Comparison of Incidence of Low Back Pain in Women with Normal Vaginal Delivery and Cesarean Section

  • Nusrat Rasheed, Muhammed Hassaan Khan, Naseem Rasheed Department of Orthopaedics, Dow International Hospital, Karachi


Objective: To compare the incidence of low back pain between women who underwent caesarean section and those had normal vaginal delivery.

Methods: This comparative study was conducted in Dow university hospital from January 2014-December 2017. Total 340 patients coming in Orthopaedics OPD with backache fulfilling the inclusion criteria were enrolled in the study after taking informed consent. Questionnaires were filled by the research team members.

Results: Mean age of the respondents was 28 years, with mean parity was 4.2, 170(50%) delivered via normal vaginal delivery, 170(50%) (%) via Caesarean section. 20(5.8) %, out of them got general anesthesia,150 (94.2%) were given regional anesthesia. Out of those 150 who got regional anesthesia,105(70%) got spinal anesthesia and 45(30%)patient got epidural anesthesia. Patients who underwent C-section, 48(28.8%)%) had elective C-section, 122(61.7%%) had emergency C-section. Back pain was started in 15(4.4%) before pregnancy, 50(16.9%) during pregnancy and 266(77.3 %) after delivery. Regarding intensity of pain, 23(6.7 %) respondents mild backache, 175(50.9%) moderate and 140(40.7%) severe backache.

Conclusion: Low back pain is a problem in women after delivery either with cesarean section or normal vaginal delivery. There are certain risk factors which are associated with low back ache, those can be avoided needs specific strategies and management plan during pregnancy, at the time of delivery or during the administration of anesthesia


1. Kristiansson P, Svardsudd K, Von Schoultz B. Back pain during pregnancy: a prospective study. Spine (Phila Pa 1976) 1996 Mar;21:702–709.
2. Mogren IM, Pohjanen AI. Low back pain and pelvic pain during pregnancy: prevalence and risk factors. Spine (Phila Pa 1976). 2005 Apr 15;30(8):983-91.
3. Ostgaard HC, Andersson GB, Karlsson K. Prevalence of back pain in pregnancy. Spine (Phila Pa 1976). 1991 May;16(5):549-52.
4. Mogren IM. Does caesarean section negatively influence the postpartum prognosis of low back pain and pelvic pain during pregnancy? Eur Spine J. 2007 Jan;16(1):115-21. Epub 2006 May 5.
5. Ostgaard HC, Andersson GB. Postpartum low-back pain. Spine (Phila Pa 1976). 1992 Jan;17(1):53-5.
6. Ostgaard HC, Roos-Hansson E, Zetherstrom G. Regression of back and posterior pelvic pain after pregnancy. Spine (Phila Pa 1976). 1996 Dec 1;21(23):2777-80.
7. Noren L, Ostgaard S, Johansson G, Ostgaard HC. Lumbar back and posterior pelvic pain during pregnancy: a 3-year follow-up. Eur Spine J. 2002 Jun;11(3):267-71.
8. Joshi A, Joshi C Comparative study of occurrence of postpartum low back pain (LBPP) after normal delivery versus ceasarean section (CS) following spinal anaesthesia and its rehabilitative management. International Journal of Therapies and Rehabilitation Research 2016; 5 (4): 24-27.
9. Cancado TO, Omais M, Ashmawi HA, Torres MLA. Chronic pain after Caesarean section. Influence of anesthetic/surgical technique and postoperative analgesia. Rrev Bras Anestesiol 2012 Nov-Dec;62:6:762-774.
10. Breen TW, Ransil BJ, Groves PA, Oriol NE. Factors associated with back pain after childbirth. Anesthesiology 1994 Jul;81:29–34.
11. Howell CJ, Dean T, Lucking LD ziedzic K, Jones PW, Johanson RB. Randomized study of long term outcome after epidural versus non-epidural analgesia during labour. BMJ 2002 Aug;325:357.
12. Russell R, Dundas R, Reynolds F. Long term backache after childbirth: prospective search for causative factors. BMJ 1996 Jun;312:1384–1388.
13. Wang CH, Cheng KW, Neoh CA, TangS, Jawan B, Lee JH Comparison of the incidence of postpartum low back pain in natural childbirth and caesarean section with spinal anesthesia. Acta Anaesthesiol Sin 1994 Dec;32:243–246.
14. Drew MK, Sibbrit D, Charlie P. No association between previous Caesarean section delivery and back pain in mid age Australian women. Australian journal of physiotherapy; 2008;54:269-272.
15. Luijendijk RW, Jeekel J, Storm RK. The low transverse pfenestial incision and the prevalence of incisional hernia and nerve entrapment. Ann Surg. 1997 Apr;225:365-369.
16. Mc Evilly M, Buggy D. Back pain and pregnancy: a review. Pain 1996 Mar;64:405-414.
17. Chia YY, Lo Y, Chen YB, Liu CP, Haung WC, Wen CH. Risk of chronic low back pain among parturient who undergo cesarean delivery with neuraxial anesthesia. Medicine (Baltimore) 2016 Apr:95(16).
18. Anil Kumar Joshi, Chitra Joshi. Comparative study of occurrence of post partum low back and pelvic pain after normal delivery versus Caesarean section following spinal anesthesia and its rehabilitative management. International journal of therapies and rehabilitation research 2016;5(4):24-29.
How to Cite
RASHEED, MUHAMMED HASSAAN KHAN, NASEEM RASHEED, Nusrat. Comparison of Incidence of Low Back Pain in Women with Normal Vaginal Delivery and Cesarean Section. Journal of Pakistan Orthopaedic Association, [S.l.], v. 29, n. 04, p. 14-18, feb. 2018. ISSN 2076-8966. Available at: <>. Date accessed: 19 mar. 2018.