Low Back Pain and Pelvic Girdle Pain in Pregnancy

Casagrande, Danielle J.; Gugala, Zbigniew; Clark, Shannon; Lindsey, Ronald W.

doi:10.5435/jaaos-d-14-00248

Cited by 135 publications

(151 citation statements)

References 38 publications

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“…Simultaneously, the muscle torque of the erector spinae was increased in a model for pregnant women, compared to a model for non-pregnant women. This has also been demonstrated in previous research [5]. An assessment of muscle torque, especially in the muscles around the trunk segment of pregnant women can help to assess muscle stress related to LPP, and this is useful for managing LPP [31].…”

Section: Results Of Estimating Muscle Torque With the Proposed Musculosupporting

confidence: 66%

“…These physical and musculoskeletal changes elicit postural and movement changes and place strain on various body segments and muscles, which subsequently contribute to musculoskeletal pain, especially lower back and pelvic girdle pain during pregnancy [3,4]. Pain around the lower back and pelvis is collectively called lumbopelvic pain (LPP), and it is a common symptom during pregnancy that lowers the quality of life in many women during and after pregnancy [5,6]. LPP is thought to be strongly related to physical stress from daily basic activities, such as walking [7], and in particular, from some motions that includes flex rotations of the trunk, such as sitting, standing and bending [8,9].…”

Section: Introductionmentioning

confidence: 99%

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Estimating Co-Contraction Activation of Trunk Muscles Using a Novel Musculoskeletal Model for Pregnant Women

Morino

Takahashi

2017

Applied Sciences

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Weight gain and stretched abdominal muscles from an enlarged gravid uterus are remarkable features during pregnancy. These changes elicit postural instability and place strain on body segments, contributing to lower back pain. In general, the agonist and antagonist muscles act simultaneously to increase joint stabilization; however, this can cause additional muscle stress during movement. Furthermore, this activation can be observed in pregnant women because of their unstable body joints. Hence, physical modalities based on assessments of muscle activation are useful for managing low back pain during pregnancy. Musculoskeletal models are common when investigating muscle load. However, it is difficult to apply such models to pregnant women and estimate the co-contraction of muscles using musculoskeletal models. Therefore, the purpose of this study is to construct a musculoskeletal model for pregnant women that estimates the co-contraction of trunk muscles. First, motion analysis was conducted on a pregnant woman and the muscle activations of the rectus abdominis and erector spinae were measured. Then, the musculoskeletal model was specifically modified for pregnant women. Finally, the co-contraction was estimated from the results of the musculoskeletal model and electromyography data using a genetic algorithm. With the proposed methods, weakened abdominal muscle torque and the co-contraction activation of trunk muscles were estimated successfully.

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Section: Results Of Estimating Muscle Torque With the Proposed Musculosupporting

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Estimating Co-Contraction Activation of Trunk Muscles Using a Novel Musculoskeletal Model for Pregnant Women

Morino

Takahashi

2017

Applied Sciences

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“…Similar to non-specific LBP in the general population, risk factors for pregnancy related LBP and PGP are believed to be multifactorial (eg, increased joint laxity, displacement of gravity centre and increased axial loading, and vascular changes) and the exact pathogenesis remains unclear 67. The complex nature and unpredictable course of the condition further complicate the prevention of first time symptom onset.…”

Section: Discussionmentioning

confidence: 99%

Exercise for the prevention and treatment of low back, pelvic girdle and lumbopelvic pain during pregnancy: a systematic review and meta-analysis

et al. 2018

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ObjectiveThe purpose of this review was to investigate the relationship between prenatal exercise, and low back (LBP), pelvic girdle (PGP) and lumbopelvic (LBPP) pain.DesignSystematic review with random effects meta-analysis and meta-regression.Data sourcesOnline databases were searched up to 6 January 2017.Study eligibility criteriaStudies of all designs were eligible (except case studies and reviews) if they were published in English, Spanish or French, and contained information on the population (pregnant women without contraindication to exercise), intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise, alone [“exercise-only”] or in combination with other intervention components [eg, dietary; “exercise + co-intervention”]), comparator (no exercise or different frequency, intensity, duration, volume and type of exercise) and outcome (prevalence and symptom severity of LBP, PGP and LBPP).ResultsThe analyses included data from 32 studies (n=52 297 pregnant women). ‘Very low’ to ‘moderate’ quality evidence from 13 randomised controlled trials (RCTs) showed prenatal exercise did not reduce the odds of suffering from LBP, PGP and LBPP either in pregnancy or the postpartum period. However, ‘very low’ to ‘moderate’ quality evidence from 15 RCTs identified lower pain severity during pregnancy and the early postpartum period in women who exercised during pregnancy (standardised mean difference −1.03, 95% CI −1.58, –0.48) compared with those who did not exercise. These findings were supported by ‘very low’ quality evidence from other study designs.ConclusionCompared with not exercising, prenatal exercise decreased the severity of LBP, PGP or LBPP during and following pregnancy but did not decrease the odds of any of these conditions at any time point.

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“…Other rare pathologies may include osteomyelitis [99] and spinal tumours [91,100] . A detailed account of the aetiology of low back and pelvic pain in pregnancy can be found in other publications [11,12] .…”

Section: Discussionmentioning

confidence: 99%

Low Back Pain in Pregnancy: Investigations, Management, and Role of Neuraxial Analgesia and Anaesthesia: A Systematic Review

Sehmbi

D’Souza

Bhatia

2017

Gynecol Obstet Invest

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Background: Low back pain (LBP) is commonly experienced during pregnancy and is often poorly managed. There is much ambiguity in diagnostic work-up, appropriate management and decision-making regarding the use of neuraxial analgesia and anaesthesia during labour and delivery in these patients. This systematic review summarises the evidence regarding investigations, management strategies and considerations around performing neuraxial blocks for pregnant women with LBP. Methods: We searched 3 databases and reviewed literature concerning LBP in pregnancy with regards to diagnostic modalities, management strategies and use of neuraxial techniques for facilitating labour and delivery. Results: In all, we included 78 studies in this review, with 32 studies concerning diagnostic investigations, 56 studies involving management strategies, and 4 studies regarding the use of neuraxial techniques for labour and delivery. Summary: MRI is the safest investigative modality for LBP in pregnancy. Antenatal educational programmes, exercise and steroid injections into the epidural space or sacroiliac joints may help with pain management. Worsening neurological deficits, vertebral fractures and tumours may need surgical management. There is limited evidence on challenges of performing neuraxial blocks in the peripartum period for analgesia and anaesthesia, but there is a potential for increased risk of neurological complications in parturients with pre-existing neurological deficits.

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Low Back Pain and Pelvic Girdle Pain in Pregnancy

Cited by 135 publications

References 38 publications

Estimating Co-Contraction Activation of Trunk Muscles Using a Novel Musculoskeletal Model for Pregnant Women

Estimating Co-Contraction Activation of Trunk Muscles Using a Novel Musculoskeletal Model for Pregnant Women

Exercise for the prevention and treatment of low back, pelvic girdle and lumbopelvic pain during pregnancy: a systematic review and meta-analysis

Low Back Pain in Pregnancy: Investigations, Management, and Role of Neuraxial Analgesia and Anaesthesia: A Systematic Review

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