Labour Epidural Cause Chronic Back Pain?

Some women experience temporary soreness at the epidural injection site after delivery, which can lead to the belief that epidurals cause chronic back pain. However, current research does not support a link between epidural analgesia during labour and long-term back pain.

Recent Study

Earlier retrospective studies suggested a mild association between epidurals and back pain months after delivery, but these studies were limited by recall bias, as they relied on mothers remembering past symptoms long after childbirth.

More recent and higher-quality studies, including research by Howell et al., found no significant difference in the incidence of chronic back pain between women who had epidural analgesia and those who used other forms of pain relief during labour.

Most postpartum back pain is instead related to:

1. Poor posture together with hormonal changes leading to ligament laxity during pregnancy

2. Pre-existing back pain before delivery

3. Muscle strain from prolonged labour positions

4. Postural stresses after childbirth, such as feeding, carrying, and lifting the baby

What Can I Do If I Have Back Pain Post-Delivery?

Back pain after pregnancy is very common, as the body is still recovering from the mechanical and hormonal changes that occurred during pregnancy and childbirth. The muscles of the abdomen, back, and pelvis may be weaker, while the joints and ligaments may still be more lax than usual.

Seeing a physiotherapist early can be beneficial. Physiotherapy focuses on:

1. Restoring core and pelvic stability

2. Improving posture during feeding, carrying, and lifting the baby

3. Gradually rebuilding strength and endurance

4. Addressing movement patterns that may be overloading the back

Simple general guidelines include:

1. Avoid staying in one position for prolonged periods when feeding or holding the baby

2. Use supportive positions and pillows during breastfeeding or bottle feeding

3. Bend through the hips and knees when lifting the baby rather than rounding the back

4. Gradually return to gentle strengthening exercises as recommended by a physiotherapist

5. Avoid wearing high heels immediately post pregnancy.

Experiencing Chronic Back Pain after Labour Epidural?

Find out more about how Core Concepts Physiotherapy Singapore can help resolve pain.

Reference:

1. Alison Macarthur, Colin Macarthur, and Sally Weeks. Epidural anaesthesia and low back pain after delivery: a prospective cohort study BMJ 1995 311: 1336-1339
2. Howell CJ, Dean T, Lucking L, et al. Randomised study of long term outcome after epidural versus non-epidural analgesia during labour. BMJ 2002; 325:357. Erratum in: BMJ 2002; 325:580
3. Loughnan BA, Carli F, Romney M, Dore J, Gordon H. Epidural analgesia and backache: a randomized controlled comparison with intramuscular for analgesia during labour.Br J Anaesth 2002; 89:466-72
4. Russell, R., Reynolds, F. Back pain, pregnancy, and childbirth.BMJ 314: 1062-1062
5. Young G, Jewell D. Interventions for preventing and treating pelvic and back pain in pregnancy.Cochrane Database Syst Rev 2002;(1): CD001139