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 hysterectomy side effect, both in hospital and when you arrive home.

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

Cause of Back Pain After Hysterectomy With Effective Solutions

There is no one single cause of back pain after hysterectomy. There are actually a number of common causes of back pain that women need to be aware of to help prevent and manage this condition.

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

1. Cause – Hysterectomy Surgery Position & Anaesthetic

Lithotomy position for hysterectomyHysterectomy surgery is sometimes 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. Cause – 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. Cause – 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. Cause – 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. Cause – 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. Cause – 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.

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?

Hysterectomy Recovery Exercises for Avoiding Post-Operative Complications eBook

Hysterectomy Recovery Exercises Book 1with Pelvic Floor Physiotherapist
Michelle Kenway

Learn Physical Therapy exercises and techniques help you move well and exercise safely to avoid major complications and common side effects of hysterectomy.

Includes exercises for constipation, gas pain, lower back pain, moving in and out of bed and safe return to activity after hysterectomy. READ MORE NOW



*This article provides 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.

We Welcome Your Comments



  1. Hi Michelle I have ongoing of back pain after my hysterectomy, do you think Pilates or Yoga could help?

    • Michelle Kenway Physiotherapist says

      Hi Jane the best exercise for your back pain will depend upon the cause of your back pain. You do need to take care with general Pilates exercises and mainstream Yoga early following hysterectomy owing to the potential risk to your pelvic floor during your hysterectomy recovery. Doing the wrong exercises could exacerbate your back condition too. If back pain doesn’t resolve with the simple tips given in this article, the best thing to do is to seek an assessment and treatment from a Physiotherapist or your regular back practitioner. All the best

  2. Hi .. I’m 43 had total hysterectomy 6 years ago… I’ve developed bad back pain more so in the last couple of years & I now have terrible back pain … I can’t lay on my back, my side or my front. I feel like I have no curve in my back and that I’d benefit from a pillow under my back as it doesn’t work under my legs.. any tips for a good night sleep ?? I also find my joints are terrible … I use to be active and now I moan and grown with every bend and turn … nobody ever told me about the long term affects … and I’ve never been asked for a check up … not once ! I’ve been pretty much abandoned

    • Michelle Kenway Physiotherapist says

      Hi Nicole thanks for posting your comment. First and foremost get a medical assessment to make sure this is back related and nothing else. This does sound like a postural issue that a Physiotherapist would be able to assist you with. Perhaps it was exacerbated by posture and lack of core support along with muscle tightening after your hysterectomy surgery. Step 1 would be to get an appointment with a Physiotherapist. Excessive curve in the lower back is a common problem in women – it can be relieved somewhat by sleeping with a pillow under the knees when lying on the back. Lying on the tummy will make this much worse. It may sound strange but tight hip flexors are often the involved in this condition (these are the muscles at the front of the hips/groin that typically become tightened and short with prolonged sitting). Sometimes stretches for tight hip flexor muscles can assist – my guess is that your hip flexors are tight too. This along with other treatment based on a good thorough assessment of your posture which may include strengthening of your core muscles would be appropriate management. I hope this helps Nicole

  3. Hi Michelle, I had a total abdominal hysterectomy in July and have developed sciatica and my spine is raised on the left side. I have an appointment with a chiropractor on Friday, the physio just wanted to give me a massage. Do you think this is a wise idea?

    • Michelle Kenway Physiotherapist says

      Hi Nicola

      Your Physio will have made the treatment decision based on his/her assessment of your condition. Massage is definitely one treatment in the Physio’s bag of armory that can be used to settle down muscle spasm related to nerve compromise. Do you have a scoliosis too?

  4. Hi Michelle, I am 47 years old, I had an abdominal hysterectomy a little over a month ago. I had problems with back pain before my surgery but now it’s worse. Do you think these exercises will help me?

    • Michelle Kenway Physiotherapist says

      Hi Doniele
      Unfortunately I can’t say whether these exercises will help you. They are general mobility exercises. You might start by trying a new one every few days and note the difference. Any worsening of symptoms cease immediately. To treat specific instances of lower back pain it’s advisable to get an assessment and treatment from a Physiotherapist or practitioner familiar with dealing with post operative back issues. All the best to you!

  5. Thank you for writing this! Heather from Washington State, USA

  6. Hi !! I am 42 ,just had my total hysterectomy 40 days before. I am having lots many complications like dryness in mouth and vagina. backache and no sex drive. Depressed always…..less stamina after taking very healthy diet.much worried about my heath pls advise …m i able to be in normal life.

  7. Today is week 3 post op. Had total abdominal hysterectomy. I’m doing well walking well getting stronger by the day.
    I’m 71 years old was worried about my age and recovery as reading post from other women they seemed to be much younger than me so you can imagine my concern. However this has not been a problem apart from wind the first 10 days after op, but sorted it with peppermint oil capsules.
    I’m very much an outside active person, so the part of taking it easy as such is killing me but I’m doing what I’m told because I understand the implications of not doing so
    Can you tell me if I can try driving at 4 weeks post op, I find when I read up on this various answers.
    Your advise would be very much appreciated.

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Brenda
      I’m glad to read that you’re recovering well and getting back to walking outside. Best to phone your surgeon’s receptionist to know when you can drive as this can vary from one woman to the next. It’s important to know exactly when you have approval to return to driving as in some countries insurance doesn’t cover the individual post op until surgeon’s approval has been provided. All the best for many days outdoors with the sun on your back.

  8. How long lower back pain last after abdominal hypertension

  9. Had a hysterectomy a year ago..waz doing fine in the first 6 mnths until l started having a chronic left lower backpain and lower abdominal pains.
    Have gone for ultrasound several times and there seems to be no cysts or any abnormality but am in constant pain. What can l do to
    Find relief. Kindly assist

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Joileen
      It is possible that the discomfort may be coming from your back, I suggest you see an experienced Physiotherapist for an assessment. I hope things go well for you and you get some answers soon.

Pelvic Exercises Physiotherapy


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