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Back and Pelvic Pain in an Underserved United States
Pregnant Population

Back and Pelvic Pain in an Underserved United States Pregnant Population: A Preliminary Descriptive Survey

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther. 2007 (Feb); 30 (2): 130–134

Clayton D. Skaggs, DC, Heidi Prather, DO,
Gilad Gross, MD, James W. George, DC,
Paul A. Thompson, PhD, D. Michael Nelson, MD, PhD

Department of Obstetrics and Gynecology,
Washington University School of Medicine,
St Louis, MO, USA.
skaggsdc@swbell.net


OBJECTIVE:   The objective of this study was to identify the prevalence of back pain and treatment satisfaction in a population of low-socioeconomic pregnant women.

METHODS:   This study used a cross-sectional design to determine the prevalence of self-reported musculoskeletal pain in pregnancy for 599 women. Women completed an author-generated musculoskeletal survey in the second trimester of their pregnancy that addressed pain history, duration, location, and intensity, as well as activities of daily living, treatment frequency, and satisfaction with treatment.

RESULTS:   Sixty-seven percent of the total population reported musculoskeletal pain, and nearly half presented with a multi-focal pattern of pain that involved 2 or more sites. Twenty-one percent reported severe pain intensity rated on a numerical rating scale. Eighty percent of women experiencing pain slept less than 4 hours per night and 75% of these women took pain medications. Importantly, 85% of the women surveyed perceived that they had not been offered treatment for their musculoskeletal disorders.

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CONCLUSION:   Multi-focal musculoskeletal pain in pregnancy was prevalent in this underserved patient population. The pain in this population negatively affected sleep and treatment appeared inadequate.


From the FULL TEXT Article:

Introduction

Low back pain (LBP) in the general population is recognized as a major health concern, and left untreated, this malady can lead to chronic, disabling morbidity. [1, 2] Accordingly, chronic pain is a major health care expense in the United States, and LBP is responsible for the majority of chronic musculoskeletal pain. [3] Low back pain and pelvic pain (PP) in pregnancy, however, are frequently viewed as transient conditions that are anticipated to subside after childbirth. In fact, recent studies have identified that women who do have LBP/PP during pregnancy receive little recommendations and/or treatment for their complaints. [4, 5] Although the prevalence of LBP/PP during pregnancy in the United States is unclear, reports from populations in other countries imply that the condition is prevalent and has a negative effect on quality of life. [6-8] Importantly, women who have been pregnant have the highest incidence of chronic LBP after pregnancy, and up to 40% of pregnant women continue to experience pain 18 months postpartum. [9, 10] Therefore, LBP/PP in pregnancy, although largely ignored, may contribute to a substantial level of morbidity and cost in pregnant women and, particularly, women postpartum.


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