-
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 -
Journal of Rehabilitation Medicine Mar 2017To investigate the effect of a supervised, structured exercise programme on the occurrence and severity of pregnancy-related lumbopelvic pain. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To investigate the effect of a supervised, structured exercise programme on the occurrence and severity of pregnancy-related lumbopelvic pain.
DESIGN
Randomized controlled trial.
SUBJECTS
A total of 45 pregnant women were randomly assigned to 2 groups: an experimental group (n = 20; mean age 32.8 (standard deviation (SD) 3.6) years) and a control group (n = 22; mean age 32.2 years (SD 4.9)).
METHODS
Exercise intervention for the experimental group consisted of aerobic and resistance exercises performed bi-weekly from the date of inclusion into the study until the end of pregnancy, together with at least 30 min of brisk daily walks. A numeric rating scale, Roland-Morris Disability Questionnaire (RMDQ), and Pelvic Girdle Questionnaire (PGQ) were used to measure outcomes. The control group received only standard antenatal care.
RESULTS
There were significant differences between the 2 groups on the numeric rating scale, PGQ and RMDQ scores in the 36th week of pregnancy (p = 0.017; p = 0.005; p < 0.001, respectively) in favour of the experimental group.
CONCLUSION
The exercise programme had a beneficial effect on the severity of lumbopelvic pain in pregnancy, reducing the intensity of pain and the level of disability experienced as a result.
Topics: Adult; Exercise Therapy; Female; Humans; Low Back Pain; Lower Extremity; Pain Measurement; Pelvic Girdle Pain; Pelvis; Pregnancy; Pregnancy Complications; Severity of Illness Index; Surveys and Questionnaires; Treatment Outcome
PubMed: 28233012
DOI: 10.2340/16501977-2196 -
Journal of Obstetrics and Gynaecology :... Oct 2011Pelvic girdle pain (PGP) is a term used specifically to pregnancy-related pain in the lumbosacral, sacroiliac and symphysis pubis joints. Pregnancy-induced hormonal and... (Review)
Review
Pelvic girdle pain (PGP) is a term used specifically to pregnancy-related pain in the lumbosacral, sacroiliac and symphysis pubis joints. Pregnancy-induced hormonal and physical changes increase the risk of musculoskeletal problems in pregnancy. The severity of these conditions varies from mild self-limiting pain to a severe disabling condition. PGP is common in pregnancy and while most can be managed as outpatients, a few patients require inpatient admission for further investigations and management. Prompt identification of these conditions is essential to avoid serious disability. Lack of awareness and failure of recognition not only results in women feeling isolated, but may also result in long-term morbidity. In this review, we explore the aetiology, presentation, risk factors, risk of recurrence, differential diagnosis and multidisciplinary management of these conditions. We also enclose obstetric guidelines to increase the awareness of the health professionals.
Topics: Diagnosis, Differential; Female; Humans; Osteonecrosis; Osteoporosis; Pelvic Girdle Pain; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pubic Symphysis Diastasis; Puerperal Disorders; Recurrence
PubMed: 21973126
DOI: 10.3109/01443615.2011.598970 -
Acta Obstetricia Et Gynecologica... Oct 2023Pelvic girdle pain during and after pregnancy is a major public health problem with significant daily problems for affected women and their families. There is now... (Observational Study)
Observational Study
INTRODUCTION
Pelvic girdle pain during and after pregnancy is a major public health problem with significant daily problems for affected women and their families. There is now accumulating evidence that pregnancy-related pelvic girdle pain originates from the sacroiliac joints and the pubic symphysis as well as their extra-articular ligaments. However, the heritability of the disease remains to be determined. We hypothesized that there is an increased familial risk of pregnancy-related pelvic girdle pain.
