Pregnancy related low back pain (PLBP) and pelvic pain (PP) are common in pregnancy. It can affect daily activities such as walking, working, sleeping, mood, etc., with consequent lower quality of life, and there is evidence of socio-economic harm, mainly due to absenteeism [1, 2].
Despite the high prevalence, treatment of this disease is a difficult topic. Women often use complementary movement therapies such as yoga, motor control exercises, breathing exercises, core stabilization exercises, pelvic stabilization exercises, and so on to manage their symptoms. However, it is currently unknown whether exercise is more beneficial than other treatments in patients with PLBP and PP.
Current research suggests that pregnancy-related LBP and PP may be related to mechanical factors, mainly due to weight gain and postural changes during pregnancy, leading to a forward shift of the body’s center of gravity, increased lumbar process, and increased pressure on the lower back [3, 4].
Pelvic floor dysfunction is closely related to LBP. A negative active straight leg raise test and a positive post-pain stimulation test can be interpreted as increased pelvic floor muscle activity to compensate for impaired pelvic stability. Meanwhile, hormonal changes and an increase in relaxin can lead to ineffective neuromuscular control, loosening of ligaments and discomfort, not only in the sacroiliac joint, but also general discomfort, pain in the entire back, pelvic instability and spinal sprain during pregnancy [3-5].
Given each woman’s personality and pregnancy situation, early detection and treatment will ensure the best possible outcomes. Thus, in order to gain muscle strength, flexibility and endurance, restore damaged tissues and contribute to the ability to sustain normal life activities, exercise is one of the most commonly used methods of rehabilitating women with pregnancy-related LBP and PP.
Agata Mroczek
References:
- Mens JMA, Pool-Goudzwaard A. The transverse abdominal muscle is excessively active during active straight leg raising in pregnancy-related posterior pelvic girdle pain: an observational study. BMC Musculoskelet Disord 2017;18:372.
- Vas Jorge, Cintado María Carmen, Aranda-Regules José, et al. Effect of ear acupuncture on pregnancy-related pain in the lower back and posterior pelvic girdle: a multicenter randomized clinical trial. Acta Obstet Gynecol Scand 2019;98:1307–17.
- Liddle SD, Pennick V. Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database Syst Rev 2015;30:CD001139.
- Katonis P, Kampouroglou A, Aggelopoulos A, et al. Pregnancy-related low back pain. Hippokratia 2011;15:205–10.
- Kokic IS, Ivanisevic M, Uremovic M, et al. Effect of therapeutic exercises on pregnancy-related low back pain and pelvic girdle pain: Secondary analysis of a randomized controlled trial. J Rehabil Med 2017;49:251–7.
