Pregnancy related back pain, is it related to aerobic fitness? A longitudinal cohort study

Abstract

BackgroundLow back pain with onset during pregnancy is common and approximately one out of three women have disabling pain. The pathogenesis of the pain condition is uncertain and there is no information on the role of physical fitness. Whether poorer physical conditioning is a cause or effect of back pain is also disputed and information from prospective studies needed.MethodsA cohort of pregnant women, recruited from maternal health care centers in central Sweden, were examined regarding estimated peak oxygen uptake by cycle ergometer test in early pregnancy, reported physical activity prior to pregnancy, basic characteristics, back pain during pregnancy and back pain postpartum.ResultsBack pain during the current pregnancy was reported by nearly 80% of the women. At the postpartum appointment this prevalence was 40%. No association was displayed between estimated peak oxygen uptake and incidence of back pain during and after pregnancy, adjusted for physical activity, back pain before present pregnancy, previous deliveries, age and weight. A significant inverse association was found between estimated peak oxygen uptake and back pain intensity during pregnancy and a direct association post partum, in a fully adjusted multiple linear regression analysis.ConclusionsEstimated peak oxygen uptake and reported physical activity in early pregnancy displayed no influence on the onset of subsequent back pain during or after pregnancy, where the time sequence support the hypothesis that poorer physical deconditioning is not a cause but a consequence of the back pain condition. The mechanism for the attenuating effect of increased oxygen uptake on back pain intensity is uncertain.

Epidemiology of Low Back Pain in Adults

“…Low back pain has been reported consistently in a higher proportion of females than males . Back pain appears to be a significant problem during pregnancy and often continues after delivery . In a recent multicenter study conducted in the Spanish National Health Service , the four‐week prevalence of low back pain and leg pain was 71.3% and 46.2%, respectively.…”

Exercise and pregnancy in recreational and elite athletes: 2016 evidence summary from the IOC expert group meeting, Lausanne. Part 1—exercise in women planning pregnancy and those who are pregnant

“…Women who reported high-impact exercise 3–5 times per week before pregnancy had a 14% lower risk of developing severe PGP in pregnancy compared with non-exercisers 296. In a longitudinal cohort study, a greater loss of physical condition seems not to be a cause but rather a consequence of LBP and/or PGP in pregnancy,297 hence knowledge about type of exercise and dose is needed. Quality rating: moderate.…”

Possible Predictive Factors for Low Back and Pelvic Pain at Three Months Postpartum Assessed in a Prospective Study from Early Pregnancy until the Postpartum Period

“…Ostgaard et al [1] reported that the proportions of women with low back pain were 44.6% at 25 weeks of pregnancy and 45.6% at 11 weeks postpartum. Thorell et al [3] reported that the prevalence rates of lumbosacral and sacral pain were 30% -37% during pregnancy and significantly decreased to 11% -24% in the postpartum period. However, to our knowledge, there has been no prospective study on the proportions of women with LBPP during early pregnancy and at 3 months postpartum in Japan.…”

“…Thorell et al [3] reported that the intensity of back pain increased with advance of gestational age to a maximum level in late pregnancy and subsequently declined until 22 weeks postpartum. Our results are consistent with the results of that study.…”