MATERIAL AND METHODS
A population-based national database linkage registry study of approximately 9.3 million individuals within 4.2 million families in Sweden with a recruitment period from 1997 to 2018. The Swedish Multi-generation register was used to find female pairs of twins, full siblings, half-siblings and first cousins where both in the pairs had a completed pregnancy. The outcome measure was diagnosis of pregnancy-related pelvic girdle pain (International Classification of Diseases-10 O26.7 [1997-2018]) in the first pregnancy. Data was obtained from the Swedish Hospital Discharge Register, the Swedish Outpatient Care Register, the Swedish Medical Birth Register, the Primary Healthcare Register, and Medical Treatment Register. Cox regression analysis was used to calculate adjusted estimated effect of the exposure variable familial history of pregnancy-related pelvic girdle pain on the outcome variable pregnancy-related pelvic girdle pain at first birth.
RESULTS
From the registers, 1 010 064 women pregnant with their first child within 795 654 families were collected. In total, 109 147 women were diagnosed with pregnancy-related pelvic girdle pain. The adjusted hazard ratio for a familial risk of pregnancy-related pelvic girdle pain was 2.09 (95% CI 1.85-2.37) among twins (monozygotic and dizygotic), 1.78 (95% CI 1.74-1.82) in full siblings, 1.16 (95% CI 1.06-1.28) in half-siblings from the mother, 1.09 (95% CI 1.024-1.16) in half-siblings from the father and 1.09 (95% CI 1.07-1.12) in first cousins.
CONCLUSIONS
This nationwide observational study showed a familial clustering of pregnancy-related pelvic girdle pain. The hazard ratio for the condition was associated with the degree of relatedness, suggesting that heredity factors contribute to the development of pregnancy-related pelvic girdle pain. There is no causal treatment available for pregnancy-related pelvic girdle pain and further studies are now encouraged to clarify the specific genetic factors that contribute to the disease and for future targeted interventions.
Topics: Female; Humans; Pregnancy; Family; Genetic Predisposition to Disease; Heredity; Pelvic Girdle Pain; Pregnancy Complications; Sweden
PubMed: 37470484
DOI: 10.1111/aogs.14646 -
Midwifery Jan 2018to systematically review the available studies which relay the experience of pregnancy related pelvic girdle pain and how this affects women psychologically and... (Review)
Review
OBJECTIVE
to systematically review the available studies which relay the experience of pregnancy related pelvic girdle pain and how this affects women psychologically and emotionally.
METHOD
a systematic review and meta-synthesis of the experiences of pregnancy related pelvic girdle pain was conducted for qualitative studies dated between 2005 and 2016. Predefined terms were used to search nine central databases and hand searches of two reference lists of identified studies were carried out.
FINDINGS
614 records were identified, eight studies met the inclusion criteria for review. Pain from pelvic girdle pain impacted on women's daily lives both at home and the workplace. This had a negative emotional and psychological impact on women as it took away their feeling of independence. Women reported feelings of frustration, guilt, irritability and upset at being unable to carry out their normal roles. Pelvic girdle pain also affected the women's sense of identity and ability to care for their children.
CONCLUSIONS AND IMPLICATIONS FOR PRACTICE
Health professionals working with pregnant and postnatal women need to be aware of the anger, frustration and negative emotions resulting from PGP. These women may become socially isolated and there is a risk they could abuse analgesics in attempt to manage the pain especially if they do not have the social support. For women with young children, it is important to be aware of safety issues they face with carrying babies and controlling toddlers. It is therefore important that health professionals recognise PGP as a serious health issue, approach this condition sensitively and refer to appropriate treatment as soon as PGP is suspected.
Topics: Adaptation, Psychological; Adult; Female; Humans; Mothers; Parturition; Pelvic Girdle Pain; Postpartum Period; Pregnancy; Pregnancy Complications
PubMed: 29096278
DOI: 10.1016/j.midw.2017.10.011 -
Journal of Physical Therapy Science Oct 2019[Purpose] The aim of this literature review was to detect the factors associated with pelvic girdle pain persisting for over 3 months in the postpartum period. [Methods]... (Review)
Review
[Purpose] The aim of this literature review was to detect the factors associated with pelvic girdle pain persisting for over 3 months in the postpartum period. [Methods] We performed a broad literature search for eligible studies published before May 1, 2018 using electronic databases and processed the data using a review process. [Results] In the initial online search, we identified 12,174 potential studies. Finally, 22 studies met the specified criteria and were included for examination of risk factors for persistent pelvic girdle pain after delivery. Pain intensity and disability during pregnancy were risk factors for pelvic girdle pain persisting for over 6 months after delivery. The active straight leg raising test predicted the risk of persistent pelvic girdle pain after delivery. Dysfunction of the pelvic floor muscles was also a risk factor for persistent pelvic girdle pain. [Conclusion] Pain intensity and disability during pregnancy, positive provocation tests, active straight leg raising test, and musculoskeletal mechanics were positively associated with pelvic girdle pain persisting for over 3 months after delivery.
