Pelvic-spine pain at pregnancy: diagnostics and treatment

Authors

  • Volodymyr Tankut Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
  • Kostiantyn Berenov Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
  • Olga Berenova «MMC Eviva», Kharkiv. Ukraine, Ukraine

DOI:

https://doi.org/10.15674/0030-59872020361-66

Keywords:

, pregnant women, lumbar-pelvic pain, factors, methods of prevention and treatment

Abstract

The course of pregnancy is often complicated by pelvic spine pain (PSP), which leads to household and occupational disability, negatively affects the condition of the fetus and the unborn child. Objective: to analyze the main factors in the development of PSP in pregnant women, to improve the methods of diagnosis and treatment. Methods: the protocols of clinical, biomechanical and ultrasound examinations of 175 women of reproductive age (18–45 years old) with PSP were studied. The following structural sources of pain were identified: facet joints, sacroiliac joints, and hip joints, intervertebral discs, pubic joints, and myofascial structures. Each type of pain was classified according to the nature of the pain syndrome. Results: mapsschemes of sources and variants of pain syndromes localization were proposed. There were 4 main factors in the development of lumbar pain syndrome (instability (40.8 %), facet joints pain, diskalgia (5.1 %), functional blockade of the lumbar vertebral motor segments (26.3 %)), 5 — pelvic (instability joints (39.5 %), arthralgia (23 %), functional blockade (40.8 %), syndromes of the sacroiliac joints (80 %) and symphysitis (48.7 %)). Basic treatment programs for pregnant women with PSP have been developed, the use of which led to a decrease in pain intensity during pregnancy by an average of 75 %. Some of the positive results of rehabilitation increased from (70.11 ± 16.42) % in the first trimester to (75.80 ± 18.43) % in the third. The rehabilitation index was (81.49 ± 19.26) %. Conclusions: PSP in pregnant women differs from pain at degenerative spine diseases and pelvic. The proposed working charts-schemes of different types of sources and variants of localization of pain syndromes significantly improved the diagnosis of these pathological conditions, which helped to determine the treatment method. The effectiveness and expediency of using the developed program for the treatment of pregnant women with PSP in medical practice has been confirmed.

