Underreported Pregnancy Related Lumbopelvic Pain (PLPP)

Details: Written by: Kasia Gondek, PT, DPT, CSCS; Published: 26 September 2023; Last Updated: 19 October 2023; 1642 Views

Underreported Pregnancy Related Lumbopelvic Pain:

A common condition that most healthcare providers are missing and how physical therapy can help

Being pregnant comes with lots of changes to an expecting mother’s body. Hormonal and physical changes to the body, as well as vascular and neural factors can cause pregnancy-related lumbopelvic pain (PLPP). About 63% of pregnant women in the U.S. experience it at some point during gestation. A recent survey study involving 538 pregnant women with pregnancy-related lumbar and pelvic pain (henceforth termed lumbopelvic pain) found that only 43% reported it, and of those, only 22% received any treatment!¹ Physical therapy through the use of manual treatments, therapeutic exercises, muscle re-education, and functional activity training (lifting mechanics, proper sitting and standing posture) have been proven effective at reducing pregnancy-related lumbopelvic pain and improving quality of life.^2,3,4 Pregnancy-related lumbopelvic pain can interfere with quality of life, physical function, inability to perform daily activities, sleep disturbances, and can contribute to mood disorders such as anxiety and depression.^1,2

This article explores the reasons why healthcare providers (HCPs) are missing the mark with identifying and recommending treatment for pregnancy-related lumbopelvic pain and what we can do to change that.

In a recent study, Hameed, et al. found that HCPs may inaccurately minimize patient’s symptoms and pain (classifying them as expected and normal with pregnancy), and fail to evaluate potential limitations (including ability to work, drive, perform daily activities and physical activity) stemming from pregnancy-related lumbopelvic pain. Recent survey studies found that participants felt their condition was normalized and overlooked by their HCPs. The study also found that because pregnancy is a self-limited condition, it may also influence the likelihood of reporting pain to their provider. In the United States, a lack of universal health care resources may also influence a person's choice to seek treatment for this.¹

It is important that any healthcare provider ask about any low back pain, pelvic girdle pain, or issues with bowel and bladder functioning (leakage, difficulty emptying, or having any pelvic pressure), as these are all things that are very treatable with orthopedic and pelvic physical therapy! All of our Physical Therapists have specialized training to identify and treat pregnancy-related lumbopelvic pain and other pelvic floor-related symptoms including pain.

Physical therapy is an effective first line treatment for pregnancy-related lumbopelvic pain.^2,3,4 Physical therapy can help decrease and relieve pain, improve your posture, core and hip strength as well as treat any muscle trigger points. Your physical therapist will also identify ways you can modify your daily activities to decrease the strain on your body and improve pain long-term.

Do you have pregnancy related lumbopelvic pain? Read more of our articles on this topic and contact our office for the help you deserve!

References:

1. Farah Hameed, Ariana Cesare, Nura Mariscal del Moral, Travis Barton, and Cynthia Chiarello. Is Pregnancy-Related Lumbopelvic Pain Reported to Health Care Providers?. Journal of Women's Health. August 3, 2023 ahead of print https://doi.org/10.1089/jwh.2022.0459

2. van Benten E, Pool J, Mens J, Pool-Goudzwaard A. Recommendations for physical therapists on the treatment of lumbopelvic pain during pregnancy: a systematic review. J Orthop Sports Phys Ther. 2014;44(7):464-A15. doi:10.2519/jospt.2014.5098

3. Fontana Carvalho AP, Dufresne SS, Rogerio de Oliveira M, et al. Effects of lumbar stabilization and muscular stretching on pain, disabilities, postural control and muscle activation in pregnant woman with low back pain. Eur J Phys Rehabil Med. 2020;56(3):297-306. doi:10.23736/S1973-9087.20.06086-4

4. Sonmezer E, Özköslü MA, Yosmaoğlu HB. The effects of clinical pilates exercises on functional disability, pain, quality of life and lumbopelvic stabilization in pregnant women with low back pain: A randomized controlled study. J Back Musculoskelet Rehabil. 2021;34(1):69-76. doi:10.3233/BMR-191810

What Our Patients Have to Say

Testimonial by Jackie W.

I was in multiple car accidents a decade ago, and I have been to many physical therapists through the years without success. They found the root of my lower back pain problems and after nearly a decade of barely being able to walk I finally can again without pain. They are also the best pelvic floor pts and the only ones who found the connection between my pelvic floor and lower back problems. If you need help with physical pain, they are your answer.

-- Jackie W., 1/19/17 via Yelp!

Testimonial by S.P., Age 26

I would like to start off by thanking Heather Jeffcoat for educating me and curing me of Vaginismus. I had been married for almost three years before I was referred to Heather. I never knew about Vaginismus until almost three years into my marriage. I knew something was wrong when I went on my honeymoon and came back a Virgin. I had always imagined how magical my first night would be but boy was I wrong.

Read more: Testimonial by S.P., Age 26

Testimonial by Fritzette H.

I went to Heather after the birth of my third child. It was lucky, really, that I was referred to her, because my doctor had referred me to a surgeon for a possible hysterectomy or pelvic wall rebuild. Thankfully, I went to Heather before undergoing either surgery, she was able to fix the problem. She has studied extensively in women's health--even written a book about it--and was able to diagnose my problem, suggest a course of treatment (6 weeks), and then follow through with said treatment. By the end, as she said, I was as good as gold. Boy, was it worth it! Though uncomfortable to talk about, much less write about, it is worth getting the word out there. If you have painful intercourse, especially after birth or other trauma, the treatment may be as simple as Physical Therapy (with Heather, of course). I highly recommend her.

-- Fritzette H., 3/24/16 via Yelp!

Testimonial by R.M., Age 40

I can’t speak highly enough of the theapists at Femina Physical Therapy and how much they have helped me grow, discover, and love my body. I had had painful sex for my entire life, and didn’t know that there was anything that could be done about it. It was at the point where my husband and I were not having sex for MONTHs, because it was just too frustrating, and I hated feeling like I was the ONLY woman out there who had this problem, especially at my age. I finally brought it up to my doctor because I was turning 40 and my husband and I were barely having enough sex to conceive. And she brought up pelvic floor, PT. I didn’t even know this was a “thing”.
Read more: Testimonial by R.M., Age 40

Testimonial by S.P., Age 26

I would like to start off by thanking Heather Jeffcoat for educating me and curing me of Vaginismus. I had been married for almost three years before I was referred to Heather. I never knew about Vaginismus until almost three years into my marriage. I knew something was wrong when I went on my honeymoon and came back a Virgin. I had always imagined how magical my first night would be but boy was I wrong.

Read more: Testimonial by S.P., Age 26

Testimonial by Alexandra B.

Heather is without exaggerating AMAZING! After years of trouble with a certain part of my body, in no time, she made everything change back to equilibrium and to what would be considered normal. She explains everything in detail and therefore gives you a better understanding of why things are the way they are, and how you can work towards turning things around. I would highly recommend Heather for any type of Physical Therapy. She has created her own "Method/Therapy" through years of studying (with some of the greatest practitioners), practice and breaking down the issues of her past patients, enabling her to fine tune her own system. I'm so thankful to have found her, and I'm especially grateful for the quick recovery I've achieved, after years of distress. If you cannot afford her, I recommend you purchase her book. Although it may not be Heather in person, it can still help you to get on the right path to recovery!

-- Alexandra B., 5/20/2015 via Yelp!

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Underreported Pregnancy Related Lumbopelvic Pain (aka PLPP)