PubMed: 31645815
DOI: 10.1589/jpts.31.831 -
Journal of Anatomy Dec 2012This article focuses on the (functional) anatomy and biomechanics of the pelvic girdle and specifically the sacroiliac joints (SIJs). The SIJs are essential for... (Review)
Review
This article focuses on the (functional) anatomy and biomechanics of the pelvic girdle and specifically the sacroiliac joints (SIJs). The SIJs are essential for effective load transfer between the spine and legs. The sacrum, pelvis and spine, and the connections to the arms, legs and head, are functionally interrelated through muscular, fascial and ligamentous interconnections. A historical overview is presented on pelvic and especially SIJ research, followed by a general functional anatomical overview of the pelvis. In specific sections, the development and maturation of the SIJ is discussed, and a description of the bony anatomy and sexual morphism of the pelvis and SIJ is debated. The literature on the SIJ ligaments and innervation is discussed, followed by a section on the pathology of the SIJ. Pelvic movement studies are investigated and biomechanical models for SIJ stability analyzed, including examples of insufficient versus excessive sacroiliac force closure.
Topics: Ankylosis; Biological Evolution; Female; Humans; Ligaments; Male; Models, Biological; Movement; Pelvis; Sacroiliac Joint; Sex Characteristics
PubMed: 22994881
DOI: 10.1111/j.1469-7580.2012.01564.x -
BMC Medicine Feb 2011A large number of scientists from a wide range of medical and surgical disciplines have reported on the existence and characteristics of the clinical syndrome of pelvic... (Review)
Review
A large number of scientists from a wide range of medical and surgical disciplines have reported on the existence and characteristics of the clinical syndrome of pelvic girdle pain during or after pregnancy. This syndrome refers to a musculoskeletal type of persistent pain localised at the anterior and/or posterior aspect of the pelvic ring. The pain may radiate across the hip joint and the thigh bones. The symptoms may begin either during the first trimester of pregnancy, at labour or even during the postpartum period. The physiological processes characterising this clinical entity remain obscure. In this review, the definition and epidemiology, as well as a proposed diagnostic algorithm and treatment options, are presented. Ongoing research is desirable to establish clear management strategies that are based on the pathophysiologic mechanisms responsible for the escalation of the syndrome's symptoms to a fraction of the population of pregnant women.
