Effect of postnatal physiotherapy during puerperal management of low back pain and diastasis recti

Association of low back pain (LBP) with diastasis recti (DR) is known and frequently encountered during obstetrical status. Exercise during puerperium is prohibited as per the Indian culture in maternal care. A 24-year-old primiparous woman developed LBP (visual analog scale 8) immediately after uneventful vaginal delivery, which jeopardized her functional independence. Examination revealed pathological DR showing interrectal distance (IRD) of 8.72 cm on Vernier caliper and 7.93 cm on transabdominal ultrasound (TAUS) at umbilical level. Physiotherapy limiting to isometric and functional activity was implemented on the patient from the 2nd postpartum day, which continued as home program up to 8 weeks. The patient reported complete resolution of LBP on the 12th postpartum day, whereas by the 8th week, her DR restored to physiological range with the reduction of IRD by 67.88% and 78% on caliper and TAUS, respectively. The case report concluded that culturally suitable postnatal physiotherapy was found to be effective in resolving postnatal LBP and restoration of DR.