Backache in Pregnancy

Mantle, Michelle; Greenwood, R. Mark; Currey, H. L. F.

doi:10.1093/rheumatology/16.2.95

Cited by 168 publications

(123 citation statements)

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“…[38][39][40] Because women often underreport LBP/PGP to their prenatal provider, 41 the topic may not garner sufficient clinical attention. Two studies indicate that the prevalence of severe LBP and/or PGP symptoms ranges from 15% to 20% 40,42 ; however, studies investigating antecedents for pregnancy-related low back and/or pelvic girdle pain have rarely considered occupational exposures. Importantly, severe cases of pregnancy-related LBP/PGP have been reported to trigger or exacerbate comorbid conditions, affecting patient well-being and functional status.…”

Section: Occupational Lifting and Fetal-maternal Health Outcomesmentioning

confidence: 99%

“…[37][38][39] Data from numerous studies show that LBP prevalence is most elevated in months 6 and 7. [38][39][40] Because women often underreport LBP/PGP to their prenatal provider, 41 the topic may not garner sufficient clinical attention. Two studies indicate that the prevalence of severe LBP and/or PGP symptoms ranges from 15% to 20% 40,42 ; however, studies investigating antecedents for pregnancy-related low back and/or pelvic girdle pain have rarely considered occupational exposures.…”

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confidence: 99%

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Clinical guidelines for occupational lifting in pregnancy: evidence summary and provisional recommendations

MacDonald

Waters

Napolitano

et al. 2013

American Journal of Obstetrics and Gynecology

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Empirically based lifting criteria established by the National Institute for Occupational Safety and Health (NIOSH) to reduce the risk of overexertion injuries in the general US working population were evaluated for application to pregnant workers. This report proposes criteria to guide decisions by medical providers about permissible weights for lifting tasks performed at work over the course of an uncomplicated pregnancy. Our evaluation included an extensive review of the literature linking occupational lifting to maternal and fetal health. Although it has been 29 years since the American Medical Association's Council on Scientific Affairs published its report on the Effects of Pregnancy on Work Performance, these guidelines continue to influence clinical decisions and workplace policies. Provisional clinical guidelines derived from the NIOSH lifting criteria that account for recent evidence for maternal and fetal health are presented and aim to improve the standard of care for pregnant workers. Keywordslifting; occupational hazard; pregnancy; recommendations Clinicians play an important role in decisions concerning work activity restrictions during pregnancy. This role is underscored in the United States where federal regulations for occupational lifting are lacking and limited opportunities for paid antenatal leave are available. 1,2 Findings from a recent survey show that recommendations to pregnant workers in physically demanding jobs vary widely, possibly because of limited clinician training in occupational health 3 and the absence of current authoritative guidelines. 4 The views expressed herein are those of the authors and do not necessarily represent the views of the National Institute for Occupational Safety and Health or the official policy or position of the Department of the Army, the Department of the Navy, the Department of Defense, or the United States Government.The authors report no conflict of interest.Reprints not available from the authors. HHS Public AccessAuthor manuscript Am J Obstet Gynecol. Author manuscript; available in PMC 2015 August 28. Author Manuscript Author Manuscript Author Manuscript Author ManuscriptTo address the need for updated empirically based recommendations that can be uniformly applied, this paper presents provisional clinical guidelines for occupational lifting in pregnancy based on an extensive review of the literature linking occupational lifting to maternal and fetal health and application of the National Institute for Occupational Safety and Health (NIOSH) lifting equation. Literature review criteriaAn extensive review of the literature linking occupational lifting to maternal and fetal health was conducted to inform the application of the NIOSH lifting equation to pregnant workers. Using the PubMed MESH Thesaurus terms, pregnancy, lifting, occupational diseases, preeclampsia, hypertension, pregnancy complications, pelvis, sacroiliac joint, pubic symphysis, range of motion articular, joint instability, relaxin, estradiol, biomechanics, stress mechanic...

