Current management of pregnancy-related low back pain: a national cross-sectional survey of UK physiotherapists

Bishop, Annette; Holden, Melanie; Ogollah, Reuben; Foster, Nadine E

doi:10.1016/j.physio.2015.02.003

Cited by 50 publications

(68 citation statements)

References 28 publications

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“…Women go through hormonal and biochemical changes during gestation 1 . Uterus in constant growth due to increased fetal size protrudes the abdomen and favors anterior gravity center displacement 2 .…”

Section: Introductionmentioning

confidence: 99%

“…Uterus in constant growth due to increased fetal size protrudes the abdomen and favors anterior gravity center displacement 2 . These changes progressively increase lumbar and thoracic curvature and pelvic anteversion, generating muscle overload and consequently pain 1,2 . Low back pain is certainly the most common complaint during gestation 1,3 .…”

Section: Introductionmentioning

confidence: 99%

“…These changes progressively increase lumbar and thoracic curvature and pelvic anteversion, generating muscle overload and consequently pain 1,2 . Low back pain is certainly the most common complaint during gestation 1,3 . Its presence is attributed to sacroiliac and intervertebral joints relaxation and increased levels of progesterone, estrogen and relaxin (responsible for favoring ligament laxity) 1,4 .…”

Section: Introductionmentioning

confidence: 99%

“…Low back pain is certainly the most common complaint during gestation 1,3 . Its presence is attributed to sacroiliac and intervertebral joints relaxation and increased levels of progesterone, estrogen and relaxin (responsible for favoring ligament laxity) 1,4 . Hypermobility of such joints generates joint instability and consequent overload on stabilizing ligaments and muscles which, associated to increased weight, determine musculoskeletal system overload, pull the spine anteriorly and determine low back pain 1,3,4 .…”

Section: Introductionmentioning

confidence: 99%

“…Its presence is attributed to sacroiliac and intervertebral joints relaxation and increased levels of progesterone, estrogen and relaxin (responsible for favoring ligament laxity) 1,4 . Hypermobility of such joints generates joint instability and consequent overload on stabilizing ligaments and muscles which, associated to increased weight, determine musculoskeletal system overload, pull the spine anteriorly and determine low back pain 1,3,4 . In non-pregnant women, lumbo-pelvic instability is a relevant factor for the genesis of low back pain, because musculoskeletal system unbalance leads to lack of dynamic stability and consequent overload of musculoskeletal structures 5 .…”

Section: Introductionmentioning

confidence: 99%

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Does abdominal diastasis influence lumbar pain during gestation?

Santos¹,

Silva²,

Vicente³

et al. 2016

Revista Dor

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BACKGROUND AND OBJECTIVES:To evaluate and compare the presence and size of recti abdominis diastasis in the second and third gestational trimester and to correlate them to lumbar pain incidence and intensity. METHODS: This is a cross-sectional observational study with 128 pregnant women divided in two groups: 53 pregnant women in the second gestational trimester and 75 pregnant women in the third gestational trimester. Lumbar pain was evaluated with Roland Morris questionnaire and Pain Visual Analog Scale. Recti abdominis diastasis was measured with a caliper rule. Data were analyzed according to Spearman correlation and Mann--Whitney U test. RESULTS:Comparison between groups has shown that pregnant women in the third gestational trimester had more recti abdominis diastasis, more reports of severe lumbar pain by the visual analog scale (p=0.0017) and further impact on daily life activities (p=0.0012). There has been positive correlation between recti abdominis diastasis size and scores obtained by Roland Morris questionnaire and visual analog scale. CONCLUSION: Recti abdominis diastasis size, pain intensity and incapacity determined by low back pain were more severe in pregnant women in the third gestational trimester. Keywords: Low back pain, Physiotherapy, Pregnant women, Quality of life, Rectus abdominis. RESUMO JUSTIFICATIVA E OBJETIVOS:Avaliar e comparar a ocorrência e dimensão da diástase dos músculos retos abdominais nos segundo e terceiro trimestres gestacionais e correlacioná-las com presença e intensidade da dor lombar. Does abdominal diastasis influence lumbar pain during gestation?A MÉTODOS:Estudo observacional do tipo transversal com 128 gestantes, divididas em dois grupos: 53 gestantes no segundo trimestre gestacional e 75 gestantes no terceiro trimestre gestacional. Utilizou-se para avaliar a dor lombar o questionário Roland Morris e a escala analógica visual da dor. A mensuração da diás-tase dos músculos retos abdominais foi realizada com auxílio de um paquímetro. Os dados foram analisados segundo a correlação de Spearman e teste U de Mann-Whitney. RESULTADOS: A comparação dos grupos demonstrou que as gestantes do terceiro trimestre apresentavam maior diástase abdominal, mais relatos de dor lombar intensa por meio da escala analógica visual p=0,0017 e maior impacto nas atividades da vida diária (p=0,0012). A correlação foi positiva entre a dimensão da diástase dos músculos retos abdominais e os escores obtidos no questionário Roland Morris e na escala analógica visual. CONCLUSÃO: A dimensão da diástase dos músculos retos abdominais, a intensidade da dor e a incapacidade determinadas pela lombalgia foram maiores nas gestantes do terceiro trimestre gestacional. Descritores: Dor lombar, Fisioterapia, Gestantes, Qualidade de vida, Reto do abdômen. INTRODUCTIONWomen go through hormonal and biochemical changes during gestation 1 . Uterus in constant growth due to increased fetal size protrudes the abdomen and favors anterior gravity center displacement 2 . These changes progressively increase...

