C-Section Scars: How They Cause Lower Back Pain
Authored by the Bodyful PT Team
Back Pain After a C-Section: What’s Going On and How Postpartum Physical Therapy Can Help
Are you experiencing back pain after a C-section?
Do you feel like you have a “bad back” after a cesarean delivery?
Do you experience burning or sharp pain during sex after a C-section?
At Bodyful Physical Therapy & Wellness, we offer postpartum physical therapy and caring for the whole body after a cesarean birth.
What Is a Cesarean Section?
A cesarean section is a surgical procedure in which a baby is delivered through an incision in the abdomen and uterus.
Like any surgical intervention, a C-section can have short-term and long-term effects. Some people experience lingering symptoms such as:
Low back pain
Postpartum sacrum pain
SI joint pain postpartum
Limited scar mobility
Pelvic and abdominal discomfort
Research shows that physical therapy interventions delivered with appropriate frequency and duration can significantly improve pain, daily function, joint mobility, comfort, and even reduce reliance on pain medications.
Do You Have a “Bad Back” After a C-Section?
Low back pain is very common during pregnancy and after cesarean delivery. One important contributor is often overlooked: abdominal scar tissue.
A 2021 randomized controlled trial found that a supervised core stability program was more effective than unsupervised home exercise for reducing pain and disability after C-section. Core coordination matters.
This type of care can be explored through:
In-person postpartum physical therapy
Telehealth physical therapy
One-to-one Pilates Reformer sessions
How Scar Tissue Contributes to Postpartum Pain
What Is Scar Tissue?
Scar tissue is structurally different from the original tissue. It often has:
Reduced mobility
Decreased blood flow
Increased sensitivity
Mobility and circulation in connective tissue are essential for easeful movement and pain-free function.
When scar tissue mobility is limited, it can affect structures that support:
The lumbar spine
The sacroiliac (SI) joints
The sacrum
This can contribute to postpartum sacrum pain, SI joint pain postpartum, and even symptoms that resemble sciatic pain after a C-section.
Internal Organs, Fascial Pull, and the SI Joint
Abdominal scar tissue also affects the internal organs and their fascial attachments.
Many pelvic organs—including the uterus—sit in front of the SI joints. When their movement is restricted by scar tissue, they can create tension and pulling on the sacrum, further sensitizing the joint.
At Bodyful, we are trained in visceral fascial mobilization, which works with the fascia around the organs and scar tissue to gently restore movement and blood flow.
This work is not about breaking adhesions or forcing tissue to change.
It is about:
Working with the nervous system
Introducing new movement possibilities
Supporting circulation and tissue adaptability
Hands-on care is paired with individualized movement to help your body integrate these changes.
The Abdominal Muscles and Core Coordination After C-Section
During a cesarean delivery, all layers of the abdominal wall are cut, including the deep stabilizing muscle called the transverse abdominis (TA).
When the TA is disrupted:
Core coordination can change
The mind-body connection to abdominal support may feel altered
Lumbar spine and SI joint support can suffer
This loss of coordination can contribute to:
Low back pain
SI joint pain postpartum
Pelvic instability sensations
Scar mobility work combined with targeted coordination training can restore:
Core support
Postural efficiency
Whole-body integration
The Role of the Respiratory Diaphragm in Postpartum Pain
The respiratory diaphragm is another key part of your core system.
Scar tissue in the abdominal wall can restrict diaphragm movement. Reduced diaphragm mobility has been linked to:
Low back pain
SI joint pain
Increased pelvic floor tension
Addressing breathing mechanics and diaphragm movement is often essential in comprehensive postpartum physical therapy.
Burning Pain With Sex After a C-Section
Even after a cesarean delivery, the pelvic floor muscles are deeply affected by pregnancy and birth.
The pelvic floor and abdominal muscles work together. When abdominal coordination is disrupted, pelvic floor function often changes as well. This can explain why some people experience:
Urinary incontinence
Pain with penetration
Burning pain during sex after a C-section
After trauma such as surgery, muscles may heal into a protective tension pattern. Chronically tense muscles become tight and painful—much like a clenched fist that struggles to open.
During penetrative sex, the pelvic floor must relax, lengthen and contract. Pain during sex after a C-section is common—and treatable.
Nerve Sensitivity After a C-Section
Several nerves can become sensitized after cesarean delivery, including:
Iliohypogastric nerve
Ilioinguinal nerve
Genitofemoral nerve
These nerves travel through the abdomen, pelvis, and hip muscles, and can be affected by:
Scar tissue
Muscle tension
Fascial restrictions
Nerve sensitivity may contribute to:
Burning pelvic pain
Groin or pubic pain
Symptoms that feel like sciatic pain after a C-section
Pelvic physical therapy can help by:
Improving blood flow to nerves
Reducing muscle tension and improving strength along nerve pathways
Teaching nerve gliding exercises
Supporting gradual, safe return to activities such as sex
You’re Not Alone—and There Is Support
If you’re experiencing:
Back pain after C-section
Postpartum sacrum pain
SI joint pain postpartum
Burning pain during sex
Nerve-related pelvic symptoms
You are not alone.
Many people see meaningful improvement within 2–3 months of postpartum physical therapy when care is individualized and comprehensive.
Work With a Postpartum Pelvic Physical Therapist
We offer:
In-person postpartum physical therapy
Online pelvic PT
Trauma-informed, somatic care
Your body has been through a lot.
Support can help it heal with more ease, clarity, and trust.
