Occurring in approximately 13% of those receiving a spinal anesthetic, a post spinal backache is postulated to occur secondary to a localized inflammatory response, often associated with a degree of muscle spasm. The backache is usually self-limited, lasting from a few days up to a week. Treatment consists of conservative measures, including hot and cold compresses and mild analgesics such as acetaminophen and NSAIDs. In terms of anesthetic associated factors, needle size and needle type have not been shown to have an influence on incidence; however, the number of attempts correlates with an increased likelihood of backache associated with the procedure. During evaluation, a post-spinal backache must be delineated from other potential causes of backache after surgery, which can occur in up to 30% of patients. Other potential causes include patient positioning, type of surgery, duration of surgery, a history of chronic back pain as well as the potential for transient neurological symptoms or more serious conditions such as abscesses and hematomas.
L E Shutt, S J Valentine, M Y Wee, R J Page, A Prosser, T A Thomas Spinal anaesthesia for caesarean section: comparison of 22-gauge and 25-gauge Whitacre needles with 26-gauge Quincke needles. Br J Anaesth: 1992, 69(6);589-94