7 reasons for lower back pain after epidural

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If you are a new mother or recently had an epidural injection, you might have had lower back pain when the local anesthetic subsided.

But, why do you still have back pain from the epidural weeks or months later?

While this is a common short-term side effect of the procedure, many patients are concerned about what it could mean. Others are just curious about the cause, especially if they haven’t had back pain before.

Reasons for Lower back pain after epidural

  • Back muscle spasm
  • Dural puncture
  • Ligament trauma
  • Nerve branch irritation
  • Infection
  • Spinal cord irritation
  • Lumbar disc herniation

I think it’s really important to find out if the epidural caused your lower back pain.

Other factors during your stay at the hospital, labor itself, or something else, might be the cause.

At a quick glance, reports of new-onset backache after an epidural vary from 2% to 31%, [1], but this includes pain for all possible reasons.

placement of epidural
Placement of epidural
[Image: Serdar Corbacı | Dreamstime.com]

Prolonged Back Pain After Epidural

Recent research consistently reports that there is no causal link between epidural analgesia and back pain.

Scientific studies consistently indicate that chronic back pain in the postpartum or postoperative period is more likely a result of other bodily changes associated with pregnancy and/or recovery. 

The use of epidural analgesia for pain relief began in the early 1900s. However, the technique and location of insertion were different. In the 1960s, the use of lumbar epidural anesthesia overtook previous methods and was adopted as the standard for the management of labor pain.

By the 1960s reports of chronic back pain by postpartum women were attributed to the increasing use of epidural analgesia. 

Back pain after Labor

Some proposed reasons for lower back pain in the postpartum period include poor posture, muscular relaxation, loss of abdominal support, changing center of gravity, and repetitive lifting tasks – such as lifting your bub!

But if you’re suspecting the epidural may have been the origin of your chronic pain, let’s revisit the procedure or skip ahead to Treatment for Lower Back Pain After Epidural.

How an epidural works

Epidural injections are a common form of pain relief during labor. They are administered through a thin catheter placed in the epidural space of the spine. The medication numbs the nerves that send pain signals in the lower body. The medication usually takes effect within 5-15 minutes after the injection is given.

epidural space infographic

Dural Puncture

The needle accidentally pierced through the meninges, which is a layer of protection around the spinal cord. If this happens you could experience symptoms like headaches and loss of vision or even dizziness as well.

You shouldn’t have chronic low back pain from a dural puncture after the appropriate medical care is given, but it is possible if scar tissue in the area is affecting spinal nerve roots. It is the most common risk of an epidural block.

Nerve Branch Irritation

The needle could also have damaged spinal nerves as it was inserted into the epidural space.

This is a rare complication, but if it does occur you may experience low back pain or other side effects like patches of numbness, that can last for weeks or months.


The needle used for the epidural block is sterile, as are the medications injected. The skin around the needle insertion site will be cleaned with a special antiseptic solution.

However, there is always a small risk of infection at the injection site or in the epidural space. Infection after an epidural block is very rare, occurring in less than 1% of cases.

Infection is a serious complication because it can spread upwards to the spinal cord and brain.

Spinal Cord Irritation

The spinal cord is the bundle of nerves that carries signals from the brain to the rest of your body. It is protected by the spinal column, but if the needle accidentally hits it when inserting the epidural, you may experience spinal cord irritation.

Symptoms of spinal cord irritation include:

– lower back pain

– muscle weakness

– difficulty urinating

– loss of sensation in the legs

If you experience any of these symptoms, immediately notify your doctor.

Lumbar Disc Herniation

Now, along with

  • muscle spasm,
  • facet joint sprain, and
  • inflamed sacroiliac joints,

A Lumbar disc herniation can cause lower back pain after epidural – but these injury types were likely sustained because of other factors during labor, or afterward.

spinal disc herniation
[Image: Alila07 | Dreamstime.com]

A lumbar disc herniation is a condition that occurs when the jelly-like center of a disc ruptures through a tear in the outer layer. This can happen due to twisting, lifting, or other sudden movements during the labor and delivery process – all of which can cause stress on your lower back.

Symptoms of a lumbar disc herniation include:

– pain that radiates from your lower back into your buttocks and legs

– muscle weakness

– numbness or tingling in your legs

– difficulty standing up or walking

So if you have the above symptoms, ask your Doctor, Chiropractor, or Physical Therapist about disc pain.

Treatment for Lower Back Pain After Epidural

If you are suffering from back pain after receiving epidural analgesia, these resources may help with your pain. 

Treatment options include:

Posture work

Postpartum women are at greater risk for pain related to poor posture. This is likely a result of repetitive bending tasks, loss of abdominal support, and changing center of gravity. Yoga is an excellent practice to promote good posture. Additionally, exercises such as these can be done at home to improve posture.

Muscle building

Pregnant women often experience a loss of muscle mass because of lower levels of activity during pregnancy. By exercising to build muscle, we can improve our posture and support the muscle groups responsible for a flexible and strong back. Check out these muscle-building exercises that can be done at home.

Chiropractic care

A licensed chiropractor can help if your back pain is from a disc or spinal joint issue. They identify the root cause of your back pain and suggest individualized exercises and treatments.

Physical therapists will also take this approach. Consider seeking out a chiro and/or physio to efficiently resolve your back pain.

Seek medical help

If you have sudden onset of severe back pain, if your back pain persists despite the techniques listed above, or if back pain is accompanied by dizziness, headache, and/or vomiting as those may be signs of a more serious condition.

Overall, epidural injections are a common and safe form of pain relief during labor. However, there are a few possible side effects that can occur, including lower back pain.

Home » 7 reasons for lower back pain after epidural

Author Bio

Dr Jason Whealing headshot

Dr. Jason Whealing is a Chiropractor with extensive experience across the UK and Australia. He is passionate about family care and injury management. The cases Jason works with daily include back pain, neck pain, jaw pain, sciatica, knee pain, shoulder pain, headaches and migraine.

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