Lombalgia gestacional: prevalência e características clínicas em um grupo de gestantes

Abstract

BACKGROUND AND OBJECTIVES: Gestational low back pain is a major complaint during gestation being responsible for many negative impacts on the quality of life of pregnant women. This study aimed at determining the prevalence of types of low back pain and their presentations in pregnant women. METHOD: This is a transversal descriptive study carried out with 21 pregnant women who attended a prenatal program in the city of Petrolina-PE. Patients were evaluated with specific tests to classify low back pain and have answered a questionnaire with sociodemographic and obstetric information. SPSS program's descriptive statistics and confidence interval were used for data analysis (CI 95%). RESULTS: From all evaluated pregnant women, 95.23% [CI 95% 76.18-99.88] have reported low back pain during gestation, being that 71.43% [CI 95% 47.82-88.72] had it previously to gestation. Most pregnant women, 57.14% [CI 95% 34.02-78.18], have reported pain lasting for more than 60 minutes. The combination of low back pain and posterior pelvic pain was observed in 66.65% [CI 95% 43.03-85.41] of patients and 28.58% [CI 95% 11.28-52.18] had just low back pain. CONCLUSION: There has been a high prevalence of low back pain among evaluated pregnant women, showing that the use of educational, preventive and rehabilitating measures is critical due to the negative impact of pregnancy-induced changes on quality of life of pregnant women. The inclusion of physical therapists as participants of Family Health Program actions with groups of pregnant women is critical to improve assistance practices.

Association between kinesiologic dysfunctions, lumbar disability and lumbopelvic pain in pregnancy

“…Studies (11,12,13,14) on the prevalence of gestational low back pain in our country have found results similar to ours, ranging from women had the first episode of pain after 14 gestational weeks, being compatible with most of the previous studies (3,4,8,27), possibly related to direct fetal pressure against the neural elements of the lumbar spine and greater overload in the lumbar muscles (13).…”

“…However, for pregnant women with low back pain, rest may be a strategy to relieve symptoms, since our study revealed that the majority (76.7%) found pain relief at bedtime, sit or relax, not related to lumbar incapacity. Previous studies (8,14) also reported improvement of the symptom with rest, possibly related to muscle relaxation (12), and worsened with the orthostatic position. Also, according to the participants, our study revealed that the walking, and this is significantly related to lumbar incapacity, possibly due to overload in the musculoskeletal system (14), but also, to the increase of the width of the step that consumes more energy and the longer time of maintenance of the feet on the ground, decreasing the simple support time, used as strategy for greater stability and support of body weight (25).…”

“…Our study revealed that posterior pelvic pain was less frequent (23.4%) followed by low back pain (36.6%), most of which were combined (40%). Previous study (14) of prevalence that have used specific clinical trials for low back pain are rare because different criteria can be used to characterize the origin of pain. A study (6) of 64 women reported gestational lumbopelvic pain, found that 17% identified the lumbar region as a site of pain, 33% of the pelvic region and 50% of both.…”

“…It is recognized in the literature that the relaxin hormone promotes greater ligament elasticity in the joints, leading to increased joint mobility (14), which leads to greater demands on muscle and ligament stabilization (31). However, our study revealed that women with lumbopelvic pain had a decrease in joint amplitude (especially for flexion and extension) of the lumbar spine in all movements, as well as lumbar flexibility, these being related to the increase of the lumbar incapacity.…”

“…According to research conducted in Brazil, the prevalence of gestational lumbopelvic pain ranges from 73% to 95.2% (11,12,13,14). This variation may be due to differences in the population of the study, the evaluation period (before or after gestational period), the study design (prospective, crosssectional or retrospective) or due to their different forms of presentation (low back pain, pelvic pain or combination of both), known popularly, regardless of the origin of pain and characterization, as low back pain in pregnancy (5).…”