Pregnancy-related low back and pelvic girdle pain : listening to Australian women

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BACKGROUND Pregnancy-related low back and/or pelvic girdle pain (PLPP) is experienced by women in the lumbar and/or sacro-iliac area and/or symphysis pubis during pregnancy or immediately after birth. At least 45% of pregnant women experience PLPP which can be associated with some form of disability, leading to social and economic consequences for the woman and for health provider organisations. PLPP is often accepted as a ‘normal’ discomfort of pregnancy; however women may use analgesics and experience a reduced ability to maintain an active lifestyle. PLPP has been reported to negatively influence psychological health and some women develop a chronic pain condition. AIM The aim of this study was to investigate the prevalence of PLPP, and the associated pain and disability experienced by a sample of Australian women. METHOD A cross-sectional survey was employed with 105 pregnant women as they attended a public hospital antenatal clinic. Women reporting PLPP completed a second survey including a pain diagram, Visual Analogue Scale and the Oswestry Disability Index (Version 2.1a). A physical assessment differentiated low back, pelvic girdle or combined low back and pelvic girdle pain. Open ended questions explored the experiences of the women. The sample was analysed descriptively. The Pearson’s Chi-Square was used to test the difference between groups for non-parametric data. A thematic analysis explored the open ended questions. RESULTS The prevalence of self reported PLPP during the pregnancy was 71%, and on the day of survey was 34%. There was an association between the reporting of PLPP and multiparity (p=0.05), a previous history of lumbo-pelvic pain (p=0.005), and the regular use of stairs (p= 0.04). The average pain score was 6.5 (SD 2) out of 10 for ‘usual’ pain, and 3.8 (SD 3) on the day of the survey. A majority of women (67%) scored a ‘mild disability’ and had reported their pain to their maternity carer (71%) but only 25% had treatment. Almost a quarter (23%) of the women had taken sick leave because of PLPP. Most women (70%) agreed that PLPP was to be expected during pregnancy. Key themes related to PLPP as expressed by the women, were pain and its affect on lifestyle, psychological health and the woman’s ability to cope. CONCLUSION PLPP is highly prevalent and expected during pregnancy. Only a small proportion of women receive treatment, despite consequences for some in terms of pain, disability, lifestyle and psychological health. Dissemination of these findings to maternity carers may assist with recognition of the condition as a potentially significant health issue during pregnancy.
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