muscles basically tears apart along the mid-line. You can almost picture it as opening a zipper that should never be opened.

Upon completing my physical therapy examination I noted that she had a 4 finger opening in her abdominal muscle. (Note that the picture to the right shows a 3 finger opening.) This is a very significant gap of about 2 inches. No one had diagnosed the anomaly up to this point. The bad news was that if it was going to heal on its own it would have by the 1 yr mark. The good news was that we now knew where the pain was coming from.

The Low Back Hurt Because it Was Overworked

With no abdominal muscle tone, she was having to use her back muscles exclusively to help her lift and stand and do all the normal activities of life.

Normally the abdominal muscles and the low back muscles work together to perform all these functions. With the added burden of no abdominal strength, the low back muscles were overwhelmed and trying to let the body know it by giving it pain.

It’s difficult enough to have a newborn with a lack of sleep and the like, without compounding the situation with unrelenting back pain. I was happy that we had a diagnosis and a program of physical therapy that would work for her. I have worked with many such mothers in similar conditions, and as long as they worked hard and followed recommendations, they did very well. The alternative is surgery, certainly not an action to take lightly.

A Successful Program

I embarked with her upon a specific protocol which included manual therapy (hands-on work) for her low back, hip, and groin muscles. This was followed by specific exercises designed to strengthen her core and other hip muscles. When she wasn’t being seen in the clinic she was asked to follow up at home with a specific exercise routine.

Patient compliance is key with this program and within a month, the separation had reduced to a 3 finger width, very good progress. The patient was ecstatic with the change and the lessening of her low back pain. It motivated her to go on and push herself to follow the protocol to the letter.

By the 2nd month, the abdominal separation was further reduced to 2 fingers, and her low back pain was almost completely gone. By the 3rd month ( a common length for a physical therapy program), the patient was almost back to normal. Not only was her low back feeling stronger than ever, but she was pleased to see her abdominal muscles were actually functioning again. Removal of the daily pain gave her a new lease of life.

he was now really enjoying the time spent with her child and looking forward to a life free of pain.

Physical Therapy is a Team Effort with the Patient

I very much enjoy what I do as a physical therapist. There is nothing more rewarding than discovering why someone has been suffering and having the skills to do something about it. Physical therapy is a “team sport” however, in that the patient and therapist have to work together to achieve the desired goal. If I could do all that was needed I would, but successful treatment requires that the patient perform some exercises at home.

The better the patient follows recommendations, the faster and more successful their treatment. Please let me know any questions you have and write to me so that I can hear your feedback.