Pregnancy and childbirth are one of the most important periods in the life of every woman. During this wonderful time, young mothers have to deal with various types of psycho-emotional and physical stress.
After childbirth, girls often feel a loss of strength, excessive anxiety and pain localized in different parts of the body. The rehabilitation period after childbirth lasts up to 2 months. But sometimes this time is delayed, especially if the birth was not natural, but by caesarean section.
Why does the lower back hurt after a caesarean section?
Epidural anesthesia for caesarean section can cause discomfort later.
In the first days after childbirth, a woman may be bothered by various somatic manifestations. The main rule that young mothers need to adhere to during this period is to inform the doctor about any ailment and follow his instructions.
If pain occurs later, it is important to exclude dangerous causes of its development and select therapy that will allow you to quickly and safely restore your well-being in order to enjoy a happy period of motherhood.
Treatment of back pain
If the reason why your back hurts after a cesarean section is determined, it's time to start treatment. Today, there are a number of medications that help combat back pain. Sometimes a woman’s back pain can be so severe that the only solution to the problem is surgery.
Massage is an effective procedure that helps reduce discomfort.
An important part of rehabilitation after a cesarean section is drug therapy, which helps maintain the patient’s condition in a normal manner. The main localization of pain after a cesarean section is in the lumbar and sacrum areas. Therefore, specialists can prescribe a course of blockades to the woman in labor.
Massage helps effectively combat pain. It can only be done after examination and permission from a doctor. Movements should be smooth and light, slowly transitioning to targeted pressure on the lumbar region. In the postpartum period, you should refrain from intense physical activity and harsh massages. Under no circumstances should you self-medicate. It is important to always seek professional help. Remember: children need healthy parents who can take care of them.
Symptoms and nature of pain
Pain is the body's way of signaling a problem. Based on its location and nature, doctors can make a presumptive diagnosis.
However, after a cesarean section, the causes of pain and its manifestations are diverse. They may depend on the specific pathology and individual sensitivity of the patient.
More often, women complain that the lower back begins to pull, but sometimes the pain can shoot into the shoulder blades, radiate to the limbs on the left and right, or spread to the entire back.
Diagnostics is the only way to identify the true problem and begin to treat it purposefully.
Recovery after surgery
After a caesarean section, you should not ask doctors for a speedy discharge. You need to stay in the maternity hospital as long as the doctors deem necessary. If the pain does not stop for a long time, but only intensifies, then you may have to contact a specialist. Still, what to do if the pain does not go away, but before going to see a doctor you need to relieve it?
You can try out some recommendations and understand which one suits the mother most. But even before using them, you should consult with your doctor, at least by telephone.
- Cold and hot compresses (if there are no contraindications). Both a heating pad and ice will do.
- Warm (not hot) bath with sea salt. Relieves back pain and relaxes.
- A smooth and elastic mattress, orthopedic at best.
- Yoga and Pilates help strengthen the abdominal muscles.
- Chiropractic and acupuncture can help significantly reduce pain.
- Discuss the dose of pain medication with your doctor if the new mother plans to breastfeed.
Causes of pain syndrome
A caesarean section is an operation to assist in childbirth and can cause complications. Most of them are diagnosed immediately or are temporary, so there is no cause for concern.
Epidural anesthesia
Back pain after epidural anesthesia occurs due to irritation of the roots.
During a CS, general anesthesia is used only if there are serious indications. Most women cope with the operation using epidural anesthesia. It has fewer contraindications and is easily tolerated.
The doctor places an injection in the back, in the space between the vertebrae and the spinal cord. After this, the patient loses sensation in the lower half of her body for a short period of time: she ceases to feel the area from the waist to the tips of her toes, which completely blocks sensations even from tactile contact for the duration of the procedure.
Statistically, complications associated with spinal anesthesia occur in no more than 0.5-1% of cases. Most often we are talking about local, point pain at the injection site. It occurs immediately after sensitivity is restored, when the woman begins to walk independently. The pain goes away on its own after a day, a maximum of several days, so treatment is usually not prescribed.
If the pain lasts longer and affects the lower back, legs, and abdomen, we may be talking about irritation of the nerve roots during the injection. This cause can be recognized by the nature of the pain: it follows the path of the nerves. In this case, the doctor usually prescribes painkillers and recommends resting the spine.
When using an epidural, psychosomatic pain often occurs. It is not dangerous, but can significantly affect the quality of life of a young mother. The symptoms can be anything, and the reason is related to the patient’s psychological discomfort due to the fact that the doctor gave an injection in the back.
Epidural anesthesia is performed under completely sterile conditions and there is little risk of infection.
Real complications from anesthesia that occur very rarely:
- injury during the procedure;
- introduced infection.
To exclude these factors, you must consult a doctor and undergo a thorough examination.
The etiology of the pain syndrome may be associated with real pathologies of the spine. Osteochondrosis, which occurs in the vast majority of people, can worsen during pregnancy.
Exacerbation of existing osteochondrosis
Increased loads on the lower back can cause exacerbation of osteochondrosis.
Pregnancy is a significant load on the musculoskeletal system. The weight increases, the fetus puts pressure on the internal organs, so the muscles that support the spinal column are stretched. The spine can become deformed, pinching the nerve roots and hurting.
The catalyst for exacerbation of osteochondrosis can be not only pregnancy, but also childbirth itself, for example, if a woman in labor takes an uncomfortable position. Due to the anesthesia, she does not feel any discomfort, but as the epidural wears off, it can become painful.
