Many women who undergo cesarean delivery, also known as a c-section, report unusual sensations such as tingling and even mild pain in their legs as the anesthetic starts to wear off, according to obstetric anesthesiogist John S. McDonald in the 2010 edition of "Current Diagnosis and Treatment: Obstetrics and Gynecology." In most cases, leg pains and sensations subside over the course of two to six hours as normal motor function and sensory perception return to the legs and abdomen. Sometimes, leg pains and sensations after a c-section signal a medical emergency.
Anesthetic Drugs
According to McDonald, who serves as chairman of anesthesiology and professor of obstetrics and gynecology at UCLA Medical Center, pain signals from the uterus enter at the thoracic and lumbar levels of the spinal cord while pain signals from the genitalia enter somewhat lower, at the sacral levels of the spinal cord. Pain and motor signals from the legs enter and exit the spinal cord at many of the same levels, sometimes making it difficult for the brain to correctly attribute the source of pain, especially as it recovers from anesthesia. Women with diabetes, vascular disease, neurologic diseases and those who are simply sensitive to anesthesia clear drugs more slowly than healthy, normal women, leading to delayed recovery.
Spinal Needle Insertion
McDonald notes that spinal anesthesia has emerged as the anesthetic technique of choice for c-sections. In rare cases, insertion of the spinal needle injures the nerves that supply the legs, leading to postoperative pain that lasts a few days or sometimes even longer. In most such cases, patients also report severe leg pain at the time of needle insertion. Common leg symptoms related to spinal needle insertion include abnormal sensation on the backs of the thighs, genitals, buttocks or big toes.
Pregnancy and Labor
Compression of the nerves that supply the legs by a large or contracting uterus can result in abnormal leg pains and sensations that become more apparent after delivery in all women, not just those who undergo c-sections. Common complaints related to pregnancy and labor include abnormal sensation over the outer aspect of the thigh, foot drop and loss of strength in one leg. In almost all cases, symptoms resolve over the course of a few days or weeks. According to anesthesiologist Wayne Kleinman in the 2006 edition of "Clinical Anesthesiology," women who labor prior to undergoing a c-section may be more susceptible to these kinds of problems than women who undergo c-section without a trial of labor.
Emergency Warning Signs
In rare cases, leg pains and sensations after a c-section signify serious or life-threatening conditions such as infection or bleeding in the spinal cord or the formation of blood clots in the legs and lungs. Patients with leg pain that is severe, develops suddenly, begins a few days after a c-section, produces progressive numbness, decreased muscle strength or loss of bowel or bladder control, or occurs in conjunction with leg swelling, purple or red legs or breathing problems should seek emergency medical care.
References
- "Current Diagnosis and Treatment: Obstetrics and Gynecology, 10th edition;" A.H. Decherney and L. Nathan (eds.); 2007
- "Clinical Anesthesiology, 4th edition;" G.E. Morgan et al. 2006
- American Society of Regional Anesthesia and Pain Medicine: Patient Information
