Study of Foreign Literature Regarding the Methods of Intervention for Pregnancy Related Backache and Pelvic Pain

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Conrad Waters
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1 Study of Foreign Literature Regarding the Methods of Intervention for Pregnancy Related Backache and Pelvic Pain ANDO Fukiko Abstract : Pregnancy related backache and pelvic pain are commonly seen, but there are many unclear points about their clinical significance. It has been reported in past 10 to 20 years that these symptoms should be separately classified into cases including backache coming from lumbar vertebra and pelvic pain coming from pelvis since they contain a multiple number of patient conditions and prognosis, which are different among patients. Since patient conditions for backache and pelvic pain are different, it is indicated that care approaches are different, too, but there has not been enough verification made on their effect. Yet, very little literature has examined these care approaches with the view of separating backache and pelvic pain due to different patient conditions. Despite this condition, approximately 60% of pregnant women with backache and pelvic pain undergo massage, acupuncture, relaxation, yoga, chiropractic and other complementary and alternative medicine. The author collected literature examining methods of intervention for pregnancy related backache and pelvic pain and looked at these methods separated by each type of pain to explore the measures that suit Japanese patient conditions. As a result, the author discovered that there are so many different terminologies and diagnostic methods to pregnancy related backache and pelvic pain that the intervention methods are varied and verifications and results on their effect differ. Exercise therapy is effective for backache, but it is preferable to do this wearing a pelvis belt for patients with pelvic pain. Acupuncture treatment is effective in alleviating back and pelvic pain. However, most research say the treatment with the best results correspond to each individual patient s symptoms. Key Wordspregnancy, backache, pelvic pain, complementary and alternative medicine

2 Posterior pelvic pain provocation test Active straight leg raise test Diagnosis-based clinical decision ruledbcdr Centralization Signs 9 MEDLINE CINAHL low back pain/ththerapyor pelvic pain/ththerapyorexercise OR complementary therapies OR Locomotion OR posture OR pelvic belt support belt 2low back pain OR pelvic pain ORpelvis AND pain OR pain mesurement 3exp pregnancy 1and 2and 3 MEDLINE 110 CINAHL 50

3 Specific stabilization exercise Specific stabilization exercise Specific stabilization exercise Diagonal trunk muscle exercises Specific stabilizing exercise 15 16, n Mens et al :14 2:14 Stuge Garshasbi Gutke Ostgaard : : 139 Noren Nilsson-Wikmar :40 2:41 3:37 Elden : : 131 Kihlstrand Granath Diagonal trunk muscle exercises 3 1 Longitudinal trunk muscle exercises 2 Specific stabilizing exercises specific stabilizing exercises Specific stabilizing exercises Diagonal trunk muscle exercises 1 quality of life Specific stabilizing exercises Specific stabilizing exercises

4 n Carr Depledge :28 2: Mens Kalus Bellybra Tubigrip Bellybra Tubigrip n Kvorning Lund :22 2: Damen 18, , Diagnosis-based clinical decision ruledbcdr

5 37, 38 Panjabi 39 3 Vleeming 6 QOLquality of life primary care B Albert, H. B., et al., Incidence of four syndromes of pregnancy-related pelvic joint pain. Spine, p p Ostgaard, H. C., E. Roos-Hansson, and G. Zetherstrom, Regression of back and posterior pelvic pain after pregnancy. Spine, p Noren, L., et al., Lumbar back and posterior pelvic pain during pregnancy : a 3-year follow-up. Eur Spine J, p Kristiansson, P., K. Svardsudd, and B. von Schoultz, Back Pain During Pregnancy. Spine, p Vleeming, A., et al., European guidelines for the diagnosis and treatment of pelvic girdle pain. European Spine Journal, p Ando, F. and K. Ohashi, Using the posterior pelvic pain provocation test in pregnant Japanese women. Nursing & Health Sciences, p.3 9. Wang, S., et al., Complementary and alternative medicine for low-back pain in pregnancy : a cross-sectional survey.

