Low Back Pain and Pregnancy

Common, Treatable Cause of Low-Back Pain in Pregnancy. Daly JM, Frame PS, Rapoza PA. University of Rochester School of Medicine and Dentistry, New York. A retrospective review of 100 consecutive pregnancies, involving 94 women receiving prenatal care at a rural western New York family practice, was conducted. Back pain was spontaneously reported to the physician by 23 women in 23 pregnancies. Eleven of the 23 women met diagnostic criteria for sacroiliac subluxation. These criteria include absence of lumbar spine and hip pathology, pain in the sacral region, a positive Piedallu’s sign (asymmetrical movement of the posterior superior iliac spines upon forward flexion), a positive pelvic compression test, and asymmetry of the anterior superior iliac spines. A cohort of 11 women meeting criteria for sacroiliac subluxation was treated with rotational manipulation of the sacroiliac joints. After manipulative therapy, 10 of the 11 women (91%) had relief of pain and no longer exhibited signs of sacroiliac subluxation. PMID: 1829312 [PubMed – indexed for MEDLINE]

Back Pain During Pregnancy and Labor

Diakow PR, Gadsby TA, Gadsby JB, Gleddie JG, Leprich DJ, Scales AM. J Manipulative Physiol Ther. 1991 (Feb); 14 (2): 116-118
84% of patients receiving spinal manipulative therapy reported relief of back pain during pregnancy. There was significantly less likelihood of back labor when spinal manipulative therapy was administered during pregnancy.

Low Back Pain During Pregnancy.

Berg G, Hammar M, Moller-Nielsen J, Linden U, Thorblad J. Obstet Gynecol. 1988 (Jan); 71 (1): 71-75
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.

Back pain during pregnancy: a prospective study.

Kristiansson P, Svardsudd K, von Schoultz B. Spine 1996 (Mar 15); 21 (6): 702-709
A cohort of 200 consecutive women attending an antenatal clinic were followed throughout pregnancy with repeated measurements of back pain and possible determinants by questionnaires and physical examinations. Seventy-six percent reported back pain at some time during pregnancy. Sixty-one percent reported onset during the present pregnancy. Back pain during pregnancy is a common complaint. The 30% with the highest pain score reported great difficulties with normal activities. The back pain started early in pregnancy and increased over time. Young women had more pain than older women. Back pain starting during pregnancy may be a special entity and may have another origin than back pain not related to pregnancy.
The prevalence of recalled low back pain during and after pregnancy: a South Australian population survey.
Stapleton DB, MacLennan AH, Kristiansson P. TAust N Z J Obstet Gynaecol. 2002 (Nov); 42 (5): 482-485
Thirty-five and a half per cent of women recall having at least moderately severe back pain during pregnancy. Women who reported such back pain were younger, were more likely to report ill health and be unemployed. Increasing parity was not associated with current back pain. The most commonly used treatments were bed rest, pain killing medication, physiotherapy, and chiropractic treatment. Half of those with symptoms were untreated. Sixty-eight per cent of women who experienced moderate or worse low back pain during pregnancy continued to experience recurring low back pain with a self reported reduction in their health.