The Common Cause of Back Pain After Hysterectomy and Physio Solutions

Back pain after hysterectomyWhat is the cause of back pain after hysterectomy?

Knowing these major causes and solutions helps you avoid and manage this common condition in hospital and when you arrive home.

These simple Physical Therapy solutions help your hysterectomy recovery and faster return to regular activity.

Cause of Back Pain after Hysterectomy and Solutions

There is no one single cause of back pain after hysterectomy.

There are a number of common causes of back pain that women need to be aware of to prevent and manage this condition.

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  • Early hysterectomy recovery (abdominal or vaginal hysterectomy)
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  • Reducing the risk of common side effects e.g. back pain, constipation and gas
  • Preparing your body for return to work and regular activity.

Some of the major causes (and solutions) of back pain are listed below in no particular order of importance.

1. Hysterectomy Surgery Position and Anaesthetic

Lithotomy position for hysterectomyHysterectomy surgery is often performed in the lithotomy position (shown right).

The lithotomy position can increase back strain by flattening out the natural curves in the lower back. This position increases the risk of straining spinal muscles, ligaments (soft tissues) and/or joints. Spending a long time in the lithotomy position may increase the risk of back strain for some women.

When you’re under an anaesthetic,  your muscles don’t work to protect your back as they normally do when you’re awake. If your back is prone to injury the likelihood of lower back strain under anaesthetic is also increased.

Back Pain Solutions 

1. Tell your surgeon about your pre-existing back condition before your hysterectomy surgery. If you regularly receive treatment for your back condition, ask your regular practitioner (e.g. Physio, Chiropractor, Osteopath) to write a brief summary about your condition for you to take to your preoperative appointment. Your surgeon may be able to modify your lithotomy position or have you spend less time in this position while you’re anaesthetised.

2. Remind your theatre nurse about your back condition in the operating theatre before you are sedated. The nursing staff may then move you or position you to avoid aggravating your back condition while you are anaesthetised.

3. Inform post-operative nursing staff about your back condition or back pain after hysterectomy surgery. Nurses can often assist with appropriate positioning, local relief (e.g. warm packs) and/or organise Physical Therapy treatment for you during your hospital stay as required.

2. Incorrect Resting Position

Incorrect resting position after hysterectomyYour resting position plays a major role in preventing and managing back pain after a hysterectomy.

Resting in bed with the bed head elevated (shown left) is a major cause of back pain after hysterectomy. Lying in this position for extended periods of time is a major cause of back pain after hysterectomy as it places the normal spinal curves under strain.

Back Pain Solutions

1. Move the bed head down so that your upper body is almost flat to rest for part of the day unless you have a medical reason for having the bed head raised (e.g. chest complications or reflux).

The bed head is kept elevated when you are recovering from your anaesthetic to help your breathing and it’s important to rest upright in this position until your breathing returns to normal.

2. Sit out of bed in a chair with a supportive back rather than lying in bed for meals when you’re well enough to do so.

3. Use a pillow under your knees when lying flat to reduce the pressure off your lower back (shown below).


 3. Prolonged Bed Rest & Decreased Movement

Lack of movement is a major cause of back pain after hysterectomy. Your spinal joints and soft tissues can become less flexible when you don’t move causing stiffness and pain.

Back Pain Solutions 

1. Perform appropriate lower back exercises for back pain after hysterectomy. These exercises can prevent or ease lower back pain. They are often commenced during the hospital stay and continued after discharge at home.

2. Perform appropriate upper back exercises to help keep your back mobile after your hysterectomy.

Lying on lounge after hysterectomy3. Change position regularly to manage or prevent back pain. When your doctor gives you approval to move out of bed, try to vary your position regularly between lying down, sitting out of bed*, standing and walking. Continue to change your resting positions during the day when recovering at home.

*Avoid sitting or lying on a low soft lounge for extending periods of time during your recovery at home. A soft lounge offers very little support for your back and can cause back dysfunction and pain. Sit on a supportive lounge chair or a dining chair with a good back rest.

4. Moving out of Bed Incorrectly

Moving out of bed is often uncomfortable and challenging after hysterectomy, particularly after an abdominal hysterectomy. Moving incorrectly can increase the risk of back or pelvic floor strain after surgery.

Back Pain Solution 

How to move out of bed safely after hysterectomy video
Watch how to get out of bed safely after a hysterectomy

Use the correct technique for moving out of bed after a hysterectomy to protect your lower back and pelvic floor from undue strain.

The safe technique for moving out of bed involves rolling onto your side and sitting up sideways shown in this video (right).

5. Uncomfortable Mattress or Pillow

Lying on a different mattress or pillow can sometimes cause some discomfort during the hospital stay. Unfortunately there’s not much you can do about the comfort of the hospital mattress however there are some steps you can take to gain relief.

Back Pain Solutions

Resting position with pillow under knees 1. Take your own pillow into hospital if your hospital allows this (use a coloured or patterned pillowcase to help you identify your pillow).

2. Rest with a pillow under the knees to relieve pressure from the lower back when lying flat in bed (shown right)

3. Change position regularly and perform regular bed exercises can help minimise the impact of resting on a different mattress.

6. Pre-existing Back Condition

If you suffer from a back condition or if you’re prone to back problems you may be more likely to suffer from an exacerbation of your back condition after your hysterectomy surgery.

Back Pain Solutions

1. Discuss your hysterectomy surgery in advance with your regular back therapist. Your therapist may give you  exercises to help you strengthen your back prior to your surgery. He/she may also give you helpful information about the best back exercises or strategies to help you manage your condition in hospital and after discharge.

2. Discuss your regular pain relief medication for your back condition with your surgeon and plan your post-operative pain relief with your doctor for when you are discharged from hospital.

More Quick Home Solutions for Back Pain After Hysterectomy

There are a number of quick general solutions back pain at home including:

  • Soft tissue massage
  • Heat pack or warming pad
  • Simple exercises for the lower and upper back (see below)
  • Sitting on a firm supportive chair with good posture
  • Using good upright standing posture and avoiding slumping forwards
  • Lying down in a well supported position (see below)
  • Regularly changing your resting position
  • Intermittent walking throughout the day
  • Over the counter back pain medications (check with your pharmacist before starting any new medication)

Further Reading & Videos for Back Pain Recovery After Hysterectomy

» 5 Physiotherapy Exercises for Relieving Low Back Pain After Hysterectomy

» How to Avoid Side Effects of Hysterectomy – What Every Woman Should Know

» Walking after a Hysterectomy – Weekly Hysterectomy Exercise Guidelines

» Pelvic Floor Exercises After Hysterectomy – Physiotherapist Guided Video Routine (Video)

» Yoga After Hysterectomy – Is It Safe For Your Pelvic Floor?

*This is intended as general information for relieving lower back pain after a hysterectomy and not a substitute for medical treatment. Always follow the specific advice of your medical provider (surgeon or Physical Therapist) regarding the exercises that are appropriate for you after your hysterectomy. These exercises should always feel comfortable and pain free, cease any exercise that causes physical discomfort.

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