During the postoperative anesthesia follow-up, I am often asked by patients, “Why do I have low back pain after gynecological surgery?” Generally speaking, the main cause of postoperative back pain is damage to the muscles and ligaments of the low back. For general gynecological surgery, such as adnexal masses, uterine fibroids, ectopic pregnancy, etc., the commonly used anesthesia is intralesional anesthesia, commonly known as “semi-anesthesia”, which is administered behind the waist, and the puncture needle has to pass through the muscles and ligaments of the lower back. The incidence of low back pain after intralesional anesthesia is about 2% to 5%. In addition, uterine and adnexal surgery is pelvic surgery, and the surgical site is often exposed by retractors during surgery, and the placement of retractors may also lead to low back pain. In addition, improper lying posture during surgery may also lead to low back pain. The incidence of the above three types of postoperative low back pain can be reduced, and prevention can focus on three aspects: 1. Appropriate padding of thin pillows when lying down during surgery. A thin pillow (5cm thick) should be placed behind the patient’s head when the patient is lying down during surgery to relax the neck muscles; a thin pillow should also be placed at the lumbar back and behind the knee joint to maintain normal bending when lying down and to avoid abnormal pulling. 2. Choose a satisfactory anesthesia method. Female patients usually tend to suffer from low back pain, the choice of anesthesia method that should be taken into account, if necessary, consider choosing general anesthesia, to avoid anesthesia puncture brought about by the ligaments of the lumbar back injury, aggravating the low back pain. 3, prevention of post-operative low back pain also requires attention to care when returning to the ward after surgery. In addition to adding thin padded pillows, the necessary turning can also relieve muscle strain and fatigue and reduce pain. In addition, it is possible to get out of bed early to prevent postural strain. Some patients with persistent low back pain may receive physical therapy, such as infrared lamp irradiation, magnetic therapy, iontophoresis, heat therapy, etc., to promote early recovery, in addition to the application of pain relievers.