“Can a spinal epidural cause back pain?”

Usually not

For a scheduled cesarean section you will have a spinal. The needle is long but very small gage. Though it’s possible to get back pain, it’s uncommon... other than feeling like you got poked in the back by a small needle.

Back pain is possible after c-section, but it is difficult to know whether it was caused by the changes in your back due to pregnancy, lying on a hard operation room table or by the spinal or epidural anesthesia.  (Usually an elective c-section is done with a spinal not an epidural).  Your anesthesiologist will discuss the risks and benefits of the various options prior to your surgery.
For women who go into labor, the incidence of back pain is similar in patients with no epidural and with an epidural.
Best wishes,
Steven Dain MD, FRCPC

Yes. It could cause back pain.

Spinal/epidural anesthesia can cause a sore spot where the needle is inserted. This spot is like a bruise and soon resolves. Back pain after any pregnancy is common due to the pregnancy causing softening of spina and hip ligaments. As pregnancy progresses, the spine, hips, and other joints adjust slowly to the growing pregnancy. At delivery, all of these softened ligaments must tighten and realign. During recovery from pregnancy, you should be careful to lift your infant properly and not awkwardly lift over crib rails or any lifting which might require twisting. You are just as likely to have an episode of back pain after pregnancy even if you do not have an epidural or spinal.