I had a back to back baby (naturally at home) and also pushed for 4 hours while she turned so the last, well, 4 hours was pretty intense. I didn't feel like it was unmanageable or like I had any obvious back labour, or at least nothing that was noticeable. But I did use a TENS machine on my back from very early in labour, just when I was having strong period cramps, through to pushing, and I practiced hypnotherapy for pain relief. So you might try that. The hypnotherapy was amazing! I really didn't feel like labour was painful. It was intense and hard work and tiring (squatted and pushed with every contraction for those 4 hours), but it wasn't especially painful, except it started to hurt my thighs and knee after awhile! I think a lot of that had to do with doing hypnotherapy. But I also think using a TENS with a back to back baby probably helped a lot because it was very focused on my back, which is probably why I didn't obviously experience any back labour.