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Does abdominal diastasis influence lumbar pain during gestation?

Santos¹,

Silva²,

Vicente³

et al. 2016

Revista Dor

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Incidence, pain, and mobility assessment of pregnant women with sacroiliac dysfunction

Filipec

Jadanec

Kostović-Srzentić

et al. 2018

Intl J Gynecology & Obste

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How do UK physiotherapists address weight loss among individuals with hip osteoarthritis? A mixed‐methods study

Holden

Waterfield

Whittle

et al. 2019

Musculoskeletal Care

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Background: Weight loss is recommended as a core treatment for individuals with hip osteoarthritis who are overweight or obese. Physiotherapists play an important role in managing patients with hip osteoarthritis, but little is known about how they address weight. We aimed to explore how UK-based physiotherapists currently address weight loss among individuals with hip OA.Methods: We carried out a mixed-methods study. A cross-sectional questionnaire was mailed to 3,126 UK-based musculoskeletal physiotherapists. Self-reported approaches to addressing weight loss among individuals with hip osteoarthritis were explored using a case vignette and associated clinical management questions. Semistructured telephone interviews (n = 21) were completed with a purposeful sample of physiotherapists who returned the questionnaire and provided consent for further contact. Interview data were analysed thematically.Results: There was a 53% response rate to the questionnaires (n = 1,646), and 1,148 responders were eligible for analyses (based on having treated an individual with hip OA in the last 6 months). Eight-five per cent of physiotherapists reported that they would address the vignette patient's weight, usually via advice (70%). Interviews identified that advice often focused on the importance of weight loss, with some physiotherapists offering basic advice on how to achieve weight loss. Multiple factors influenced their approach, including confidence, perceived remit and patient receptiveness.Conclusions: UK physiotherapists commonly address weight loss among patients with hip osteoarthritis, by offering advice relating to the importance of weight loss.However, provision of more specific guidance on how to achieve weight loss is variable. With additional training, physiotherapists could play an important role in supporting weight loss among patients with hip OA, thus potentially optimizing treatment outcomes.

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Current management of pregnancy-related low back pain: a national cross-sectional survey of UK physiotherapists

Abstract: This study provides the first robust data on the management of pregnancy-related LBP by U.K. physiotherapists. Multimodal management is common, although exercise is the most frequently used treatment for pregnancy-related LBP. Acupuncture is used less often for this patient group.

Cited by 50 publications

References 28 publications

Does abdominal diastasis influence lumbar pain during gestation?

Does abdominal diastasis influence lumbar pain during gestation?

Incidence, pain, and mobility assessment of pregnant women with sacroiliac dysfunction

How do UK physiotherapists address weight loss among individuals with hip osteoarthritis? A mixed‐methods study

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