-
Obstetrical & Gynecological Survey Jun 2023Pelvic girdle pain is often thought to be a recent phenomenon, but this condition was described as early as 400 BC by Hippocrates. Despite being identified for years,... (Review)
Review
IMPORTANCE
Pelvic girdle pain is often thought to be a recent phenomenon, but this condition was described as early as 400 BC by Hippocrates. Despite being identified for years, confusion continues about the definition and management of this ailment affecting many pregnancies.
OBJECTIVE
The purpose of the review is to assess the incidence, etiology, pathophysiology, risk factors, diagnosis, management, and pregnancy outcomes/recovery of current pregnancies, and outcomes of future pregnancies complicated by pelvic girdle pain.
EVIDENCE ACQUISITION
Electronic databases (PubMed and Embase) were searched from 1980 to 2021 with the only limitation being that the articles were in English. Studies were selected that examined associations between pelvic pain/pelvic girdle pain and pregnancy.
RESULTS
There were 343 articles identified. After reviewing the abstracts, 88 were used in this review. Pelvic girdle pain is a common condition of pregnancy, affecting a reported 20% of pregnant women. The pathophysiology is poorly understood and likely multifactorial, involving both hormonal and biomechanical changes that occur during pregnancy. Several risk factors have been identified. This diagnosis is most commonly made based on symptoms related to pelvic pain during pregnancy. Treatment should be multimodal, including pelvic girdle support, stabilizing exercises, analgesia, and potentially complementary therapies. The effects on future pregnancies are uncertain, although some limited information suggests an increased risk of recurrent PGP in subsequent pregnancies.
CONCLUSIONS
Pelvic girdle pain in pregnancy is a common condition that is often overlooked as a normal part of pregnancy but has a significant impact on quality of life during, after, and in subsequent pregnancies. Multimodal therapies are available and are largely low cost and noninvasive.
RELEVANCE
Our aim is to increase the awareness of pelvic girdle pain in pregnancy as a common but often underdiagnosed and undertreated condition.
Topics: Pregnancy; Female; Humans; Pelvic Girdle Pain; Quality of Life; Pregnancy Complications; Exercise Therapy; Risk Factors
PubMed: 37322996
DOI: 10.1097/OGX.0000000000001140 -
International Urogynecology Journal Sep 2023The Pelvic Girdle Questionnaire (PGQ) is designed to determine pain and limited activities in pregnant and postpartum women with pelvic girdle pain (PGP). The purpose of...
INTRODUCTION AND HYPOTHESIS
The Pelvic Girdle Questionnaire (PGQ) is designed to determine pain and limited activities in pregnant and postpartum women with pelvic girdle pain (PGP). The purpose of this study was to translate the PGQ into the Urdu language and find out the cross-cultural validity and reliability of the Urdu PGQ among pregnant and postpartum women.
METHODS
A translation and cultural adaptation study was performed following international guidelines. The PGQ (the Urdu version) was drafted and a pilot study was conducted on 16 pregnant and postpartum women. A total of 125 pregnant and postpartum females participated in this study for validity and test-retest reliability. SPSS 25 was used for data analysis.
RESULTS
Content validity was analyzed by the content validity index ranging from (0.92 to 1). Convergent validity was determined by correlating the Urdu version of the PGQ with the Oswestry Disability Index (ODI). Pearson rank correlation coefficient between the PGQ and the ODI (p=0.84) showed convergent validity. Internal consistency and test-retest reliability of the Urdu version of the PGQ were calculated by Cronbach's alpha (α=0.98), and intra-class correlation coefficient (ICC=0.98) respectively.
CONCLUSION
The Urdu version of the PGQ showed good content and convergent validity as well as high internal consistency and test-retest reliability.
Topics: Pregnancy; Humans; Female; Reproducibility of Results; Pilot Projects; Postpartum Period; Translating; Surveys and Questionnaires; Psychometrics
PubMed: 37039857
DOI: 10.1007/s00192-023-05523-3 -
Anticancer Research Aug 2022Ewing sarcoma is a common primary bone tumor, often located in the distal femur or pelvis. Although the scapula is a flat bone similar to the pelvis, scapular Ewing... (Review)
Review
BACKGROUND/AIM
Ewing sarcoma is a common primary bone tumor, often located in the distal femur or pelvis. Although the scapula is a flat bone similar to the pelvis, scapular Ewing sarcoma is rare. The aim of this study was to review our institution's experience with the management of scapular Ewing sarcomas.