Author Biographies

Volodymyr Tankut, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

MD, Prof. in Traumatology and Orthopaedics

Kostiantyn Berenov, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

PhD in Traumatology and Orthopaedics

References

  1. Giannoulis, D. K., Koulouvaris, P., Zilakou, E., Papadopoulos, D. V., Lykissas, M. G., & Mavrodontidis, A. N. (2015). Atraumatic sacral fracture in late pregnancy: A case report. Global Spine Journal, 5(3), 248-251. doi:10.1055/s-0035-1549429
  2. Fedorov, D.V., & Kirgizova, O. Yu. (2019). Back pain in pregnant women: causes, pathogenesis and biomechanics features. Acta Biomedica Scientifica, 4(2), 60–64. doi: 10.29413/ABS.2019-4.2.9. [in Russian]
  3. Shevlyukova, T. P., Scriabin, E. G., Galieva, G. D., & Afanasyeva, I. A. (2017). Pelvic pathology in pregnant women suffering from scoliosis and osteochondrosis of the spine. VII International scientific and practical conference “World science: problems and innovations". Penza: Science and Education. [in Russian]
  4. Prodan, A. I., Berenov, K. V., Kolesnichenko, V. A., & Staude, V. A. (2007). Vertebral-pelvic pain during pregnancy: pathogenesis and risk factors. Orthopedics, Traumatology and Prosthetics, 2, 108–114. [in Russian]
  5. Prodan, O. I., Berenov, K. V., Staude, V. A., & Karpinsky, M. Yu. (2009). Biomechanical aspects of the pathogenesis of lumbar-pelvic pain in pregnant women. Orthopedics, Traumatology and Prosthetics, 4, 68–72. doi: 10.15674/0030-59872009468-72. [in Ukrainian]
  6. Unsgaard-Tøndel, M., Vasseljen, O., Woodhouse, A., & Morkved, S. (2016). Exercises for women with persistent pelvic and low back pain after pregnancy. Global Journal of Health Science, 8(9), 107. doi:10.5539/gjhs.v8n9p107
  7. Casagrande, D., Gugala, Z., Clark, S. M., & Lindsey, R. W. (2015). Low back pain and pelvic girdle pain in pregnancy. The Journal of the American Academy of Orthopaedic Surgeons, 23(9), 539–549. doi: 10.5435/JAAOS-D-14-00248
  8. Homer, C. (2018). Pregnancy care. Clinical practice guidelines. Canberra: Australian Government, Department of Health
  9. Elden, H., Gutke, A., Kjellby-Wendt, G., Fagevik-Olsen, M., & Ostgaard, H. (2016). Predictors and consequences of long-term pregnancy-related pelvic girdle pain: A longitudinal follow-up study. BMC Musculoskeletal Disorders, 17(1). doi:10.1186/s12891-016-1154-0
  10. Casagrande, D., Gugala, Z., Clark, S. M., & Lindsey, R. W. (2015). Low back pain and pelvic girdle pain in pregnancy. The Journal of the American Academy of Orthopaedic Surgeons, 23(9), 539–549. doi: 10.5435/ JAAOS-D-14-00248;00:1-11
  11. Skryabin, E. G., & Ponomareva, G. A. (2016). Pelvic pathology in pregnant women suffering from scoliosis and osteochondrosis of the spine. Academic Journal of Western Siberia, 12(1), 70. [in Russian]
  12. Bernard, M., & Tuchin, P. (2016). Chiropractic management of pregnancy-related Lumbopelvic pain: A case study. Journal of Chiropractic Medicine, 15(2), 129-133. doi:10.1016/j.jcm.2016.04.003
  13. Allamuratov, K. E., Utepbergenova, G. T., & Adizov, S. R. (2017). Complicated injuries of the spine and spinal cord in osteochondrosis and herniated discs. Bulletin of Science and Practice, 5, 82–85. doi: 10.5281/ zenodo.579729. [in Russian]
  14. Clinton, S. C., Newell, A., Downey, P. A., & Ferreira, K. (2017). Pelvic girdle pain in the antepartum population: physical therapy clinical practice guidelines linked to the international classification of functioning, disability, and health from the Section on Women’s Health and the Orthopaedic Section of the American Physical Therapy Association. Journal of Women’s Health Physical Therapy, 41(2), 102– 125. doi: 10.1097/JWH.0000000000000081
  15. Kirilin, B. A., Deev, A. S., & Zhigunova, I. A. (1999). Manual therapy in the treatment of patients with lumbar and pelvic pain during pregnancy and in the postpartum period. Scientific-practical conf. Ministry of Health of the Russian Federation. Novosibirsk. [in Russian]
  16. Maksimenko, E. N. (1997). Influence of tocolytic doses of calcium channel blockers on pain sensitivity during pregnancy in the experiment and clinic. Scientific-practical conf. "Organization of medical care for patients with pain syndromes". Novosibirsk. [in Russian]
  17. Dufour, S. & Daniel, S. (2018). Understanding clinical decision making: pregnancy-related pelvic girdle pain. Journal of Women's Health Physical Therapy, 42(3), 120–127. doi: 10.1097/JWH.0000000000000100
  18. Skryabin, E. G., Durov, M. F., Prokopyev, N. Ya., Durov, M. F., & Prokopiev, N. Ya. (2003). A new safe method for diagnosing spinal column deformities and a system of non-drug treatment of vertebral pain syndrome in pregnant women. Genius of Orthopedics, 1, 14–16. [in Russian]
  19. Kreneva, Yu. A., Panov, V. P., Avdeeva, M. V., & Bogomolova, K. A. (2018). The recovery potential of complex rehabilitation measures in the provision of primary health care to patients with degenerative diseases of the spine. Preventive and Clinical Medicine, 2, 76–82. [in Russian]
  20. Skidanov, A., Dupliy, D., Kotulskiy, I., Barkov, O., Kis, A., Piontkovsky, V., & Radchenko, V. (2015). Functional state of back muscles in patients with degenerative spine disorders. Orthopaedics, Traumatology and Prosthetics, 4, 59-68. doi: 10.15674/0030-59872015459-68. [in Russian]
  21. Berenov, K.V. (2011). Lumbar-pelvic pain in pregnant women: diagnosis, prognosis and treatment: dissertation of PhD in Medical Sciences. Kharkov. [in Russian]
  22. Staude, V. A., Prodan, O. I., Prochan, V. M., & Berenov, K. V. (2009). Method of elimination of dislocation and subdislocation of sacroiliac joint. Ukraine. Patent 44444 A. [in Ukrainian]
  23. Staude, V. A., Prodan, O. I., Prochan, V. M., & Berenov, K. V. (2009). A method of treating dislocation and subluxation of the sacroiliac joint. Ukraine. Patent 44445 А. [in Ukrainian]
  24. Prodan, O. I., Berenov, K. V., & Tymchenko, I. B. (2007). Device for stabilizing the pelvic ring. Ukraine. Patent 28774 А. [in Ukrainian]
  25. Dynnik, O. A., Tymchenko, I. B., & Fadeev, O. G. (2019). Express orthoses in the system of treatment

How to Cite

Tankut, V., Berenov, K., & Berenova, O. (2023). Pelvic-spine pain at pregnancy: diagnostics and treatment. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (3), 61–66. https://doi.org/10.15674/0030-59872020361-66

Issue

Section

ORIGINAL ARTICLES