6 Journal of Alternative & Complementary Medicine, p Murphy, D. R., et al., Outcome of pregnancy-related lumbopelvic pain treated according to a diagnosis-based decision rule : a prospective observational cohort study. Journal of Manipulative & Physiological Therapeutics, p Stuge, B., et al., The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy : a two-year follow-up of a randomized clinical trial. Spine, E Ferreira, P., Specific stabilising exercise improves pain and function in women with pelvic girdle pain following pregnancy. Australian Journal of Physiotherapy, p.259 Stuge, B., I. Holm, and N. Vollestad, To treat or not to treat postpartum pelvic girdle pain with stabilizing exercises? Man Ther, p Ee,C.C.,etal.,Acupuncture for pelvic and back pain in pregnancy : a systematic review. American Journal of Obstetrics & Gynecology, p Gutke, A., et al., Specific muscle stabilizing as home exercises for persistent pelvic girdle pain after pregnancy : a randomized, controlled clinical trial. Journal of Rehabilitation Medicine, p Ferreira, P., et al., Specific stabilisation exercise for spinal and pelvic pain : A systematic review. Australian Journal of Physiotherapy, : p Kihlstrand, M., et al., Water-gymnastics reduced the intensity of back/low back pain in pregnant women. Acta Obstet Gynecol Scand, p Granath, A. B., M. S. Hellgren, and R. K. Gunnarsson, Water aerobics reduces sick leave due to low back pain during pregnancy. J Obstet Gynecol Neonatal Nurs, p Damen, L., et al., Does a pelvic belt influence sacroiliac joint laxity? Clin Biomech Bristol, Avon p Lund, I., et al., Decrease of pregnant women s pelvic pain after acupuncture : a randomized controlled single-blind study. Acta Obstetricia et Gynecologica Scandinavica, p Elden, H., et al., Acupuncture as an adjunct to standard treatment for pelvic girdle pain in pregnant women : randomised double-blinded controlled trial comparing acupuncture with non-penetrating sham acupuncture. BJOG : An International Journal of Obstetrics & Gynaecology, p Elden, H., et al., Regression of pelvic girdle pain after delivery : follow-up of a randomised single blind controlled trial with different treatment modalities. Acta Obstetricia et Gynecologica Scandinavica, p Elden, H., et al., Treatment of pelvic girdle pain in pregnant women : adverse effects of standard treatment, acupuncture and stabilising exercises on the pregnancy, mother, delivery and the fetus/neonate. BMC Complementary & Alternative Medicine, : 34 Wang, S. M., et al., Auricular acupuncture as a treatment for pregnant women who have low back and posterior pelvic pain : a pilot study. American Journal of Obstetrics & Gynecology, e 1 9. Ekdahl, L. and K. Petersson, Acupuncture treatment of pregnant women with low back and pelvic pain an intervention study. Scandinavian Journal of Caring Sciences, p Mens, J. M., C. J. Snijders, and H. J. Stam, Diagonal trunk muscle exercises in peripartum pelvic pain : a randomized clinical trial. Phys Ther, p Garshasbi, A. and S. Faghih Zadeh, The effect of exercise on the intensity of low back pain in pregnant women. Int J Gynaecol Obstet, p Ostgaard, H. C., et al., Reduction of back and posterior pelvic pain in pregnancy. Spine, p Noren, L., et al., Reduction of sick leave for lumbar back and posterior pelvic pain in pregnancy. Spine, p Nilsson-Wikmar, L., et al., Effect of three different physical therapy treatments on pain and activity in pregnant women with pelvic girdle pain : a randomized clinical trial with 3, 6 and 12 months follow-up postpartum. Spine, p Elden, H., et al., Effects of acupuncture and stabilising exercises as adjunct to standard treatment in pregnant women with pelvic girdle pain : randomised single blind controlled trial. BMJ : British Medical Journal, p Carr, C. A., Use of a maternity support binder for relief of pregnancy-related back pain. J Obstet Gynecol Neonatal Nurs, p Depledge, J., et al., Management of symphysis pubis dysfunction during pregnancy using exercise and pelvic support belts. Phys Ther, p Mens,J.M.,etal.,The mechanical effect of a pelvic belt in patients with pregnancy-related pelvic pain. Clin BiomechBristol, Avon p Kalus, S. M., et al., Managing back pain in pregnancy using a support garment : a randomised trial. BJOG : An International Journal of Obstetrics & Gynaecology, p Kvorning, N., et al., Acupuncture relieves pelvic and lowback pain in late pregnancy. Acta Obstet Gynecol Scand, p Joanne Borg-Stein, K. C. M., Sheila Dugan, Michelle Mottola, & Jane Gruber, Evaluation and Management of Musculoskeletal and Pelvic Disorders of Pregnancy. Crinical reviews in Physucal and Rehabilitation Medicine, p

7 Wu,W.H.,etal.,Pregnancy-related pelvic girdle pain PPP I : Terminology, clinical presentation, and prevalence. European Spine Journal, p Mens, J. M. A., A. Pool-Goudzwaard, and H. J. Stam, Mobility of the pelvic joints in pregnancy-related lumbopelvic pain : a systematic review. Obstetrical & Gynecological Survey, p Panjabi, M., The stabilizing system of spine. Part 1 : Function, dysfunction, adaptation, and enhancement. JSpinal Dis, : p Vermani, E., et al., Pelvic girdle pain and low back pain in pregnancy : a review. Pain Practice, p Stuge, B., G. Hilde, and N. Vollestad, Physical therapy for pregnancy-related low back and pelvic pain : a systematic review. Acta Obstet Gynecol Scand, p

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