Postpartum Back Pain: Can Spinal Injections Cause Chronic Pain?

Many women receive spinal blocks, also called nerve blocks or spinal injections, during C-section births to relieve pain and allow them to stay alert. There is some debate over whether or not these injections can lead to chronic postpartum back pain.

Spinal blocks are administered through a long, thin needle filled with anesthetic and/or narcotics that is injected into the spine in the lower back. It is meant to numb the nerves that sense pain and send signals to and from the lower body and abdomen.

Since the injection is administered below the spinal cord, or the bundle of nerves that runs along the upper half of the spine, nerve damage is considered rare and implausible. However, internet forums are full of mothers with sciatica-like postpartum back pain who feel pain centered around the site of their injection.

It is undeniable that many women who have had C-sections experience lower back pain and sciatica pain. The question is: Is this pain related to spinal injection?

It is, unfortunately, not possible to say for sure. We have reason to believe, however, that having an injection may increase your risk of postpartum back pain, but not necessarily due to the needle itself. It is possible that the position women are put in to receive the injection is the source of pain. Some doctors put a wedge underneath one side of he buttock while the injection is administered, and this tilted position needs to be held for a few minutes. See the case study at http://www.sciencedirect.com/science/article/pii/S0959289X06000501 for more information on this potential cause of post-Cesarean back pain.

Another potential culprit of pain is the position assumed after delivery. Women who have C-sections spend the following days recovering, which involves a lot of sitting. Since the abdomen has been stretched during pregnancy and injured during delivery, the abdominal muscles are not able to assist in supporting the weight of the upper body. This strains muscles in the back and hips, possibly leading to piriformis syndrome. This is characterized by tightness of the piriformis muscle deep within the buttocks that places pressure on the sciatic nerve. See a relevant case study at http://linkinghub.elsevier.com/retrieve/pii/S1098733904000434.

It is rare but possible that the injection caused damage to the sciatic nerve. Sciatic nerve damage manifests as tingling, numbness, weakness and, in extreme cases, loss of function of the lower body, bladder and bowels.

There are numerous potential causes of back pain, especially for women who have given birth. Postpartum back pain could be related to additional weight straining muscles and changing posture, the delivery itself, or spinal injection. It is important to be knowledgeable about the potential causes of your back pain; while some doctors may dismiss it as a normal aftermath of delivery, it may be abnormal and become chronic. Take pain seriously, and educate yourself on possible causes and treatments.