Back Pain After A C-Section
About one-third of babies born in the U.S. are delivered by Cesarean section, or C-section. Many women experience back pain both during and after pregnancy, and those who have had C-sections often wonder if their postpartum pain is related to this form of delivery
The changes a woman's body undergoes during pregnancy create a ripe situation for back pain. The muscles of the abdomen and pelvic floor are stretched, causing the lower back muscles to bear the burden of stabilizing the spine and supporting the upper body without adequate assistance. This burden is increased by the fact that your center of gravity shifts and you are carrying substantially more weight in your belly during pregnancy. While anyone may experience back pain after birth, there are a couple potential causes more likely among women who have delivered by C-section
Anesthetic Complications
Epidural anesthesia is used in many births, but almost always for women who are having Cesarean sections. Complications associated with these injections are rare, but they have been known to occur
The epidural space is located in your spine between the vertebrae and the spinal cord, the bundles of nerves that runs from your brain to the top of your lower back. The epidural space consists of blood vessels and fat. When you receive an epidural injection, the needle pierces the epidural space and a catheter is slipped through. Steroid solution runs through the catheter and bathes the spinal cord, numbing the nerves. The needle is removed while the catheter remains in place throughout delivery
It is normal to experience soreness at your injection site after receiving an epidural, but pain that lasts more than a couple weeks may indicate a complication. One main concern associated with epidurals is infection which, in the epidural space, is called epidural abscess. This problem is characterized by the buildup of pus between the vertebrae and the spinal cord. It can cause nerve compression and severe, prolonged pain. Other than pain, nerve compression is usually associated with weakness, numbness and tingling along the affected nerve path. The cause of abscess is often not identified. It is important to treat infections of the spine; an MRI is sufficient to confirm or rule out epidural abscess
Another epidural-related cause of back pain is nerve damage; this is a very rare occurrence and results from either administering an epidural to someone with a blood disorder, which can result in excess bleeding in the epidural space, or a careless injection
Abdominal Muscle Weakness
All pregnant women experience a stretching and weakening of the abdominal muscles as their bellies stretch out. The muscles of the pelvic floor are also stretched as your baby grows. As mentioned above, these muscles are very important for proper posture and spinal stabilization. Back pain related to muscle weakness likely results from the combination of two factors: slackened posture and overburdened lower back muscles
With less support from the front and base of the trunk, the body is more likely to slump forward. This changes spinal alignment and muscle length throughout the torso. The lower back muscles are left alone to support the upper body and spine, leading to chronic tension. Tense muscles are weak, as they do not get the rest and recuperation they need to take in nutrients and stay strong. As the whole core grows weaker, posture further suffers and the spine grows more unstable. This cycle can only be broken by exercise and postural awareness.
While core muscle rehabilitation is important for all women who have been pregnant, it is particularly important for those who have had C-sections. C-sections require extra trauma to the abdominal muscles; during the procedure, the muscles are pulled apart so that your surgeon can obtain access to your uterus. Pregnancy stretches the muscles outward, and the C-section procedure pulls them apart to the sides. This extra stretching may necessitate extra strengthening upon recovery
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