Expert: Dr Ian Jackson - please note UK based - 10/3/2008

Question
I had my son 4 weeks ago When the Epidural was placed it worked fine. approximately. 4 hrs later I began to feel pain and the drugs were administered again. Nothing they tried worked, by the time someone mentioned reinserting I couldn't have stayed still long enough. Now when I get tired I hurt from the insertion site all the way to my toes. It is a sciatic type pain down my legs and when I bend over and straighten back up my back feels like it is going to break and like I have no control of my back almost like I could bend over the opposite way perfectly. I have to take 4 Motrin every 8 hrs to function and am not doing much of anything.By 7 PM I have to go to bed I don't know how I am going to go back to work when a trip to the grocery store kills me. What can I do? Is there anything (therapy, neurologist,massage, medication)and what? Can this heal itself?

Answer
Hi Tina
I am sorry to hear about your problem. Firstly back problems following childbirth are quite common and extensive research has shown little relation to epidurals. Women who don't have epidurals also have problems. One area that can be an issue is pressure on your sacral nerves inside your pelvis from babies head as it descends. Another problem is the hormone progesterone which is high in pregnancy makes your ligaments lax (loose) again this can cause problems to which we add the strain of lifting baby - sometimes in awkward ways e.g. in and out of the car in a baby seat.
So I'm not saying the epidural didn't contribute to this problem - just that the picture is probably bigger than just thinking about it alone.
So what to do?
Firstly you are doing the right thing by using ibuprofen - this is usually good for this type of pain. It might be worth also taking paracetamol (I think that is acetaminophen in the states) as well as they work in different ways and so would combine to give you better pain relief.
The old adage of rest is no use so you are doing the right thing by trying to keep going. However I find that regular exercise can help - swimming, cycling going to the gym. You need to take your pain killers and then exercise to promote movement in your back. I know fitting this in with being a mother is difficult but if you could do this I am sure it would help.
Finally rest assured that this usually settles over time, however the proactive approach with exercise usually speeds this up and means you'll get off the pain killers quicker.
Sorry no magical cure. If after another 4 weeks you are still having problems then please seek medical advice.
Kind regards
Dr Ian Jackson