Topics: Female; Humans; Pain; Pain Management; Pelvis; Pregnancy; Pregnancy Complications
PubMed: 21324134
DOI: 10.1186/1741-7015-9-15 -
Journal of Clinical Medicine Nov 2021During their lifespan, many women are exposed to pain in the pelvis in relation to menstruation and pregnancy. Such pelvic pain is often considered normal and inherently... (Review)
Review
During their lifespan, many women are exposed to pain in the pelvis in relation to menstruation and pregnancy. Such pelvic pain is often considered normal and inherently linked to being a woman, which in turn leads to insufficiently offered treatment for treatable aspects related to their pain experience. Nonetheless, severe dysmenorrhea (pain during menstruation) as seen in endometriosis and pregnancy-related pelvic girdle pain, have a high impact on daily activities, school attendance and work ability. In the context of any type of chronic pain, accumulating evidence shows that an unhealthy lifestyle is associated with pain development and pain severity. Furthermore, unhealthy lifestyle habits are a suggested perpetuating factor of chronic pain. This is of specific relevance during lifespan, since a low physical activity level, poor sleep, or periods of (di)stress are all common in challenging periods of women's lives (e.g., during menstruation, during pregnancy, in the postpartum period). This state-of-the-art paper aims to review the role of lifestyle factors on pain in the pelvis, and the added value of a lifestyle intervention on pain in women with pelvic pain. Based on the current evidence, the benefits of physical activity and exercise for women with pain in the pelvis are supported to some extent. The available evidence on lifestyle factors such as sleep, (di)stress, diet, and tobacco/alcohol use is, however, inconclusive. Very few studies are available, and the studies which are available are of general low quality. Since the role of lifestyle on the development and maintenance of pain in the pelvis, and the value of lifestyle interventions for women with pain in the pelvis are currently poorly studied, a research agenda is presented. There are a number of rationales to study the effect of promoting a healthy lifestyle (early) in a woman's life with regard to the prevention and management of pain in the pelvis. Indeed, lifestyle interventions might have, amongst others, anti-inflammatory, stress-reducing and/or sleep-improving effects, which might positively affect the experience of pain. Research to disentangle the relationship between lifestyle factors, such as physical activity level, sleep, diet, smoking, and psychological distress, and the experience of pain in the pelvis is, therefore, needed. Studies which address the development of management strategies for adapting lifestyles that are specifically tailored to women with pain in the pelvis, and as such take hormonal status, life events and context, into account, are required. Towards clinicians, we suggest making use of the window of opportunity to prevent a potential transition from localized or periodic pain in the pelvis (e.g., dysmenorrhea or pain during pregnancy and after delivery) towards persistent chronic pain, by promoting a healthy lifestyle and applying appropriate pain management.
PubMed: 34830680
DOI: 10.3390/jcm10225397 -
Progres En Urologie : Journal de... Mar 2018Pelvic girdle pain (PGP) is characterized by the presence of pain in the posterior pelvic area, distally and laterally to the fifth lumbar vertebra, and/or at the pubic... (Review)
Review
INTRODUCTION
Pelvic girdle pain (PGP) is characterized by the presence of pain in the posterior pelvic area, distally and laterally to the fifth lumbar vertebra, and/or at the pubic symphysis. PGP is a very common pain condition in women, especially during pregnancy and postpartum. After delivery, pain prevalence decreases to 7 % in the first three months. The current literature describes an association between pelvic girdle pain and different perineal characteristics and symptoms.
OBJECTIVES
A better understanding of perineal structures influence on PGP could assist towards the management of this condition. The aim of this review is to describe the peer-reviewed literature about perineal function in patients with PGP.
METHODS
A bibliographic search on PubMed was conducted. The key words used were: pelvic girdle pain, pregnacy-related low back pain, lumbopelvic pain, posterior pelvic pain, peripartum pelvic pain, pelvic girdle relaxation, pelvic joint instability, peripartum pelvic pain, sacroiliac joint pain, sacroiliac joint dysfunction, sacroiliac-joint related pelvic pain and pelvic floor. Two hundred and twenty-one (221) articles were identified. Out of them, a total of nine articles were selected. The level of evidence was determined using Oxford's scale.
RESULTS
Patients with PGP showed increased activity of the pelvic floor muscles (P=0.05) (LE3), decreased urogenital hiatus area (PGP 12.4 cm±2.7, control 13.7 cm±2.8, P=0.015) (LE3), shorter endurance time (PGP 17.8 s; control 54.0 s, P=0.00) (LE3), significantly later onset time during affected side leg elevation (PGP 25ms, control -129ms, P=0.01) (LE3), levator ani and obturator internus tenderness (PGP 25/26; control 5/25, P<0.001) (LE3) and a higher prevalence of vesico-sphincteric disorders compared to asymptomatic subjects (LE3).
CONCLUSION
This review confirms that subjects suffering PGP present particular perineal characteristics regarding morphology and biomechanics. It would be interesting to develop clinical research concerning pelvic floor release effect in PGP.
Topics: Biomechanical Phenomena; Female; Humans; Pelvic Girdle Pain; Perineum; Pregnancy; Symptom Assessment
PubMed: 29307482
DOI: 10.1016/j.purol.2017.12.007