Low back pain during pregnancy.

Department of Obstetrics and Gynecology, Linköping University Hospital, Sweden.
Obstetrics and Gynecology (Impact Factor: 4.37). 02/1988; 71(1):71-5. DOI: 10.1097/00132582-198807000-00002
Source: PubMed

ABSTRACT 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.

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    ABSTRACT: Objectives The issue of low back pain (LBP) is as common as it is perplexing. LBP is thought to be a chronic issue in approximately 10% of the U.S. population. This condition has wide-reaching social and economical reverberations. Despite the availability of modern diagnostic tools, the cause of the pain generator is often unidentifiable. The authors were asked to create an overview of the etiology of LBP for physicians who implant neurostimulation devices for the treatment of chronic pain patients. Some prevalence data, based on the current available literature, have been provided for the more common structural conditions causing LBP. However, a comprehensive review of prevalence of various conditions and their respective manifestations as LBP is beyond the scope of this article.Materials and MethodsA review was performed of frequently cited articles with search terms for “low back pain” using PubMed, Medline, and Google Scholar. The authors also reviewed other literature from commonly utilized sources in the field of interventional pain medicine such as the journals of Neuromodulation, Pain Medicine, Spine, and Neurosurgery in the publication date range of 1975 to the present. Moreover, recent edition textbooks of other specialties such as obstetrics and gynecology, neurology, internal medicine, and surgery were referenced to develop a comprehensive list of the differential diagnoses. In order to capture the broad scope of information presented in this article, the criteria used to choose the references included published peer-reviewed articles that provided information on LBP as a symptom of a case report to common presentations of various conditions as described in a number of current, and commonly used, textbooks in their specialty.ResultsThe article serves as a reference for commonly cited causes of LBP as well as less common conditions presenting with LBP as a possible symptom, which may occur as a solitary pain generator or in combination with other etiologies. The information is structured in such a fashion to allow a comprehensive overview for every reader, including the most experienced implanting physicians. The article is designed to kindle critical thinking regarding the massive scope involved in the assessment of a patient with a complaint of LBP. The results of the comprehensive research to produce this article clearly indicate the broad scope of this list of differential diagnoses. The reader should be aware that the lists are by no means all-inclusive. Perhaps additional efforts will be necessary to build on the available information in this article in the future. Furthermore, although some prevalence data for LBP, as it is related to structural spine, is readily available based on the excellent work of our colleagues and presented throughout this paper, for other disease processes, the prevalence data are scarce to nonexistent. This underscores the need for further research to better understand this elusive condition. The size and breadth of the topic at hand in this article would arguably deserve its own comprehensive textbook. The complexity and discussion points of each identified pain generator could be given a chapter or section to reflect complex learning deserved by each topic. With these limitations, the authors recommend the reader to evaluate this article in the context of a broader topic of LBP and neurostimulation.ConclusionsLBP is an extremely common condition associated, as a symptom, with various disease processes, regardless of their relationship with the lumbar spine or its innervation. This article underscores the broad nature of LBP as a symptom of many diagnoses. The primary conclusion reached by the authors is the most important recommendation by all mentors in medicine, which is to obtain a comprehensive history and perform a complete physical examination on each patient. Despite the fact that there is an emerging school of thought questioning the validity of the physical examination, this tool continues to be the current standard of care and used by a majority of clinicians around the world. The physician must analyze the information obtained from his/her history, physical examination, and diagnostic tools with the recognition of the broad nature of the differential diagnoses of LBP in order to be able to best treat the patient.
    Neuromodulation 10/2014; 17(S2). DOI:10.1111/ner.12173 · 1.79 Impact Factor
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    ABSTRACT: [Purpose] The aim of this study was to investigate the changes in pain intensity, spinal curvature, and balance and gait ability according to the pregnancy period. [Subjects] Nineteen pregnant women and fifteen nonpregnant women were recruited in this study. [Methods] The pain intensity, spinal curvature, gait, and balance of pregnant women were measured according to the pregnant period (2nd and 3rd trimester). The changes in the pregnant women were also compared with those in the nonpregnant women. [Results] The pain intensity and spinal curvature in the third trimester of pregnancy were significantly increased compared with the second trimester. Only the lumbar spine curvature in the third trimester pregnancy was significantly greater in the pregnant women than in non-pregnant women. The gait velocity and cadence in the third trimester of pregnancy showed a significant decrease compared with the second trimester. The gait speed in the second and third trimester of pregnancy showed a significant decrease in the pregnant women compared with nonpregnant women. Balance in the third trimester of pregnancy showed significant improvement compared with the second trimester. The balance of the pregnant women showed a significant decrease compare with that nonpregnant women only on unstable surfaces. [Conclusion] These research findings can be used as basic data for health promotion programs for sound daily activities in pregnant women.
    Journal of Physical Therapy Science 01/2015; 27(1):279-284. DOI:10.1589/jpts.27.279 · 0.20 Impact Factor