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Section: Occupational Lifting and Fetal-maternal Health Outcomesmentioning

confidence: 99%

mentioning

confidence: 99%

Clinical guidelines for occupational lifting in pregnancy: evidence summary and provisional recommendations

MacDonald

Waters

Napolitano

et al. 2013

American Journal of Obstetrics and Gynecology

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“…Herniated intervertebral disc disease: The approximate frequency of herniated disc disease (HDD) as a cause of low back pain during pregnancy or in the postpartum period has been estimated at 1 for 10,000 pregnancies with unilateral sciatica in 41% and bilateral sciatica in 21% [102,116]. MRI without the use of gadolinium chelates now allows detailed evaluation of HDD without exposure of the fetus to the potential negative effects of ionising radiation [65,104].…”

Section: Sciatica In Pregnancymentioning

confidence: 99%

Sciatica in the female patient: anatomical considerations, aetiology and review of the literature

2006

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“…Pain in the lumbar spine and pelvic region frequently complicates pregnancy and delivery; the reported 9-month prevalence ranges from 48 to 56% [3,10,17,18]. In retrospective studies among young and middle-aged women with chronic low back pain, 10-28% state that their first episode of back pain occurred during pregnancy [4,23].…”

Section: Introductionmentioning

confidence: 99%

The active straight leg raising test and mobility of the pelvic joints

Mens

Vleeming

Snijders

et al. 1999

European Spine Journal

288

205

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Objective signs to assess impairment in patients who are disabled by peripartum pelvic girdle pain hardly exist. The purpose of this study was to develop a clinical test to quantify and qualify disability in these patients. The study examined the relationship between impaired active straight leg raising (ASLR) and mobility of pelvic joints in patients with peripartum pelvic girdle pain, focusing on (1) the reduction of impairment of ASLR when the patient was wearing a pelvic belt, and (2) motions between the pubic bones measured by X-ray examination when the patient was standing on one leg, alternating left and right. Twenty-one non-pregnant patients with peripartum pelvic girdle pain in whom pain and impairment of ASLR were mainly located on one side were selected. ASLR was performed in the supine position, first without a pelvic belt and then with a belt. The influence of the belt on the ability to actively raise the leg was assessed by the patient. Mobility of the pelvic joints was radiographically visualized by means of the Chamberlain method. Assessment was blinded. Ability to perform ASLR was improved by a pelvic belt in 20 of the 21 patients (binomial two-tailed P = 0.0000). When the patient was standing on one leg, alternating the symptomatic side and the reference side, a significant difference between the two sides was observed with respect to the size of the radiographically visualized steps between the pubic bones (binomial two-tailed P = 0.01). The step at the symptomatic side was on average larger when the leg at that side was hanging down than when the patient was standing on the leg at that side. Impairment of ASLR correlates strongly with mobility of the pelvic joints in patients with peripartum pelvic girdle pain. The ASLR test could be a suitable instrument to quantify and qualify disability in diseases related to mobility of the pelvic joints. Further studies are needed to assess the relationship with clinical parameters, sensitivity, specificity and responsiveness in various categories of patients. In contrast with the opinion of Chamberlain, that a radiographically visualized step between the pubic bones is caused by cranial shift of the pubic bone at the side of the standing leg, it is concluded that the step is caused by caudal shift of the pubic bone at the side of the leg hanging down. The caudal shift is caused by an anterior rotation of the hip bone about a horizontal axis near the sacroiliac joint.

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Backache in Pregnancy

Cited by 168 publications

References 0 publications

Clinical guidelines for occupational lifting in pregnancy: evidence summary and provisional recommendations

Clinical guidelines for occupational lifting in pregnancy: evidence summary and provisional recommendations

Sciatica in the female patient: anatomical considerations, aetiology and review of the literature

The active straight leg raising test and mobility of the pelvic joints

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