Pregnancy Related Low Back Pain

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Pregnancy-related LBP

Researchers estimate that between 45-75% of pregnant women will experience low back pain at some stage of their pregnancy.  (1-5) Up to 33% rate their pain as severe. (6) Pregnancy-related low back pain (P-LBP) leads to lower quality of life, restricted activity, and disability – with almost 25% of pregnant women taking sick leave for LBP.  (2,7-11) The recurrence rate for pregnancy-related low back pain is 85-90%.  (11-14) Consequently, almost 1 in 5 women who report P-LBP during an initial pregnancy will avoid future pregnancies due to fear of returning symptoms.  (15) 

Pharmacologic options during pregnancy are limited, however a new study highlights a conservative alternative. A December 2017 systematic review of 102 studies found moderate-quality evidence suggesting manipulation had a significant effect on decreasing pain and increasing functional status in pregnant and post-partum women with LBP. (16)

This concurs with prior research showing that almost 75% of women undergoing chiropractic manipulation report significant pain reduction and clinically significant improvements in disability. (17,18) Postpartum LBP also responds favorably to spinal manipulation – approximately 10 times better than watchful waiting. (19)

Our providers strive to deliver safe and effective evidence-based care for your patients. Incorporating gentle manipulation with the appropriate exercises generally provides significant relief in very few visits.  

 

References
1. Wu WH, Meijer OG, Uegaki K, Mens JM, van Dieën JH, Wuisman PI, et al. Pregnancy related pelvic girdle pain (PPP), I: terminology, clinical presentation, and prevalence. Eur Spine J 2004;13:575–89.
2. Pierce H, Homer C, Dahlen H, King J. Pregnancy related low back and/or pelvic girdle pain: listening to Australian women. Abstract presented at the XI International Forum for Low Back Pain Research in Primary Care, Melbourne, Australia, 15–18 March 2011.
3. Diakow P.R.P., Gadsby T.A., Gadsby J.B., Gleddie J.G., Leprich D.J., Scales A.M. Back pain during pregnancy and labor. J Manipulative Physiol Ther. 1991;14(2):116–118.
4. Berg G., Hammer M., Moller-Nielsen J., Linden U., Thorblad J. Low back pain in pregnancy. Obstet Gynecol. 1988;71:71–75. 
5. Mogren IM, Pohjanen AI. Low back pain and pelvic pain during pregnancy: prevalence and risk factors. Spine . 2005 Apr 15;30(8);983-91. 
6. Hall J, Cleland J, Palmer J. The Effects of Manual Physical Therapy and Therapeutic Exercise on Peripartum Posterior Pelvic Pain: Two Case Reports. Journal of Manual and Manipulative Therapy. 2005;13(2): 94-102 
7. Wellock VK, Crichton MA. Symphysis pubis dysfunction: women’s experiences of care. Br J Midwif 2007;15:494
8. Kristiansson P, Svarsudd K, von Schoultz B. Back pain during pregnancy: a prospective study. Spine 1996;21:702-9.
9. Wu W, Meijer OG, Jutte PC, et al. Gait in patients with pregnancy-related pain in the pelvis: an emphasis on the coordination of transverse pelvic and thoracic rotations. Clin Biomech 2002;17:678-86.
10. Owens K, Pearson A, Mason G. Symphysis pubis dysfunction: a cause of significant obstetric morbidity. Eur J Obstet Gynecol Reprod Biol
11. George JW, Skaggs CD, Thompson PA, Nelson DM,  Gavard JA, Gross GA. A randomized controlled trial comparing a multimodal intervention and standard  obstetrics for low back and pelvic pain in pregnancy. Am J Obstet Gynecol 2013 Apr; 208(4):295.e1-7
13. Sabino J, Grauer JN. Pregnancy and low back pain. Curr Rev Musculoskelet Med. 2008 Jun; 1(2): 137–141.
14. Mens JMA, Vleeming A, Stoeckart R, Stam HJ, Snijders CJ. Understanding peripartum pelvic pain. Implications of a patient survey. Spine. 1996;21(11):1363–70. 
15. Wang SM, DeZinno P, Fermo L, et al. Complementary and alternative medicine for low-back pain in pregnancy: a cross-sectional survey. J Altern Complement Med. 2005;11(3):459-464.
16. Franke, Helge et al. Osteopathic manipulative treatment for low back and pelvic girdle pain during and after pregnancy: A systematic review and meta-analysis
Journal of Bodywork and Movement Therapies , Volume 21 , Issue 4 , 752 – 762
17. Shaw G. When to adjust: chiropractic and pregnancy. J Am Chiro Assoc. 2003;40(11):8-16
18. Murphy DR, Hurwitz EL, McGovern EE. Outcome of pregnancy-related lumbopelvic pain treated according to a diagnosis-based decision rule: a prospective observational cohort study. J Manipulative Physiol Ther 2009;32:616-24.
19. Schwerla F, et al. Osteopathic manipulative therapy in women with postpartum low back pain and disability: A pragmatic randomized controlled trial. J Am Osteopath Assoc. 2015 Jul;115(7):416-25.
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