Stuge Britt
Seksjon for operativ forskningsstøtte, Oslo universitetssykehus, Ullevål, Kirkeveien 166, 0407 Oslo, Norway.
Tidsskr Nor Laegeforen. 2010 Nov 4;130(21):2141-5. doi: 10.4045/tidsskr.09.0702.
Pelvic girdle pain (PGP) usually presents during pregnancy. About 25% of all pregnant women and 5% of all women suffer from postpartum lumbopelvic pain causing them to seek medical help. This article discusses possible causes, diagnostic aspects and treatment of PGP.
The paper is based on literature identified through non-systematic searches in PubMed, Medline, Embase, Cinahl and Cochrane. Only randomized controlled trials were considered for effect of treatment.
Possible underlying mechanisms are hormonal, biomechanical, inadequate motor control and stress of ligament structures. The diagnosis should be based on pain location and several clinical tests. Characteristic signs are problems with walking, standing and sitting. There is evidence for the existence of PGP subgroups that require different treatment. It is well documented that individualized physiotherapy focused on body awareness and specific functional training, has a good and long-lasting effect. Patients with PGP may benefit from reassuring information based on medical history and clinical examination. When needed, patients may be referred to targeted individualized physiotherapy which is continuously evaluated. Few seem to have effect of general or stabilizing exercises.
General or stabilizing exercises seem to have miner effect in a number of women.
骨盆带疼痛(PGP)通常在孕期出现。约25%的孕妇及5%的女性患有产后腰骨盆疼痛并因此寻求医疗帮助。本文讨论了PGP的可能病因、诊断要点及治疗方法。
本文基于通过在PubMed、Medline、Embase、Cinahl和Cochrane中进行非系统检索所确定的文献。仅考虑随机对照试验以评估治疗效果。
可能的潜在机制包括激素、生物力学、运动控制不足及韧带结构应力。诊断应基于疼痛部位及多项临床检查。典型体征为行走、站立及坐姿问题。有证据表明存在需要不同治疗的PGP亚组。有充分文献记载,以身体感知及特定功能训练为重点的个体化物理治疗具有良好且持久的效果。PGP患者可从基于病史及临床检查的安心信息中获益。必要时,患者可被转介至持续评估的针对性个体化物理治疗。几乎没有证据表明一般或稳定性锻炼有效果。
一般或稳定性锻炼似乎对许多女性效果甚微。