causes, prevention and management of post spinal backache: an overview

ABSTRACT

Back pain is one of humanity's most frequent complaints, a common reason for physician visits and a major psychological, physical and economical burden. Although the frequency of backache is as high as 46% even after general anaesthesia, it was the major cause for 13.4% patients refusing spinal anaesthesia. Multiple factors are involved in the pathogenesis of postoperative back pain and include type and duration of surgery, duration of immobilization, and the position of the patient during spinal puncture. Diagnosis of back pain is not simple; contributing factors may include needle trauma, surgical positioning, and injection of saline or local anaesthetic into the interspinous ligaments, development of a supraspinous hematoma, excessive stretching of ligaments after relaxation of paraspinal muscles and localized trauma to the intervertebral disc. Its relationship with various types and sizes of spinal needle is yet to be confirmed. Some preventive aspects have been discussed. Acute post spinal backache usually resolves within 7 days without any treatment but the possibility of epidural abscess or epidural hematoma must be ruled out. Counselling, hot and cold massage, mild analgesics like paracetamol or topical NSAIDs ointments may be prescribed