Association of Cesarean Study with Chronic Low Back Ache in Multiparous Women – A Hospital Based Study

Abstract

Background: Chronic low back ache is a common musculoskeletal complaint among women after childbirth and can significantly impair quality of life. The increasing rate of cesarean section has raised concerns regarding its long-term effects on maternal musculoskeletal health. This study aimed to evaluate the association between previous cesarean section and chronic low back ache in multiparous women.

Methods: A hospital-based observational study was conducted at the Department of Obstetrics and Gynaecology, Kodagu Institute of Medical Sciences, Madikeri, Karnataka, from April 2024 to March 2025. A total of 200 multiparous women were included, comprising 100 women with a history of one or more cesarean sections and 100 women with previous vaginal deliveries. Demographic details, obstetric history, prevalence and severity of chronic low back ache, functional disability, and associated risk factors were assessed using a structured questionnaire, clinical examination, the Visual Analog Scale (VAS), and the Oswestry Disability Index (ODI). Statistical analysis was performed using IBM SPSS Statistics version 25.0, with p < 0.05 considered statistically significant.

Results: The baseline demographic and obstetric characteristics were comparable between the two groups. Chronic low back ache was significantly more prevalent among women with previous cesarean section than those with vaginal delivery (61.0% vs. 39.0%, p = 0.002). Women in the cesarean group had significantly higher pain severity and greater functional disability scores. Obesity (BMI ≥30 kg/m²) and multiple cesarean sections were significantly associated with chronic low back ache. Women with previous cesarean section had 2.45 times higher odds of developing chronic low back ache compared with women who had only vaginal deliveries.

Conclusion: Previous cesarean section is significantly associated with chronic low back ache in multiparous women. Early identification of at-risk women, along with postpartum physiotherapy, core strengthening exercises, and weight management, may help reduce long-term musculoskeletal morbidity and improve maternal quality of life.