Determinants for lumbopelvic pain 6 months postpartum

Abstract

Purpose: To evaluate potential determinants of self-reported lumbopelvic pain 6 months postpartum for pregnant women with and without lumbopelvic pain. Methods: Questionnaires were answered in weeks 19–21 of pregnancy and at 6 months postpartum. The Pain Catastrophizing Scale was used to assess exaggerated negative thoughts about pain experiences, the Fear-Avoidance Beliefs Questionnaire to assess beliefs about how physical activity affects back pain, the Visual Analogue Scale to assess pain intensity, the Disability Rating Index to assess physical ability, and the Nottingham Health Profile to assess health-related quality of life. A Cox proportional hazards model was used to analyse the data. Results: Of the 273 women who answered at both occasions, 112 had lumbopelvic pain in pregnancy and 161 did not. For pregnant women with lumbopelvic pain a higher level of catastrophizing and a more restricted physical ability both doubled the risk for postpartum lumbopelvic pain. Conclusions: We conclude that catastrophizing and physical ability, in weeks 19–21 of pregnancy determine postpartum lumbopelvic pain, and hence that, women at risk might be identified by the use of a biopsychosocial approach in pregnancy. It seems important to take these results into consideration both when forming preventive strategies and in rehabilitation.

Implications for Rehabilitation

• A high level of catastrophizing and a low physical ability in women with lumbopelvic pain during pregnancy increased the risk of reporting postpartum lumbopelvic pain.

• A biopsychosocial approach during pregnancy seems important for to identify women at risk for future pain.

• Interventions targeting catastrophizing might have a positive effect but that needs to be studied for this specific population.

Keywords::

• back pain
• limitation of activity
• pelvic girdle pain
• risk factors

Declaration of interest: Financial support was provided through the regional agreement on medical training and clinical research (ALF) between Stockholm County Council and the Karolinska Institute, Stockholm, Sweden.