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Obstetrical & Gynecological Survey Mar 2009About 45% of all pregnant women and 25% of all women postpartum suffer from pelvic girdle pain and/or low back pain (PLPP). It has been suggested that increased motion... (Review)
Review
About 45% of all pregnant women and 25% of all women postpartum suffer from pelvic girdle pain and/or low back pain (PLPP). It has been suggested that increased motion of the three joints in the pelvic ring is one of the causes of PLPP. However, in spite of the availability of high technology the relation between enlarged motion of the pelvic joints and pain remains unclear. This article presents 14 studies on this topic, of which 8 are of sufficient quality to draw conclusions. The conclusion is that, during the last months of pregnancy and the first 3 weeks after delivery, motion of the pelvic girdle joints is 32-68% larger in patients with PLPP than in healthy controls. The overlap in the range of symphyseal motion between PLPP patients and healthy controls is too large to use motion as a diagnostic tool in individual cases. The findings support the idea that enlarged motion is one of the factors that causes PLPP and justifies treatment with measures to reduce this motion.
Topics: Female; Humans; Joints; Low Back Pain; Pelvic Pain; Pelvis; Pregnancy; Pregnancy Complications; Range of Motion, Articular
PubMed: 19228440
DOI: 10.1097/OGX.0b013e3181950f1b -
European Spine Journal : Official... Nov 2004Pregnancy-related lumbopelvic pain has puzzled medicine for a long time. The present systematic review focuses on terminology, clinical presentation, and prevalence.... (Review)
Review
Pregnancy-related lumbopelvic pain has puzzled medicine for a long time. The present systematic review focuses on terminology, clinical presentation, and prevalence. Numerous terms are used, as if they indicated one and the same entity. We propose "pregnancy-related pelvic girdle pain (PPP)", and "pregnancy-related low back pain (PLBP)", present evidence that the two add up to "lumbopelvic pain", and show that they are distinct entities (although underlying mechanisms may be similar). Average pain intensity during pregnancy is 50 mm on a visual analogue scale; postpartum, pain is less. During pregnancy, serious pain occurs in about 25%, and severe disability in about 8% of patients. After pregnancy, problems are serious in about 7%. The mechanisms behind disabilities remain unclear, and constitute an important research priority. Changes in muscle activity, unusual perceptions of the leg when moving it, and altered motor coordination were observed but remain poorly understood. Published prevalence for PPP and/or PLBP varies widely. Quantitative analysis was used to explain the differences. Overall, about 45% of all pregnant women and 25% of all women postpartum suffer from PPP and/or PLBP. These values decrease by about 20% if one excludes mild complaints. Strenuous work, previous low back pain, and previous PPP and/or PLBP are risk factors, and the inclusion/exclusion of high-risk subgroups influences prevalence. Of all patients, about one-half have PPP, one-third PLBP, and one-sixth both conditions combined. Overall, the literature reveals that PPP deserves serious attention from the clinical and research communities, at all times and in all countries.
Topics: Female; Humans; Pelvic Pain; Pregnancy; Pregnancy Complications; Prevalence; Risk Factors; Terminology as Topic
PubMed: 15338362
DOI: 10.1007/s00586-003-0615-y