Pregnancy is characterized by widespread deep-tissue hypersensitivity independent of lumbopelvic pain intensity, a facilitated response to manual orthopedic tests, and poorer self-reported health
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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). Perspective 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.
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Wand, B.; Elliott, R.; Sawyer, A.; Spence, R.; Beales, Darren; O'Sullivan, Peter; Smith, Anne; Gibson, W. (2017)Background: Recent investigations have suggested that disrupted body-image may contribute to the lumbopelvic pain experience. The changes in body shape and size associated with pregnancy suggest that pregnancy-related ...
Disturbed body perception, reduced sleep, and kinesiophobia in subjects with pregnancy-related persistent lumbopelvic pain and moderate levels of disability: An exploratory studyBeales, Darren; Lutz, A.; Thompson, Judith; Wand, B.; O'Sullivan, Peter (2014)Background: For a small but significant group, pregnancy-related lumbopelvic pain may become persistent. While multiple factors may contribute to disability in this group, previous studies have not investigated sleep ...
Correlations between the active straight leg raise, sleep and somatosensory sensitivity during pregnancy with post-partum lumbopelvic pain: An initial explorationBeales, Darren; Gaynor, O.; Harris, J.; Fary, Robyn; O'Sullivan, Peter; Slater, Helen; Graven-Nielsen, T.; Palsson, T. (2018)© 2018 Scandinavian Association for the Study of Pain. Published by Walter de Gruyter GmbH, Berlin/Boston. All rights reserved. For some women, lumbopelvic pain (LPP) developed during pregnancy becomes a continuing ...