Hi Sharon,
One of the problems with epidurals (especially those done years ago when full blocks were popular) is that it is very easy to wrench the joints and ligaments, especially if the woman is moved in any way while the epidural is in place. Without the protection of the musculature, the joints are vulnerable, and midwives know that if her legs need to be lifted (for example, into stirrups in preparation for forceps) then both legs should be lifted together, to avoid the lower vertebrae, especially their junction with the spine, being jarred.
The back pain that may result after the birth may not be because of the epidural itself, but rather what happened to the woman's body while the epidural was in effect. A study by Macarthur that investigated the long term results of epidurals in 11,701 women in Birmingham found that backache was more common for women who had epidurals (18.9% compared to 10.5%), more frequent headaches ( 4.6% compared to 2.9%) more neckache (2.4% compared to 1.6%) and tingling in the hands or fingers (3.0% compared to 2.2%). The results could not be correlated to social or obstetric factors. 26 women had numbness or tingling in the lower back, buttocks and leg, of whom 23 had epidurals. Of 34 women with spinal headache, nine reported long term headaches.
This is not a randomised controlled trial but is nevertheless one of the few studies that have investigated long term problems.
Important to note that RCTs of epidurals are very unlikely to occur, as the anaesthetists have taken the stand that to perform an RCT would require that women in the control group would be denied access to this technique and to do this would be unethical. Perhaps this is one reason why they are so uninterested in the problems women report - they can claim that there is no "evidence" to support their claims that the problem was linked to the epidural. The reason there is no evidence is because they are not doing any studies!
Macarthur C, Lewis M, Knox E. Investigation of long term problems after obstetric epidural anaesthesia. BMJ 1992; 304:(1279-82.
Regards
Andrea
t 08:45 AM 14/02/2005, you wrote:
the reason im so interested is that 20 years ago I had one during my sons birth. I now suffer from backpain when I get overtired especially in the area where I had the epidural. my sister also has the same problem after her epidural which she had 4 years ago.this pain is deep muscle pain which takes your breath away and all you can do to alleviate it is go to sleep for a few hours. in my practice as a midwife I feel we should be warning women of the long term effects of epidurals say 10 to 20 years from when they have them administered but I needed the evidence to back up my claim.
regards sharon
----- Andrea Robertson Birth International * ACE Graphics * Associates in Childbirth Education
e-mail: [EMAIL PROTECTED] web: www.birthinternational.com
-- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