PATIENTS AND METHODS
We reviewed 9 patients with an Ewing sarcoma of the scapula, which included 5 males and 4 females with a mean age of 19±6 years. All patients were treated with chemotherapy and local control. Local control included surgical resection (n=7) and definitive radiotherapy (n=2). Mean follow-up was 6 years.
RESULTS
Prior to induction chemotherapy, the mean tumor size and volume were 10±2 cm and 181±112 cm, respectively. Following induction chemotherapy, there was a reduction in the mean tumor size (6±3, p=0.02) and volume (20±12 cm, p<0.01). The mean tumor necrosis in patients undergoing resection was 72±23%. The median survival was 30-months, and the 5-year disease specific survival was 38%. At most recent follow-up, the mean Musculoskeletal Tumor Society Score was 79±14%.
CONCLUSION
Scapular Ewing sarcoma is a rare, aggressive tumor. Even with chemotherapy and local control with surgery or definitive radiotherapy, patient survival is poor.
Topics: Adolescent; Adult; Female; Humans; Male; Young Adult; Bone Neoplasms; Neoplasm Recurrence, Local; Retrospective Studies; Sarcoma, Ewing; Scapula
PubMed: 35896233
DOI: 10.21873/anticanres.15879 -
SAGE Open Medical Case Reports 2021Lumbo-pelvic pain is a common and non-specific problem during pregnancy and postpartum. Although perinatal pyogenic sacroiliitis is uncommon during this time, it might...
Lumbo-pelvic pain is a common and non-specific problem during pregnancy and postpartum. Although perinatal pyogenic sacroiliitis is uncommon during this time, it might be difficult to distinguish from reactive sacroiliitis in women who are experiencing significant lower back and pelvic girdle pain, as the symptoms and signs are not clear and the tests are not definitive. A 34-year-old primigravida went to the emergency department with severe lower back pain radiating to the right gluteal region and down to the back of the right thigh. This pain began 12 days prior to her presentation and eventually worsened to the point that she could not stand or walk. Her vital signs were within normal ranges, and she was experiencing a fever. Apart from a slight widening of the symphysis pubis, her pelvic and lumbo-sacral pain X-rays revealed no important findings. With the clinical impression of right lumbo-pelvic pain, the patient was admitted for pain management and further inquiries. Despite the fact that the antibiotherapy was prescribed to treat a urinary tract infection, the significant recovery of the patient's symptoms, even in the absence of a definitive culture of aspirate from the right sacroiliac joint, supported the diagnosis of pyogenic sacroiliitis.
PubMed: 34659772
DOI: 10.1177/2050313X211052442 -
PM & R : the Journal of Injury,... Aug 2019
Topics: Arthralgia; Humans; Low Back Pain; Pelvic Girdle Pain; Sacroiliac Joint
PubMed: 31276319
DOI: 10.1002/pmrj.12215 -
Expert Review of Clinical Immunology 2023Polymyalgia rheumatica is a common inflammatory rheumatic disease in subjects aged 50 years or older and classically presents with shoulder and/or pelvic girdle pain... (Review)
Review
INTRODUCTION
Polymyalgia rheumatica is a common inflammatory rheumatic disease in subjects aged 50 years or older and classically presents with shoulder and/or pelvic girdle pain and prolonged morning stiffness. Glucocorticoids represent the standard of treatment; glucocorticoid therapy is usually required for 1-2 years and often results in significant glucocorticoid-related side effects, especially in the elderly.
AREAS COVERED
In this review, we aimed to provide a comprehensive overview of the management of polymyalgia rheumatica, with a particular focus on adjunctive therapies to the standard glucocorticoid treatment.
EXPERT OPINION
Given the high frequency of disease relapses (one-third of patients) and the adverse events related to prolonged glucocorticoid use, the need for glucocorticoid-sparing agents remains an important issue in the management of polymyalgia rheumatica. In selected patients, who are at risk for glucocorticoid-related side effects or in those with glucocorticoid-refractory disease, the addition of a glucocorticoid-sparing agent, either a synthetic or biologic disease-modifying anti-rheumatic drug, may represent a reasonable and effective therapeutic approach.
