All pregnant women from a well defined area (the central district of the County of Ostergötland, Sweden) attending antenatal clinics over a period of seven months were interviewed with regard to low back pain during pregnancy. Of 862 women who answered the questionnaires, about half developed some degree of low back pain. Seventy-nine women who were unable to continue their work because of severe low back pain were referred to an orthopedic surgeon for an orthoneurologic examination. The most common reason for severe low back pain was dysfunction of the sacroiliac joints. Physically strenuous work and previous low back pain were factors associated with an increased risk of developing low back pain and sacroiliac dysfunction during pregnancy.
"Exercise in later pregnancy has been found to be beneficial for reducing pregnancy-related LBPP, as has exercise in water (Kihlstrand et al. 1999, Garshasbi & Faghih Zadeh 2005). There is conflicting evidence about the benefits of interventional back classes (Berg et al. 1988, Dumas et al. 1995). Pregnant women with LBPP may also use simple home remedies like heat pads (Sabino & Graeur 2008). "
[Show abstract][Hide abstract] ABSTRACT: AimTo evaluate and summarize the current evidence on the effectiveness of complementary and alternative medicine for the management of low back pain and/or pelvic pain in pregnancy. Background
International research demonstrates that 25–30% of women use complementary and alternative medicine to manage low back and pelvic pain in pregnancy without robust evidence demonstrating its effectiveness. DesignA systematic review of randomized controlled trials to determine the effectiveness of complementary and alternative medicine for low back and/or pelvic pain in pregnancy. Data sourcesCochrane library (1898–2013), PubMed (1996–2013), MEDLINE (1946–2013), AMED (1985–2013), Embase (1974–2013), Cinahl (1937–2013), Index to Thesis (1716–2013) and Ethos (1914–2013). Review methodsSelected studies were written in English, randomized controlled trials, a group 1 or 2 therapy and reported pain reduction as an outcome measure. Study quality was reviewed using Risk of Bias and evidence strength the Cochrane Grading of Recommendations and Development Evaluation Tool. ResultsEight studies were selected for full review. Two acupuncture studies with low risk of bias showed both clinically important changes and statistically significant results. There was evidence of effectiveness for osteopathy and chiropractic. However, osteopathy and chiropractic studies scored high for risk of bias. Strength of the evidence across studies was very low. Conclusion
There is limited evidence supporting the use of general CAM for managing pregnancy-related low back and/or pelvic pain. However, the restricted availability of high-quality studies, combined with the very low evidence strength, makes it impossible to make evidence-based recommendations for practice.
Journal of Advanced Nursing 02/2014; DOI:10.1111/jan.12360 · 1.74 Impact Factor
"Lower back pain and neck/shoulder pain has also been found to be inversely associated with regular exercise during pregnancy in a Norwegian study by Owe et al. . This is in accord with the results in the present study where pain intensity was influenced by oxygen uptake and physical activity while the prevalence of back pain was similar to that found in previous studies [2,23-26]. "
[Show abstract][Hide abstract] ABSTRACT: Low 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.
A 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.
Back 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.
Estimated 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.
"According to several studies (Dumas et al., 1995; Ostgaard et al., 1991), back pain affects about 50% or more of pregnant women, and for some the pain is severe enough to prevent them from continuing to work (Berg et al., 1988). Despite the incidence of pregnancy related back pain the causes remain unclear. "
[Show abstract][Hide abstract] ABSTRACT: Back pain is the most frequently reported musculo-skeletal problem during pregnancy. High muscle fatigability has been associated with back pain in the general population. During pregnancy, the gradual increase in loads may have a training effect, increasing strength and endurance of back muscles. This adaptation however may be too slow, or insufficient to be significant in light of other changes during pregnancy.
Thirty-two pregnant women performed a fatigue test which consisted of maintaining a fixed load of 70 Nm for 60 s while the surface EMG of the longissimus lumborum and multifidus muscles were recorded bilaterally at 14, 24 and 34 weeks of pregnancy. The measure of fatigability was the highest absolute slope of the median frequency of the power spectrum of the EMG of the four muscles. Occurrence and severity of back pain were reported on questionnaires at 14, 19, 24, 29 and 34 weeks. Binomial logistic regressions between back pain occurrence and the median frequency slopes were calculated.
None of the five logistic analyses demonstrated an improvement of the one-predictor model over the constant-only model, which indicates that the degree of fatigability of back extensor muscles did not predict the occurrence of back pain in our sample.
Fatigability of back extensor muscles was not found to be a predictor of back pain during pregnancy. This result should be taken with caution due to the small number of participants and broad definition of back pain used, and should be confirmed by studies with a larger number of participants.
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