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Pain from the pelvic area in relation to pregnancy: Prevention and explanation - two different approaches
Nordic Council of Ministers, Nordic School of Public Health NHV. Department of Antenatal Care, Southern Bohuslän County, Sweden.
2007 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

From a public health perspective pain from low back and/or pelvis was studied in relation to pregnancy. Two interventions, water gymnastics or Friskis and Svettis ́ gymnastics for pregnant women, were evaluated regarding effects on symptoms and need for sick leave due to low back or pelvic pain. In an intervention study with 390 randomised women, 266 participated in physical activity during 60 minutes once a week during just about half their pregnancies. No one was sick-listed due to low back pain in the water gymnastic group compared to 6 women in the land-based exercise group (p=0.03). Some doubts may be raised regarding recommendations to pregnant women with a history of low back pain to participate in gymnastics. On the contrary, water gymnastics seems to be beneficial regarding low back pain. Methods to prevent pelvic pain in relation to pregnancy are not known. Furthermore, a possible relation between longstanding pelvic pain after pregnancy was investigated. Such a relation has never been described before. Fifteen subjects, women with defined posterior pelvic pain during and after pregnancy and as many controls without anamnesis of such pain were tested for lactose intolerance, using the BH2-test. A correlation was found, p=0.05 but results need to be confirmed in larger studies. The possible link towards explaining such a relation goes through the fact that lactose intolerance and “irritable bowel syndrome”, IBS, often overlap and lactose intolerance test is recommended to be included in investigation of IBS. Can low back/pelvic pain in relation to pregnancy sometimes be correlated to lactose intolerance?

Abstract [sv]

Med utgångspunkt från ett folkhälsoperspektiv studerades smärta från ländrygg och eller bäcken hos gravida kvinnor. Två interventioner, vattengymnastik respektive Friskis och Svettis ́ Vänta-barn-gympa, utvärderades avseende symtom på smärta från ländrygg och bäcken samt sjukskrivning härför i samband med graviditet. I en interventionsstudie med 390 randomiserade kvinnor deltog 266 kvinnor i fysisk aktivitet under en timma per vecka under drygt halva graviditeten. Ingen var sjukskriven för ländryggsmärta i vattengymnastikgruppen jämfört med 6 kvinnor i gymnastikgruppen (p=0.03). Viss försiktighet föreslås när det gäller att rekommendera vanlig gymnastik till kvinnor med anamnes på ryggsmärta under graviditet medan vattengymnastik förefaller ha god effekt för just ländryggsmärta. Någon metod för att förebygga bäckensmärta finns inte beskriven. Vidare studeras ett eventuellt samband mellan laktosintolerans och kvarstående bäckensmärta, något som inte tidigare undersökts. När det gäller sambandet graviditet – laktosintolerans gjordes en pilotstudie med 15 deltagare och lika många kontroller. Ett visst samband kunde konstateras, p=0.05, men resultaten måste verifieras i större studier. Den tänkbara förklaringsmekanismen bakom sambandet med laktosintolerans går via ”irritable bowel syndrome”, IBS. Symtom från IBS och från laktosintolerans överlappar varandra och det rekommenderas att laktosbelastning skall ingå i utredning av oklara buksmärtor. Kan även bäckensmärtor i samband med graviditet i vissa fall ha samband med laktosintolernas?

Place, publisher, year, edition, pages
Göteborg: Nordic School of Public Health NHV , 2007. , 36 p.
Series
Master of Science in Public Health, MScPH, ISSN 1404-904X ; 2007:1
Keyword [en]
Pregnancy, Pelvic Pain, Low Back Pain, Water Gymnastics, Land-Based Gymnastics, Lactose Intolerance
Keyword [sv]
Graviditet, bäckensmärta, ländryggsmärta, vattengymnastik, gymnastik, laktosintolerans
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:norden:org:diva-2552ISBN: 978-91-85721-10-8 (print)OAI: oai:DiVA.org:norden-2552DiVA: diva2:703142
Presentation
2007-05-14, Nordic School of Public Health NHV, Boc 12133, SE 402 42 Göteborg, Sverige, 00:00 (Swedish)
Supervisors
Available from: 2014-03-05 Created: 2014-03-05 Last updated: 2014-03-25Bibliographically approved
List of papers
1. Lactose intolerance and long-standing pelvic pain after pregnancystudy.: a case control
Open this publication in new window or tab >>Lactose intolerance and long-standing pelvic pain after pregnancystudy.: a case control
2007 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 86, no 10, 1273-1276 p.Article in journal (Refereed) Published
Abstract [en]

Background.Long-standing pelvic pain during pregnancy and after delivery (PPP) is common. Its causes are not fullyunderstood. A scientifically, undocumented, clinical observation is PPP patients often reporting unspecific abdominal painand adverse reactions to milk. The main objective in this pilot study was to investigate if lactose intolerance, celiac diseaseor allergic propensity are risk factors for developing pelvic pain after delivery.Methods.A matched, case control study,where consecutive patients consulting a registered physiotherapist specialised in treating women with postpartum pelvicpain were compared to matched controls.Results.Lactose intolerance was found in 10 of 15 patients, and in 3 of 15matched, healthy controls (p0.05). No difference was seen between groups in the prevalence of celiac disease or allergicpropensity.Conclusion.This study suggests that lactose intolerance might be a possible risk factor for pelvic pain afterdelivery.

Place, publisher, year, edition, pages
Copenhagen: Munksgaard Forlag, 2007
Keyword
Case-Control Studies, Lactose Intolerance, Pelvic pain, Low Back Pain, Pregnancy
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:norden:org:diva-2551 (URN)17851802 (PubMedID)
Available from: 2014-03-05 Created: 2014-03-05 Last updated: 2015-02-03Bibliographically approved
2. Water aerobics reduces sick leave due to low back pain during pregnancy.
Open this publication in new window or tab >>Water aerobics reduces sick leave due to low back pain during pregnancy.
2006 (English)In: Journal of Obstetric, Gynecologic and Neonatal Nursing, ISSN 0884-2175, E-ISSN 1552-6909, Vol. 35, no 4, 465-471 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE:

To compare the effect of a land-based, physical exercise program versus water aerobics on low back or pelvic pain and sick leave during pregnancy.

DESIGN:

Randomized controlled clinical trial.

SETTING:

Three antenatal care centers.

PARTICIPANTS:

390 healthy pregnant women.

INTERVENTIONS:

A land-based physical exercise program or water aerobic once a week during pregnancy.

MAIN OUTCOME MEASURES:

Sick leave, pregnancy-related low back pain or pregnancy-related pelvic girdle pain, or both.

RESULTS:

Water aerobics diminished pregnancy-related low back pain (p=.04) and sick leave due to pregnancy-related low back pain (p=.03) more than a land-based physical exercise program.

CONCLUSIONS:

Water aerobics can be recommended for the treatment of low back pain during pregnancy. The benefits of a land-based physical exercise program are questionable and further evaluation is needed.

Place, publisher, year, edition, pages
Hoboken, NJ : Wiley-Blackwell Pub., 2006
Keyword
Gymnastics, Low Back Pain, Pelvic Painn, Pregnancyk, Sick Leave
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:norden:org:diva-2550 (URN)16881990 (PubMedID)
Available from: 2014-03-05 Created: 2014-03-05 Last updated: 2014-03-25Bibliographically approved

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