Pain Management for Postpartum Pain: A Narrative Review

Lianzhen Zhou,1,* Junmin Li,2,* Yali Zhou,2 Yanan Liang,3 Qingling Ma,3 Luyao Yang,3 Yunting Pang,3 Yong Fang,3 Yaqiu Guo3 1Department of Anesthesiology, Jinan Central Hospital, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China; 2Department of Obstetrics and Gynecology, Jinan Maternal and Child Health Hospital, Affiliated to Shandong First Medical University, Jinan, People’s Republic of China; 3Department of Anesthesiology, Jinan Maternal and Child Health Hospital, Affiliated to Shandong First Medical University, Jinan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yaqiu Guo; Yong Fang, Department of Anesthesiology, Jinan Maternal and Child Health Hospital, Affiliated to Shandong First Medical University, No. 22029 Jingshi Road, Jinan, 250001, People’s Republic of China, Tel +86-0531-89029588 ; +86-0531-89029532, Email [email protected]; [email protected]: Postpartum pain is a complex clinical phenomenon that encompasses multiple types, including uterine contraction pain, perineal pain, breast pain, incisional pain, pelvic pain, low back pain(LBP), and pelvic girdle pain. These conditions can significantly impair maternal recovery and quality of life, thereby exerting adverse effects on maternal and neonatal health outcomes. The underlying mechanisms are diverse, involving tissue injury, inflammatory responses, neural sensitization, myofascial dysfunction, and psychological stress. Given its high prevalence and broad clinical impact, the study and management of postpartum pain hold substantial clinical significance. Although research in this field has increased in recent years, existing studies are largely confined to specific pain types or single intervention modalities, with limited efforts toward a comprehensive integration of the full spectrum of postpartum pain or a systematic analysis of its underlying mechanisms. Therefore, a comprehensive review is warranted to summarize the classifications, pathophysiological mechanisms, and multimodal management strategies of postpartum pain. The objectives of this review are threefold: (1) to systematically categorize different types of postpartum pain and outline their epidemiological characteristics and clinical burden; (2) to summarize the potential etiological factors and pathophysiological mechanisms underlying each pain type; and (3) to evaluate the clinical effectiveness of current multimodal analgesic strategies, with particular attention to the role of non-pharmacological interventions in postpartum pain management. Through this review, we aim to provide clinicians with a structured reference framework, while also identifying priorities for future research, thereby contributing to the development of systematic and individualized management strategies to ultimately improve maternal and neonatal outcomes.Keywords: postpartum pain, multimodal analgesia, pain assessment tools, perineal pain, pelvic girdle pain, chronic pain