Low back pain and causative movements in pregnancy: a prospective cohort study

Saori Morino; Mika Ishihara; Fumiko Umezaki; Hiroko Hatanaka; Hirotaka Iijima; Mamoru Yamashita; Tomoki Aoyama; Masaki Takahashi

doi:10.1186/s12891-017-1776-x

Low back pain and causative movements in pregnancy: a prospective cohort study

BMC Musculoskelet Disord. 2017 Oct 16;18(1):416. doi: 10.1186/s12891-017-1776-x.

Authors

Saori Morino^{1

2}, Mika Ishihara³, Fumiko Umezaki³, Hiroko Hatanaka³, Hirotaka Iijima^{4

5}, Mamoru Yamashita³, Tomoki Aoyama⁶, Masaki Takahashi⁴

Affiliations

¹ School of Science for Open and Environmental Systems, Graduate School of Science and Technology, Keio University, 3-14-1 Hiyoshi, Kohoku-ku, Yokohama, Kanagawa, 223-8522, Japan. morino-s@keio.jp.
² Japan Society for the Promotion of Science, Tokyo, Japan. morino-s@keio.jp.
³ Kishokai Medical Corporation, Nagoya, Japan.
⁴ School of Science for Open and Environmental Systems, Graduate School of Science and Technology, Keio University, 3-14-1 Hiyoshi, Kohoku-ku, Yokohama, Kanagawa, 223-8522, Japan.
⁵ Japan Society for the Promotion of Science, Tokyo, Japan.
⁶ Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Abstract

Background: Low back pain (LBP) during pregnancy might be strongly related to posture and movements of the body, and its management is a clinically important issue. The purpose of this study was to investigate the activities related to LBP during pregnancy.

Methods: Participants included 275 women before 12 weeks of pregnancy. The women were evaluated at 12, 24, 30, and 36 weeks of pregnancy. The intensity of LBP was assessed using the Numerical Rating Scale (NRS). Movements related to LBP were investigated by free descriptive answers. Descriptive statistics were used to compile the movements that pregnant women thought induced LBP at each evaluation. Subsequently, a linear regression analysis was performed to evaluate the degree of association of certain movements with LBP using the data of participants who had LBP. The intensity of LBP (NRS score) was specified as the dependent variable, the movements that were related to pain were specified as the independent variables at the analysis. A significance threshold was set at 0.05.

Results: The final sample used in the analyses was 254, 249, 258, and 245 women at 12, 24, 30, and 36 weeks of pregnancy, respectively. There were 16 kinds of movements that induced LBP and all of them were daily activities rather than special movements that require extra task or effort. As pregnancy progressed, less number of participants attributed pain to a specific movement. At all evaluations, movements, especially sitting up, standing up from a chair, and tossing and turning were thought to be related to LBP. Furthermore, standing up from a chair and tossing and turning were significantly related to LBP throughout the pregnancy. In contrast, lying down and sitting up were significantly related to LBP but the relationship did not continue till late pregnancy.

Conclusions: Daily routine activity is related to LBP during pregnancy. These results suggest that recommendations for pregnant women about basic physical movements, such as ways of standing up that reduce the load on the body might be useful in the management of LBP.

Keywords: Activity; Low back pain; Lumbopelvic pain; Motion; Pregnancy.

MeSH terms

Activities of Daily Living*
Adult
Female
Humans
Low Back Pain / etiology*
Pregnancy
Pregnancy Complications / etiology*
Prospective Studies