When Pain Comes Back: Addressing the Layers of Postpartum Pain

Healing postpartum pain is rarely linear as often times there are multiple layers that need to be addressed for full healing to happen. Sometimes, even when a client initially improves, the pain can return – stronger and more confusing than before. For practitioners, this can be both humbling and illuminating. When postpartum pain worsens after treatment, it often signals that the body is asking us to look deeper, beyond structure and mechanics, into emotion and memory.

Today, I want to share a case study with you that highlights how physical symptoms can hold emotional stories, and what we can learn as clinicians when healing doesn’t go as expected.

Case Study: The Layers Beneath Pain

A client came to me four months after an intense, unmedicated vaginal birth. She reported:

• Shooting pain down her right leg that worsened when getting out of bed or lifting
• Occasional numbness and tingling in her heel
• Persistent hamstring and low back pain
• A sensation that her hips felt “wider” than before

She had a history of herniated discs and had received chiropractic treatments. Interestingly, activities like Peloton cycling sometimes gave her temporary relief.

During her first session, my assessment uncovered marked pelvic asymmetry, sacral flexion, and tension in the right uterine ligaments and pelvic floor. After gentle release work, she left feeling 80% better, but by her next visit, her pain had returned and she reported only feeling 30% better.

This shift told me something important: we were no longer just dealing with the body’s mechanics. Something deeper was asking to be heard.

Clinical Progress and Unexpected Setbacks

Between visits, my client went horseback riding, which aggravated her symptoms – reminding us how easily postpartum tissues can be strained before full recovery.

Her chiropractor suspected piriformis syndrome, but my palpation kept drawing me back to S2 on the right. Both external and internal work revealed tension and possible shearing at the sacrum. The tissues released gradually without forced manipulation, but I could still feel something being held there. We ended the session gently, with the intention to return to that deeper layer next time.

Two days after this session, she called in severe pain, the “pain came back worse.” This prompted an unscheduled, emergency visit.

Uncovering the Emotional Roots

As we worked through the tissues, the emotional narrative surfaced. The right-sided tension was connected to feelings of inadequate support during labor, specifically from her partner. The timing of her pain flare coincided with a difficult conversation in which she asked her husband for help, and his ambivalent response triggered old patterns of feeling unsupported.

As we explored further, childhood memories surfaced: her parents’ divorce, caring for her younger sibling, and the ingrained belief that “I have to do everything myself.”

Acknowledging, releasing and reframing this limiting belief catalyzed a meaningful shift in her relationship once she shared her experience with her partner. This shift opened the door to greater support and emotional healing.

Repatterning Birth Memories

Even with emotional progress, my client’s physical pain lingered. Another practitioner suspected coccyx malalignment, prompting a closer look at the sacral-coccygeal area. I noticed a bump near the right ILA, which may indicate an undiagnosed sacral fracture – a finding consistent with MRI studies showing postpartum pelvic bruising and fractures.

To facilitate deeper healing, we revisited the birth itself, allowing her to mentally replay the experience in a more supportive, empowered way. During this guided imagery, the tissues softened noticeably, and her pain lessened. Symptoms such as hamstring discomfort improved, although some numbness and tingling remained, revealing the multi-layered nature of recovery.

Key Lessons for Practitioners

When pain “comes back worse,” it’s not failure, it’s feedback. The body may be inviting us to explore what’s been hidden or unspoken. When working with postpartum clients:

• Get curious. Instead of trying to chase the pain away, ask what message it carries.
• Work gently. Forced releases can shut the body down. True healing unfolds when tissues feel safe.
• See the whole person. Pain is rarely just physical – it can hold emotional memories and beliefs waiting to be acknowledged and released.
• Collaborate. A multidisciplinary approach often provides the insight needed for complex postpartum cases.

Learn to Address the Deeper Patterns

At the Institute for Birth Healing, we help practitioners develop the sensitivity and confidence to navigate these deeper layers where physical and emotional healing meet.

If this case has sparked a chord with you, consider joining the Birth Healing Intensive. This program that is offered just once a year is designed to help you do your own interior work, so you can learn how to guide your clients in their deeper healing and get to the root of issues.

👉 Learn more or apply at instituteforbirthhealing.com/birth-healing-intensive/

Share this story with colleagues navigating complex postpartum recoveries. Together, we can help more birthing people experience smoother healing, deeper self-awareness, and the empowerment that comes from truly listening to the body.

About the Author: Lynn Schulte is a Pelvic Health Therapist and the founder of the Institute for Birth Healing, a pelvic health continuing education organization that specializes in prenatal and postpartum care. For more information, go to https://instituteforbirthhealing.com