Nilsson-Wikmar L, Harms-Ringdahl K, Pilo C, Pahlbäck M
Department of Physical Therapy, Karolinska Institutet, Stockholm, Sweden.
Physiother Res Int. 1999;4(3):201-13. doi: 10.1002/pri.166.
At least half of all pregnant women experience back pain at some time during pregnancy and some of them also have persisting back pain post-partum. The aim of the present study was to identify and classify back problems in women post-partum by use of different pain provocation tests and define their relationship to spinal sagittal configuration and mobility.
One hundred and nineteen women with back pain persisting two months after delivery were interviewed and examined, on average 7.2 months post-partum. Ten clinical pain provocation tests were performed. The first was performed to identify hip pain, the second to identify radiating pain and the other eight tests were performed to provoke pain in the areas of the posterior pelvic/sacroiliac joints, the symphysis pubis and the lumbar spine. The spinal sagittal configuration and mobility were measured in the thoracic and lumbar spine, respectively, with Debrunner's kyphometer (Protek AG, Berne, Switzerland).
Twenty-seven per cent of women had pain in the area of the posterior pelvic/sacroiliac joints, 18% in the area of the lumbar spine, 39% both in the area of the posterior pelvic/sacroiliac joints and in the lumbar spine, and in 16% no pain could be provoked. There were no statistically significant differences between the four groups with respect to the spinal sagittal configuration or the mobility in the thoracic or lumbar spine.
Back pain post-partum is not a unitary concept. Based on the clinical tests, women with back pain post-partum can be separated into groups with different pain localizations. The measuring of the spinal sagittal configuration and mobility did not help to further identify or classify post-partum back pain.
至少半数孕妇在孕期的某些时候会经历背痛,其中一些人产后也会持续背痛。本研究的目的是通过使用不同的疼痛激发试验来识别和分类产后女性的背部问题,并确定它们与脊柱矢状位形态及活动度的关系。
对119名产后背痛持续两个月的女性进行了访谈和检查,平均产后7.2个月。进行了10项临床疼痛激发试验。第一项试验用于识别髋部疼痛,第二项试验用于识别放射痛,另外八项试验用于激发骨盆后/骶髂关节、耻骨联合和腰椎区域的疼痛。分别使用德布勒纳弯度计(Protek AG,瑞士伯尔尼)测量胸椎和腰椎的脊柱矢状位形态及活动度。
27%的女性在骨盆后/骶髂关节区域疼痛,18%在腰椎区域疼痛,39%在骨盆后/骶髂关节区域和腰椎区域均有疼痛,16%未激发疼痛。四组在脊柱矢状位形态或胸椎及腰椎活动度方面无统计学显著差异。
产后背痛并非一个单一的概念。基于临床检查,产后背痛的女性可分为疼痛部位不同的组。脊柱矢状位形态及活动度的测量无助于进一步识别或分类产后背痛。