Palsson Thorvaldur Skuli, Beales Darren, Slater Helen, O'Sullivan Peter, Graven-Nielsen Thomas
Laboratory for Musculoskeletal Pain and Motor Control, Center for Sensory-Motor Interaction, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Denmark.
School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
J Pain. 2015 Mar;16(3):270-82. doi: 10.1016/j.jpain.2014.12.002. Epub 2014 Dec 23.
Lumbopelvic pain is common in pregnancy but the sensitization factors underlying the condition are largely unknown. This study characterized the somatosensory profile of pregnant and nonpregnant women and the relationship between pain, hypersensitivity, and commonly used manual clinical tests. Thirty-nine pregnant and 22 nonpregnant women were included. Although lumbopelvic pain was not an inclusion criterion, the pregnant women were divided into low- and high-pain groups following data collection. The sensitivity to light brush, pin-prick, and pressure pain was assessed bilaterally at 3 sites in the lumbopelvic region, at the shoulder, and in the lower leg. Responses to the active straight leg raise test and pain provocation tests of the sacroiliac joint were recorded. Participants completed questionnaires addressing emotional and physical well-being and rated disability using the Pelvic Girdle Questionnaire. Compared with controls, the high-pain group rated the active straight leg raise test as more difficult (P < .05), and both pain groups had more positive pain provocation tests (P < .05). The pregnant groups demonstrated significantly lower pressure pain thresholds at most assessment sites compared with controls (P < .05), but self-reported disability and pain were not correlated with pressure pain thresholds within pregnant participants. The high-pain group reported worse emotional health and poorer sleep quality than controls (P < .05).
This article presents the somatosensory profile of a healthy pregnant cohort. The results indicate that pain sensitivity increases during pregnancy possibly owing to the physical changes the body undergoes during pregnancy but also owing to changes in emotional health. This should be accounted for in clinical management of pregnant women with lumbopelvic pain.
腰骶部疼痛在孕期很常见，但该病潜在的敏感因素大多未知。本研究对孕妇和非孕妇的躯体感觉特征以及疼痛、超敏反应和常用手动临床检查之间的关系进行了描述。纳入了39名孕妇和22名非孕妇。虽然腰骶部疼痛并非纳入标准，但在收集数据后将孕妇分为低疼痛组和高疼痛组。在腰骶部区域、肩部和小腿的3个部位双侧评估对轻刷、针刺和压痛的敏感性。记录主动直腿抬高试验和骶髂关节疼痛激发试验的反应。参与者完成了关于情绪和身体健康的问卷，并使用骨盆带问卷对残疾程度进行评分。与对照组相比，高疼痛组认为主动直腿抬高试验更困难（P <.05），且两个疼痛组的疼痛激发试验阳性结果更多（P <.05）。与对照组相比，孕妇组在大多数评估部位的压痛阈值显著更低（P <.05），但孕妇参与者自我报告的残疾和疼痛与压痛阈值无关。高疼痛组报告的情绪健康状况比对照组差，睡眠质量也比对照组差（P <.05）。
本文介绍了一个健康孕妇队列的躯体感觉特征。结果表明，孕期疼痛敏感性增加可能是由于孕期身体发生的生理变化，也可能是由于情绪健康的变化。在对患有腰骶部疼痛的孕妇进行临床管理时应考虑到这一点。
