Research Article

An Investigation of the Relationship between Anthropometry (Height, Weight and Body Mass Index) and Incidence of Low Back Pain Following Spinal Anesthesia in Elective and Emergency Surgical Procedures


Background: The incidence of low back pain in adults after spinal anesthesia is rather similar to that of general anesthesia. The pain is often mild with an increased incidence of low back pain that rarely spreads to the lower extremities but persists for several days after surgery. Fear of complications of back pain after neuraxial injection is one the main reason for patient’s refusal of neuraxial anesthesia. Some studies repoted obesity and BMI above 32 as risk factors for low back pain after surgery.
In this study, we aimed to investigate the relationship between selected parameters of body composition, including the amount of total body fat and muscular tissue, and the incidence of low back pain after spinal anesthesia.
Methods: A cross-sectional study was carried out on 100 patients who were candidates for elective or emergency surgery under spinal anesthesia. At first demographic data, a history of back pain and assessment and anthropometric assessment was asked. The history of back pain and intensity of pain were asked after one day, one month and 4 months after surgery. Then the relationship between pain intensity and anthropometric data were assessed.
Results: The mean pain intensity in the normal weight group was 1.3 ± 0.63. In the overweight group, the mean pain intensity was 1.1 ± 0.41. In the obese group, the mean pain intensity was 2.2± 1.2.
Regarding the relationship between mean pain intensity and weight, BMI, and anthropometry, the incidence of pain was not related to patients' anthropometry; the mean pain intensity of these groups were compared; and the incidence of pain was not dependent on weight, BMI, and anthropometry (p-value= 0.4).
Conclusion: Based on the obtained results, it can be concluded that no correlation exists between the incidence of low back pain and mean severity of pain and anthropometric indicators such as BMI, however, low back pain lasted longer in obese patients, which requires further study to investigate the exact nature of such a relationship.

[1] Urits I, Burshtein A, Sharma M, Testa L, Gold PA, Orhurhu V, et al. Low back pain, a comprehensive review: pathophysiology, diagnosis, and treatment. Curr Pain Headache Rep. 2019. 23(3):23.
[2] Benzon HT, Asher YG, Hartrick CT. Back pain and neuraxial anesthesia. Anesth Analg. 2016. 122(6): 2047-58.
[3] Stevens RA, Urmey WF, Urquhart BL, Kao TC. Back pain after epidural anesthesia with chloroprocaine. Anesthesiology. 1993; 78(3):492-7.
[4] Lund PC, Cwik JC, Quinn JR. Experiences with epidural anesthesia: 7730 cases. 2. Anesth Analg. 1961; 40:164-73.
[5] Heuch I, Heuch I, Hagen K, Zwart JA. Body mass index as a risk factor for developing chronic low back pain: a follow-up in the Nord-Trøndelag Health Study. Spine (Phila Pa 1976). 2013; 38(2):133-9.
[6] Chia YY, Lo Y, Chen YB, Liu CP, Huang WC, Wen CH. Risk of Chronic Low Back Pain Among Parturients Who Undergo Cesarean Delivery With Neuraxial Anesthesia: A Nationwide Population-Based Retrospective Cohort Study. Medicine (Baltimore). 2016; 95(16):e3468.
[7] Heuch I, Hagen K, Heuch I, Nygaard Ø, Zwart JA. The impact of body mass index on the prevalence of low back pain: the HUNT study. Spine (Phila Pa 1976). 2010; 35(7):764-8.
[8] Noormohammadpour P, Mansournia MA, Asadi-Lari M, Nourian R, Rostami M, Kordi R. A Subtle Threat to Urban Populations in Developing Countries: Low Back Pain and its Related Risk Factors. Spine (Phila Pa 1976). 2016; 41(7):618-27.
[9] Schwabe K, Hopf HB. Persistent back pain after spinal anaesthesia in the non-obstetric setting: incidence and predisposing factors. Br J Anaesth. 2001; 86(4):535-9.
[10] Urquhart DM, Berry P, Wluka AE, Strauss BJ, Wang Y, Proietto J, et al. 2011 Young Investigator Award winner: Increased fat mass is associated with high levels of low back pain intensity and disability. Spine (Phila Pa 1976). 2011; 36(16):1320-5.
[11] Toda Y, Segal N, Toda T, Morimoto T, Ogawa R. Lean body mass and body fat distribution in participants with chronic low back pain. Arch Intern Med. 2000; 160(21):3265-9.
[12] Han TS, Schouten JS, Lean ME, Seidell JC. The prevalence of low back pain and associations with body fatness, fat distribution and height. Int J Obes Relat Metab Disord. 1997; 21(7):600-7.
[13] Tekgül ZT, Pektaş S, Turan M, Karaman Y, Çakmak M, Gönüllü M. Acute Back Pain Following Surgery under Spinal Anesthesia. Pain Pract. 2015; 15(8):706-11.
[14] Kock S, Hopf HB. Inzidenz und prädisponierende Faktoren persistierender Rückenschmerzen nach lumbaler Katheterperiduralanästhesie im nichtgeburtshilflichen Bereich [Incidence and predisposing factors of persistent backache after lumbar catheter epidural anesthesia in a non-obstetrical settingø]. Anasthesiol Intensivmed Notfallmed Schmerzther. 1998; 33(10):648-52. German.
[15] BROWN EM, ELMAN DS. Postoperative backache. Anesth Analg. 1961; 40:683-5.
[16] Dahl JB, Schultz P, Anker-Møller E, Christensen EF, Staunstrup HG, Carlsson P. Spinal anaesthesia in young patients using a 29-gauge needle: technical considerations and an evaluation of postoperative complaints compared with general anaesthesia. Br J Anaesth. 1990; 64(2):178-82.
IssueVol 6 No 4 (2020): Autumn QRcode
SectionResearch Article(s)
low back pain spinal anesthesia weight obesity

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Gharedaghi R, Rajabian Tabesh M, Imani F, Abolhasani M. An Investigation of the Relationship between Anthropometry (Height, Weight and Body Mass Index) and Incidence of Low Back Pain Following Spinal Anesthesia in Elective and Emergency Surgical Procedures. Arch Anesth & Crit Care. 2020;6(4):161-166.