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Underreported pregnancy related lumbopelvic pain LBPP | Image Courtesy of Filipp Romanovski via Unsplash
Underreported pregnancy-related lumbopelvic pain LBPP | Image Courtesy of Filipp Romanovski via Unsplash

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

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Testimonial by R.S.

I wanted to thank you so much for helping me get through something I thought I may never be able to. We have achieved pain-free intercourse and this has really solidified our marriage. We are so grateful to you for all the work you do! Thank you!!

-- R.S.

Testimonial by A.B.

Before I was referred to Heather Jeffcoat I was living in a nightmare. I had been married to my husband for three years and I was suffering from Vaginismus. That all changed when I visited my OBGYN and she said she knew of someone with a great success rate. To be honest I was hesitant at first because my first doctor had already told me that all I needed to do was order dilators from the internet and I should overcome my problem. She was wrong because I had followed the book on how to use the dilators with absolutely no advancements in my condition. However, that all changed when I went in for my first visit and Heather took the time to explain my condition and how we were going to work together to overcome it.

I remember leaving her office with a glimmer of hope that I could live a normal life. As my sessions continued I began to see immediate results. With only four sessions and a strict dedication to my home programs I was cured of Vaginismus. In the beginning of this process I was made aware that my health insurance company might not cover the costs, which was disappointing but today I can say one hundred percent that it was the best money I ever spent. Now thanks to Heather I am finally enjoying my life to the fullest with my husband. Thank you Heather, I can’t begin to tell you how much I appreciate all that you have done for me. I will never forget it. Those who are suffering from these types of conditions don’t be afraid because she makes you feel so comfortable and the end result is worth it. Good luck to you all and I hope you experience the success I have.
-- A.B.

Testimonial by J.B.

My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

-- J.B.

Testimonial by M.M.

My husband and I were married for 5 years and unable to have intercourse, but I never knew why. After numerous awful experiences at doctor’s offices (where many doctors told me I “just needed to relax”), a surgery that didn’t fix the problem, and a year of owning dilators that didn’t get me anywhere, someone finally referred me to Heather for Physical Therapy. I finally had answers and information from someone who knew exactly what I was dealing with!

Read more: Testimonial by M.M.

Testimonial by R.D., age 38

"I had a severe tear during childbirth that was not stitched together correctly and therefore healed poorly. Even after having a surgery a year later to remove the scar tissue, I was still having pain, and no one could explain why -- there was no overt 'reason' to explain the pain. I had tried other 'specialists' and even saw another physical therapist who had me do hip / leg stretches -- what a joke! I was about to give up and just 'live with it' until thankfully I kept searching online and found Heather.

Read more: Testimonial by R.D., age 38

Testimonial by Ann V.

I wish i could give this place 10 stars!! 
I have been suffering from vaginismus for 5 years and never found the cure to it. I had seen an ob/gyn and he diagnosed me with vaginismus and told me i needed a surgery to cure my condition, which i refused to do. He also referred me to a PT that he works with, i had given them multiple calls and they never responded back to me, so i started searching yelp for another PT. I am SO HAPPY I found Heather's office! I was working with Laureen, and with her guidance and techniques i was able to be cured from vaginismus in only 2 1/2 short months!!! I couldn't believe how quickly their program worked for me! I am forever grateful and thankful from Heather, and Laureen! They are the absolute best at what they do!

Read more: Testimonial by Ann V.

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