Frequency of Low Back Pain After Spinal Anaesthesia in Obstetric and Non-Obstetric Patients: A Comparative Study in Bangladesh
Keywords:
Low back pain, Spinal anaesthesia, Obstetric patients, Non-obstetric patients, Cesarean sectionAbstract
Background: Low back pain after spinal anaesthesia is a recognised postoperative complaint. Clinical observations suggest it disproportionately affects pregnant women undergoing cesarean section, while non-obstetric patients rarely report similar symptoms. Aim of the study: This study aimed to compare the frequency and pattern of low back pain after spinal anaesthesia in obstetric and non-obstetric patients at a tertiary care hospital in Bangladesh. Methods: This retrospective comparative study was conducted at Gazi Medical College Hospital, Khulna, Bangladesh, from July 2024 to June 2025, and included 80 patients undergoing surgery under spinal anaesthesia: 40 obstetric and 40 non-obstetric. Data were extracted from hospital records and postoperative follow-up documents, and group comparisons were performed using chi-square, Fisher’s exact, and unpaired t-tests, with binary logistic regression used to identify predictors of post-spinal low back pain. Results: Obstetric patients were significantly younger than non-obstetric patients. The mean age was 27.8 ± 4.6 versus 38.9 ± 12.4 years. Obstetric patients also had higher BMI (28.1 ± 3.2 versus 24.6 ± 3.8 kg/m²), both p<0.001. They more often underwent spinal anaesthesia in the sitting position (77.5% vs 50.0%, p=0.010) and had multiple spinal attempts (40.0% vs 22.5%). Low back pain after spinal anaesthesia was significantly more frequent in obstetric patients at 6 months (40.0% vs 17.5%; p=0.027) and at 6 to 12 months (27.5% vs 10.0%; p=0.044). Among patients with low back pain, obstetric patients had higher pain scores at 6 months (4.8 ± 1.6 vs 3.6 ± 1.2) and greater functional limitation (43.8% vs 14.3%). Multivariable analysis showed independent predictors of low back pain: obstetric status (AOR 2.86, 95% CI 1.02 to 8.01, p=0.046), previous low back pain (AOR 3.78, 95% CI 1.02 to 14.06, p=0.047), multiple spinal attempts (AOR 3.12, 95% CI 1.08 to 9.04, p=0.036), and immediate post-procedure back discomfort (AOR 4.63, 95% CI 1.39 to 15.41, p=0.013). Conclusion: Low back pain after spinal anaesthesia was more common in obstetric than non-obstetric patients, suggesting that spinal anaesthesia alone may not fully explain the observed differences. The findings suggest that factors such as previous back pain, higher BMI, multiple spinal attempts, and early post-procedure back discomfort also influence post-spinal low back pain.
Mediscope 2026;13(2): 82-88
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Copyright (c) 2026 Abhijit Mondol, Gaitri Kashyapi, Amina Jannat Peea, Naznin Naher, Saddam Hossain, Murad Hossain
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