Backache

Low back pain is common after delivery. Many patients believe that back pain is linked in some way to epidural analgesia administered for labor, and the alleged relationship between labor epidurals and postpartum backache has been suggested by two retrospective studies. One study reported new-onset long-term backache in 19% of women who delivered vaginally with labor epidural analgesia and in 10% of women who did not have an epidural in situ.^[224] A different group found an 18% incidence of new-onset postpartum back pain in women who delivered with an epidural versus a 12% incidence in those who delivered without an epidural.^[225] More recently, however, prospective studies evaluating labor epidural analgesia and postpartum back pain failed to find a significant link between epidural analgesia and back pain. One study reported that the incidence of postpartum backache in women who received epidural anesthesia was equivalent to the incidence in those who did not (44% versus 45%). Further data analysis demonstrated an association of new-onset postpartum back pain with greater weight and shorter stature; postpartum back pain was also associated with a previous history of back pain, greater weight, and younger age.^[226] Similarly, another recent study found no difference in the incidence of long-term low back pain in patients receiving epidurals for labor and controls who did not. ^[227]