Postpartum Upper Back Pain Relief
Postpartum Upper Back Pain
As a pelvic floor physical therapist, I frequently work with postpartum moms who are surprised by persistent upper back and neck pain after delivery.
While much attention is placed on pelvic floor recovery, upper back pain is one of the most common musculoskeletal complaints during the postpartum period.
From a research based perspective, this pain is both predictable and treatable when we understand why it occurs and how the postpartum body adapts.
What Factors Contribute to Postpartum Upper Back Pain?
Upper back pain is common after pregnancy mostly due to postural changes that begin during pregnancy and often continue after birth.
As the abdomen grows, the body’s center of gravity shifts forward, which increases rounding of the upper spine, forward head posture, and rib cage flaring. These compensations help maintain balance during pregnancy but frequently persist postpartum, especially when reinforced by feeding, holding, and carrying an infant.
Research has shown that prolonged thoracic flexion and forward head posture significantly increase muscular load on the upper trapezius, levator scapulae, and cervical extensors, contributing to pain and fatigue.
Another major contributor to postpartum upper back pain is feeding posture. Whether breastfeeding or bottle-feeding, many new moms spend long periods leaning forward, looking down, and holding static positions for 20 to 40 minutes at a time.
Sustained, unsupported postures reduce blood flow to postural muscles and increase mechanical stress on the thoracic spine and shoulder girdle. Studies have consistently linked prolonged static positioning to neck and upper back pain, particularly in caregiving populations.
Changes in core and pelvic floor function also play an important role. The pelvic floor is part of a pressure management system that includes the diaphragm, deep abdominal muscles, and spinal stabilizers.
After pregnancy, these systems may be inhibited or poorly coordinated. Rib cage mobility may be reduced, breathing patterns often shift toward shallow chest breathing, and deep core activation may be delayed. When this occurs, the upper back and neck muscles compensate to provide stability, often leading to overuse and discomfort.
What can you do to prevent upper back pain postpartum?
From a physical therapy perspective, postpartum upper back pain responds well to targeted, research-supported exercises that restore mobility, strength, and breathing mechanics. Thoracic extension exercises using a towel roll or foam roller help counteract prolonged flexion and improve spinal mobility. Studies show that improving thoracic extension can reduce neck and shoulder muscle overactivity and improve posture.
Scapular retraction exercises paired with controlled breathing activate the mid-back stabilizers, such as the rhomboids and lower trapezius, which are often weakened postpartum. These muscles play a critical role in maintaining upright posture during feeding and carrying tasks. Scaption raise exercises further improve shoulder and upper back coordination while reinforcing rib cage and pelvic alignment.
Breathing exercises are especially important in postpartum rehabilitation. Seated diaphragmatic breathing that encourages 360-degree rib expansion helps restore coordination between the diaphragm, pelvic floor, and deep abdominal muscles. Research demonstrates that improved breathing mechanics reduce compensatory upper chest and neck muscle activation, decreasing upper back strain.
Stretching positions such as child’s pose with side bending provide gentle lengthening of tight thoracic and latissimus muscles while encouraging relaxation of overactive tissues. When combined with slow, controlled breathing, these movements can significantly reduce muscle tension.
Daily habits matter just as much as exercise. Bringing the baby to the breast instead of leaning forward, using arm and back support during feeding, changing positions frequently, and avoiding prolonged unsupported sitting can dramatically reduce cumulative strain on the upper back. Ergonomic adjustments often provide relief faster than stretching alone.
How long is too long?
Postpartum moms should consider seeing a pelvic floor physical therapist if upper back pain persists beyond six to eight weeks, worsens over time, or is accompanied by headaches, nerve symptoms, or pelvic floor concerns such as leaking, pressure, or pain.
A pelvic floor physical therapist evaluates the entire system. We will check posture, breathing, core function, and daily movement patterns rather than focusing on the painful area in isolation.
Postpartum upper back pain is common, understandable, and highly treatable. The body is not broken, it is adapting after pregnancy, birth, and the demands of early motherhood.
With evidence-based movement, improved breathing, and appropriate support, most postpartum moms can experience meaningful relief and improved function. Whole-body care is not optional in postpartum recovery, it is essential.
Looking for postpartum upper back pain relief or pelvic health physical therapy in Jacksonville Beach, FL?
If you’re looking for personalized, one-on-one sessions to address your pregnancy or postpartum concerns, we provide pelvic health physical therapy services to women in the Jacksonville Beach area.
If you’re looking for providers who will listen to you and help you get to the root cause of your postpartum concerns, we’ve got you. We’re here to help you if you’re experiencing pain, heaviness, leaking, or are pregnant/postpartum and want to continue safely working out/running/lifting during your pregnancy and get back to your sport after birth.
Get started today by booking a discovery call.
Resources:
Falla, D., O’Leary, S., Farina, D., & Jull, G. (2012). The relationship between cervical flexor muscle activation and neck pain. Manual Therapy, 17(3), 220–225.
Szeto, G. P. Y., Straker, L. M., & O’Sullivan, P. B. (2005). A comparison of symptomatic and asymptomatic office workers performing monotonous keyboard work. Manual Therapy, 10(4), 270–280.
Hodges, P. W., & Gandevia, S. C. (2000). Activation of the human diaphragm during a repetitive postural task. Journal of Physiology, 522(1), 165–175.
Sapsford, R., Hodges, P., Richardson, C., Cooper, D., Markwell, S., & Jull, G. (2001). Co-activation of the abdominal and pelvic floor muscles during voluntary exercises. Neurourology and Urodynamics, 20(1), 31–42.
Lee, D., & Lee, L. J. (2011). The thorax: An integrated approach. Journal of Orthopaedic & Sports Physical Therapy, 41(11), 817–826.
Vermani, E., Mittal, R., & Weeks, A. (2010). Pelvic girdle pain and low back pain in pregnancy: A review.Pain Practice, 10(1), 60–71.