Pregnancy & Postpartum
Published January 1, 2026
What You Need to Know
Pregnancy and postpartum bring hormonal and biomechanical changes that often lead to musculoskeletal pain and pelvic floor dysfunction. Physical therapy offers effective, conservative treatment to reduce pain and improve function.
Key Points
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Common issues include low back pain, pelvic girdle pain, diastasis recti, and nerve-related conditions.
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Only a small percentage of pregnant individuals report pain to providers, yet most who receive PT see improvement.
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Pain can persist postpartum and become chronic without treatment.
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PT also addresses pelvic floor dysfunction, blocked milk ducts, and post-Cesarean scar pain
Insights from the Literature: Pelvic Health in Pregnancy and Postpartum Care
Pregnancy and postpartum changes often lead to musculoskeletal and pelvic floor dysfunctions such as low back pain, pelvic girdle pain, diastasis recti, and nerve-related conditions. Despite their prevalence, many individuals do not report symptoms or receive care. Research shows that early physical therapy improves pain, function, and quality of life, with 87% of treated patients reporting improvement. Without intervention, symptoms may persist and become chronic.
Physical therapy also supports Cesarean recovery, resolves blocked milk ducts, and treats pelvic floor issues like dyspareunia and bladder/bowel dysfunction. Early education and referral are essential to improving outcomes and reducing long-term impact.
The hormonal, physiological, and biomechanical changes occurring throughout pregnancy and into postpartum may result in musculoskeletal dysfunction and pain. More common conditions include pregnancy-related low back pain, posterior pelvic girdle pain and sacroiliac joint pain, anterior pelvic girdle pain and pubic joint pain, coccydynia, round ligament pain, abdominal wall strain, diastasis rectus abdominis, costal/rib pain and dysfunction, carpal tunnel syndrome, De Quervain’s tenosynovitis, neuropathies, and foot, ankle and lower leg dysfunction and pain (Stephenson & Cathcart, 2025a). Pregnancy-related low back (PLBP) and pelvic girdle pain (PGP) are cited commonly in research and are reported in between 70% and 86% of pregnant women in the United States.
(Gutke et al., 2018). Experiencing PLBP and PGP results in disrupted sleep in 58% (Wang et al., 2004) impaired activities of daily living in 57% (Wang et al., 2004), more time off work in 28% (Stafne et al., 2019) and negative emotions and fear of childbirth.(Close et al., 2016) Of those who report pain (only 32%) to their pregnancy care providers, treatment recommendations are offered to only 25%.(Wang et al., 2004) Improvements are reported in 87% of those receiving treatments( Gutke et al., 2018) indicating a critical need for educating the pregnant population and their care providers on the availability and benefits of receiving treatment.
It is commonly suggested that discomforts and low back pain are “normal” in pregnancy and will resolve in postpartum, likely contributing to the lack of reporting pain and seeking treatment. However, it is shown that lumbopelvic pain persists postpartum in up to 50% (Munro et al., 2017; Stomp-van den et al., 2012) and can become chronic with reports of pain continuing 12 years after childbirth.(Bergstrom et al., 2017). Conservative physical therapy treatment for musculoskeletal conditions can reduce pain and improve function during pregnancy and postpartum. In addition to addressing general musculoskeletal discomforts, pelvic floor-related dysfunction such as dyspareunia and bladder and bowel dysfunction may be addressed in pregnancy and postpartum. (Stephenson & Cathcart, 2025b). Physical therapy may also address blocked milk ducts and post-Cesarean scar pain and dysfunction in the postpartum. (Stephenson & Cathcart, 2025b).
References
Expand List of References
- Stephenson R, Cathcart D. Physical Therapy Examination, Evaluation, and Treatment of Musculoskeletal Disorders during Pregnancy and Postpartum, in The Physical Therapist’s Guide to Women’s Pelvic, Perinatal, and Reproductive Health. Routledge: New York. 2025-a.
- Gutke A, Boissonnault J, Brook G, Stuge B. The Severity and Impact of Pelvic Girdle Pain and Low-Back Pain in Pregnancy: A Multinational Study. J Womens Health (Larchmt). 2018; 27(4), 510-517.
- Wang SM, Dezinno P, Maranets I, Berman MR, Caldwell-Andrews AA, Kain ZN. Low Back Pain During Pregnancy: Prevalence, Risk Factors, and Outcomes. Obstet Gynecol. 2004; 104(1), 65-70. 2004. doi:10.1097/01.AOG.0000129403.54061.0e
- Stafne SN, Vollestad NK, Morkved S, Salvesen KA, Stendal Robinson H. Impact of Job Adjustment, Pain Location and Exercise on Sick Leave Due to Lumbopelvic Pain in Pregnancy: A Longitudinal Study. Scand J Prim Health Care. 2019; 37(2), 218-226. doi:10.1080/02813432.2019.1608058
- Close C, Sinclair M, Liddle D, McCullough J, Hughes C. Women’s Experience of Low Back and/or Pelvic Pain (LBPP) During Pregnancy. Midwifery. 2016; 37, 1-8. doi:10.1016/j.midw.2016.03.013
- Munro A, George RB, Chorney J, Snelgrove-Clark E, Rosen NO. Prevalence and Predictors of Chronic Pain in Pregnancy and Postpartum. J Obstet Gynaecol Can. 2017; 39(9), 734-741. doi:10.1016/j.jogc.2017.01.026
- Stomp-van den Berg, S. G., Hendriksen, I. J., Bruinvels, D. J., Twisk, J. W., van Mechelen, W., & van Poppel, M. N. (2012). Predictors for postpartum pelvic girdle pain in working women: The Mom@ Work cohort study. PAIN, 153(12), 2370–2379. doi:10.1016/j.pain.2012.08.003
- Bergstrom C, Persson M, Nergard KA, Mogren I. Prevalence and Predictors of Persistent Pelvic Girdle Pain12 Years Postpartum. BMC Musculoskelet Disord. 2017; 18(1), 399.
- Stephenson R, Cathcart D. Physical Therapy and Postpartum Care, in The Physical Therapist’s Guide to Women’s Pelvic, Perinatal, and Reproductive Health. Routledge: New York. 2025-b.