Topics: Aged; Humans; Polymyalgia Rheumatica; Glucocorticoids; Giant Cell Arteritis; Antirheumatic Agents; Steroids
PubMed: 37480289
DOI: 10.1080/1744666X.2023.2240519 -
Journal of Clinical Medicine Dec 2020Pelvic girdle pain (PGP) refers specifically to musculoskeletal pain localised to the pelvic ring and can be present at its anterior and/or posterior aspects. Causes... (Review)
Review
Pelvic girdle pain (PGP) refers specifically to musculoskeletal pain localised to the pelvic ring and can be present at its anterior and/or posterior aspects. Causes such as trauma, infection and pregnancy have been well-established, while patients with hypermobile joints are at greater risk of developing PGP. Research exploring this association is limited and of varying quality. In the present study we report on the incidence, pathophysiology, diagnostic and treatment modalities for PGP in patients suffering from Hypermobility Spectrum Disorder (HSD) and Hypermobility-Type Ehlers-Danlos Syndrome (hEDS). Recommendations are made for clinical practice by elaborating on screening, diagnosis and management of such patients to provide a holistic approach to their care. It appears that this cohort of patients are at greater risk particularly of mental health issues. Moreover over, they may require a multidisciplinary approach for their management. Ongoing research is still required to expand our understanding of the relationship between PGP, HSD and hEDS by appropriately diagnosing patients using the latest updated terminologies and by conducting randomised control trials to compare outcomes of interventions using standardised patient reported outcome measures.
PubMed: 33317183
DOI: 10.3390/jcm9123992 -
International Urogynecology Journal May 2021Many observational studies have suggested the existence of a link between urinary incontinence (UI) and lumbopelvic pain. The aim of our study is to evaluate the... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION AND HYPOTHESIS
Many observational studies have suggested the existence of a link between urinary incontinence (UI) and lumbopelvic pain. The aim of our study is to evaluate the association between UI and back pain (BP) or pelvic girdle pain (PGP) in the adult population.
METHODS
This systematic review with meta-analysis was registered in PROSPERO under the number 2019:CRD42019120047. Literature was sought in the Medline, Embase, and PEDro databases. The search was limited to English, Spanish, and French records, and was conducted from inception until November 2019. Observational studies evaluating the association between UI and BP/PGP were selected by two independent reviewers. Quality assessment was performed using the "Critical Review Form for quantitative studies" (McMaster University).
RESULTS
From the 2,055 retrieved articles, 18 were selected. Both qualitative (n = 18) and quantitative analysis (n = 7) were performed. Fifteen out of 18 studies (83%) found a positive association between UI and BP or PGP for at least one type of incontinence. Pooled estimates were OR 1.61, 1.53, and 1.51 for stress, urgency, and mixed urinary incontinence respectively. A similar degree of association between women and men was found. Subjects with stress and mixed incontinence showed greater likelihoods of mild pain compared with severe pain, although severe pain was more frequently associated with urgency incontinence than mild pain.
CONCLUSIONS
Our results support the association between UI and BP/PGP, which seems to be independent of gender-based differences. The strength of this association depends on pain or incontinence subtypes. Clinicians should be aware of the relationship in their clinical practice.
Topics: Adult; Female; Humans; Male; Pelvic Girdle Pain; Urinary Incontinence; Urinary Incontinence, Stress; Urinary Incontinence, Urge
PubMed: 33620534
DOI: 10.1007/s00192-020-04670-1 -
FP Essentials Jun 2021Manual therapy, or manipulative therapy, is performed primarily by osteopathic physicians, chiropractors, and physical therapists to relieve pain and improve function....
Manual therapy, or manipulative therapy, is performed primarily by osteopathic physicians, chiropractors, and physical therapists to relieve pain and improve function. As safe prescribing of opioids has become a concern and nondrug therapies for pain management are used more widely, manual therapy has become an attractive treatment option for many patients. A variety of techniques are used, including myofascial release, strain-counterstrain, muscle energy, high velocity/low amplitude, Still, and others. The most common conditions for which patients seek manual therapies are back pain, neck pain, and extremity problems. These therapies also are used to manage many other conditions. Studies show that, in general, manual therapies may improve pain and function in the short and moderate term in patients with acute and chronic back pain, neck pain, rotator cuff conditions, and temporomandibular joint disorders. These therapies also are used in patients with sciatica, migraine, carpal tunnel syndrome, pregnancy-related pelvic girdle pain, and infantile colic. Manual therapies may result in improvements in these conditions, but there is no high-quality research to confirm their benefits. Many studies show benefits that are similar to those of other commonly used therapies, or that are not superior to the benefits shown with sham manipulation.
Topics: Back Pain; Female; Humans; Integrative Medicine; Manipulation, Osteopathic; Musculoskeletal Manipulations; Neck Pain; Pregnancy
PubMed: 34128626
DOI: No ID Found