A woman's behavior after childbirth may matter. If she has not developed a muscular corset and is not used to physical activity, carrying a baby in her arms can lead to back pain. In addition, you often have to bend and unbend over the crib.
Treatment in this case is long-term, aimed at maintaining the normal position of the spine and relieving symptoms.
Hormonal changes
A woman’s body helps her survive childbirth as painlessly as possible. In order for the fetus to pass through the birth canal, the pelvic bones must move apart. To do this, the hormone relaxin is produced, which softens the joint ligaments. But it cannot act locally, affecting only the pelvic area. Therefore, discomfort in the spine is a common companion for young mothers.
Pain after epidural anesthesia
Women who have undergone epidural anesthesia during childbirth often associate the appearance of back pain with the manipulation performed. But in fact, this method of pain relief is extremely rarely the cause of back pain.
What is epidural anesthesia
Epidural anesthesia is used during childbirth - both natural and caesarean sections - as well as during operations on the urinary system and lower extremities.
The anesthesiologist makes an injection and injects a painkiller (anesthetic) into the space between the spine and the membrane of the spinal cord, after which you will no longer feel pain below the injection site, and you will also temporarily (while the anesthetic is active) be unable to move your legs or feel touch from the lower ribs to the tips of the toes.
Such anesthesia is much easier to tolerate than general anesthesia - an epidural has less impact on the overall well-being and functioning of internal organs, and recovery after the procedure is faster. Nevertheless, many patients unfairly consider this manipulation to be the cause of long-term back pain.
Back pain that patients complain about after epidural anesthesia can be divided into two groups: pain directly related to the procedure, and pain for other reasons.
Pain associated with manipulation
In the vast majority of cases, pain after epidural anesthesia goes away on its own within a few hours or days. This may include:
- Point pain at the injection site. Like many medical procedures, epidural anesthesia can cause discomfort for the patient. In this case, they are associated with damage to the ligaments and muscles at the injection site. Unpleasant sensations may bother you for the first few hours after the end of epidural anesthesia. They usually go away without treatment, do not pose a threat to life and health, and therefore you should not worry about pinpoint pain.
- Pain along the nerves that radiates to one or both legs. These sensations are associated with irritation of the nerve roots during injection and administration of the medicine. A “shooting” type of pain is characteristic, usually appearing immediately after the injection and quickly passing without treatment. Don't worry, this is a normal reaction of the body to an epidural.
Pain caused by complications during epidural anesthesia occurs very rarely (less than 1% of all procedures performed). Their cause may be vascular injury or infection at the injection site. Pain at the injection site does not occur immediately, but after several hours; it can have a different nature and clinical manifestations (weakness and loss of sensation in the legs, urinary incontinence, increased body temperature and other symptoms may occur). In this case, you should immediately consult a doctor; there may be a serious danger to your health.
Pain due to other reasons
Most often, the cause of long-term back pain that patients complain about after epidural anesthesia is an exacerbation of existing back problems. For example:
- an uncomfortable position of the patient during surgery can provoke an exacerbation of arthrosis of the joints of the lumbar spine/sacrum or intervertebral hernia;
- Bearing a child and childbirth themselves can cause overload and strain on the ligaments, muscles and joints of the lumbar spine and pelvic bones, which leads to back pain during pregnancy and its intensification after childbirth.
Studies have shown that epidural anesthesia is an extremely rare (less than 0.05%) cause of long-term back pain. However, there is a so-called risk group: overweight patients, as well as those with intervertebral hernias. They experience pain somewhat more often than the average population.
It also happens that back pain is psychological in nature. The very fact of an “injection in the back” can lead to pain in the back in some patients - so-called psychosomatic pain.
Psychosomatic and neurological pain can bother you for months and even years, but they are not directly related to epidural anesthesia. If the discomfort is severe or continues to bother you for a long time, then you need to consult a neurologist.
Examination and treatment
Since pain is most often not associated with epidural anesthesia, a neurologist may recommend further examination in the form of MRI of the spine and electroneuromyography (a study of impulse transmission along nerves) to determine the real causes of pain.
Treatment usually includes a short course of nonsteroidal pain medications (eg, ibuprofen, diclofenac), physical therapy, and manual therapy (if there are no contraindications to it).
Remember: pain directly associated with epidural anesthesia is short-term and usually goes away without treatment. If you experience or increase pain after this procedure, be sure to consult a doctor.
Be healthy!
Maria Meshcherina
Photo istockphoto.com
Related products: (ibuprofen), (diclofenac)
When to see a doctor
After surgery, inflammation in the uterus is possible, which causes back pain
. Whatever the cause of the pain, a woman should definitely visit a doctor. If a short period of time has passed after childbirth, you can visit the specialist who managed the pregnancy. He will prescribe studies that will eliminate the risk of inflammation of the uterus and appendages, since against the background of this process the pain can radiate to the back:
- general blood and urine analysis;
- Ultrasound of the pelvic organs.
If no abnormalities are found in the organs of the reproductive system, the doctor may recommend contacting a urologist. During pregnancy, the kidneys are under high load, so chronic pyelonephritis may worsen after childbirth.
To find the cause of pain in the musculoskeletal system, you need to consult a neurologist. Magnetic resonance therapy and electroneuromyography will allow you to quickly make an accurate diagnosis.
A woman does not always have to go through a long, multi-stage diagnostic system. In the vast majority of cases, if the symptoms clearly indicate a specific pathology, it is enough to visit a therapist.