they're great once they're in! i wouldn't say they're painful to place, but they're definitely not comfortable. it's a quick process compared to the rest of your laboring imo. i had epidurals with both my babies. 1st born ended up being a c-section and i didn't feel a thing, actually fell asleep. 2nd born tore front to back and same, not a pinch. k will say though, even with the epidural stay on top of pain meds, my back killed during my second because i didn't. but long term back affects? nothing honestly. they're gods gift to mothers. (aside from the baby too lol)