Post-Spinal Anaesthesia Back Pain: What You Need to Know

By Dr. Amod Manocha – Pain Specialist, International Pain Centre, Delhi

Introduction

Have you or a loved one experienced back pain that started or worsened after spinal anaesthesia—especially following childbirth or surgery? This condition, often referred to as Post-Dural Puncture Backache (PDPB) or Post-Spinal Anaesthesia Back Pain, is a common but frequently misunderstood problem.

In this blog, we explain why this happens, who is more at risk, how long it usually lasts, and what you can do to manage or prevent it.

Is Post-Spinal Back Pain Common?

Yes, back pain after spinal anaesthesia is common. In fact, up to 70–80% of adults will suffer from back pain at some point in their life, and 20–40% of patients undergoing spinal anaesthesia report back discomfort in the days or weeks following the procedure.

Among women undergoing C-section deliveries, up to 24% experience significant backache afterwards. While most cases are mild and resolve on their own, some people experience pain that lasts for several weeks or even months.

Why Does This Happen?

There are several possible causes of back pain after spinal anaesthesia:

• Needle trauma to tissues and ligaments in the back
• Multiple attempts during the spinal injection
• Muscle spasm or inflammation at the injection site
• Prolonged surgical positioning, especially in awkward or strained positions (e.g. lithotomy)
• Pregnancy-related changes like increased weight, posture changes, and ligament laxity

Sometimes, back pain may be coincidental and not directly caused by the spinal anaesthesia at all—especially if the patient had back pain before the procedure.

Who Is More At Risk?

Certain people are more likely to experience this kind of pain, such as:

• Those with pre-existing back pain
• Individuals with a high BMI (Body Mass Index)
• Patients who remained in one position for long surgeries
• Women who have undergone C-sections
• Those who needed multiple spinal puncture attempts

Interestingly, studies show that new cases of persistent back pain after spinal anaesthesia are rare—less than 1%.

How Long Does It Last?

In most cases, this type of back pain:

• Appears within a few days after the procedure
• Begins to improve within 1–2 weeks
• Resolves completely by 3 months

Only a very small number of patients experience pain beyond this period. When this happens, it’s often related to underlying issues that were already present before the spinal injection.

How Can You Prevent It?

While it may not always be preventable, the following steps can reduce the risk:

• Using smaller gauge spinal needles
• Choosing the paramedian approach instead of the midline technique (less tissue trauma)
• Minimising the number of puncture attempts
• Ensuring good positioning during and after surgery
• Staying active after surgery (as per medical advice)

Your anaesthetist can play a key role in adopting these techniques to make your spinal procedure safer and more comfortable.

What Can You Do to Manage the Pain?

Most cases of PDPB are self-limiting and respond well to conservative care. Here are some useful management tips:

• Rest: Allow your back to recover, especially in the early days.
• Heat therapy: Warm compresses or hot baths can relax tense muscles and reduce spasms.
• Gentle exercise: Light stretching, yoga, or walking can aid recovery and prevent stiffness.
• Maintain good posture: Use pillows for support while feeding your baby or sitting for long periods.
• Avoid heavy lifting: Learn to lift using your legs, not your back.
• Pain relief medications: Paracetamol or anti-inflammatory medicines can be helpful if prescribed by your doctor.
• Physiotherapy: Can be very effective in restoring strength and function.
• Massage therapy: Helps to relax the back muscles and improve blood circulation.

If your pain continues or worsens over time, consult a pain specialist to rule out other causes and discuss further treatment options.

Final Thoughts

Back pain after spinal anaesthesia can be a source of discomfort but is usually temporary and treatable. With the right care and guidance, most people make a full recovery within a few weeks.

If you’re experiencing persistent back pain after surgery or childbirth, don’t ignore it. At the International Pain Centre in Delhi, we offer expert evaluation and evidence-based treatments to help you live pain-free.

Need help with persistent back pain?

Contact our experienced Pain Specialists at International Pain Centre, Delhi.

Let’s work together to remove your pain.

For more information watch the video below

References

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• Aryasa T, Pradhana AP, Ryalino C, Hartawan IGAGU. Post-Spinal Backache after Cesarean Section: A Systematic Review. Bali Journal of Anesthesiology. 2021;5(4):234–238. https://doi.org/10.4103/bjoa.BJOA_72_21
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• Mishra NK, Singh R, Prakash R, et al. Post-Spinal Anesthesia Low Back Pain in Obese Female Patients: Comparison of the Median Versus Paramedian Approach. Cureus. 2024;16(3):e56784. https://doi.org/10.7759/cureus.56784
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• Shanthi M, Gayathiri N, Paul EJ. Prevalence of back-pain following caesarean section under spinal anesthesia. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2023;12(9):2876–2880. https://doi.org/10.18203/2320-1770.ijrcog20232758
• Akdemir M, Kaydu A, Yanlı Y, et al. The Postdural Puncture Headache and Back Pain: The Comparison of 26-gauge Atraucan and 26-gauge Quincke Spinal Needles in Obstetric Patients. Anesthesia: Essays and Researches. 2017;11(2):458–462.