scholarly journals Pregnancy-related lumbopelvic pain: classification and diagnostics according to European guidelines and a review of literature

2017 ◽  
Vol 21 (3) ◽  
pp. 58-63
Author(s):  
Małgorzata Starzec ◽  
Aleksandra Truszczyńska-Baszak
Keyword(s):  
Lumbar Spine ◽  
Clinical Symptoms ◽  
Negative Impact ◽  
Mechanical Load ◽  
Pelvic Girdle ◽  
Pelvic Girdle Pain ◽  
Lumbar Pain ◽  
Foreign Literature ◽  
European Guidelines ◽  
Pain Syndromes

Lumbopelvic pain associated with pregnancy may originate from the lumbar spine, the pelvic girdle or may be mixed. According to European guidelines, individual subtypes of pain require different procedures, for which a detailed differential diagnosis is necessary. These ailments arouse a lot of controversy. The aim of the work was to present the current state of knowledge on the aforementioned ailments, including European guidelines and the latest trends in foreign literature. The diagnosis of lumbopelvic pain, with particular emphasis on the pathophysiology and methods of differentiation of both pain syndromes, was discussed. Lumbar spine pain is mainly related to the mechanical load caused by a pregnant uterus. In the case of pelvic girdle pain, the main cause is the disorder of optimal stability, which depends on the correct mechanisms of force and form closure. Pelvic girdle pain is characterized by other clinical symptoms and risk factors, it also often remains after pregnancy, having negative impact on the daily functioning of a woman even years after giving birth. Depending on the location (one or both sacroiliac joints, pubic symphysis), several types of this pain syndrome are distinguished. The worst prognosis is pelvic pain associated with the involvement of all three joints at the same time. Until now, this term has not been more widely used in the Polish-language literature. The complexity of chronic pain syndromes, in which the discomforts of the pregnancy period may develop, entails the necessity of early identifi cation and deliberate action. Knowledge of the etiopathogenesis of these ailments is a prerequisite for therapeutic success. Introduction of terminology popular in foreign literature will improve treatment of these diseases, adapting it to current standards and will also enable better exchange of experience between professionals. pelvic girdle pain, lumbar pain, pregnancy

scholarly journals Development of an algorithm for the clinical and instrumental diagnosis of non-compression lumbar pain syndromes to optimize the use of puncture surgical techniques

2020 ◽  
pp. 27-34
Author(s):  
A. A. Kalinin ◽  
A. K. Okoneshnikova ◽  
Yu. Ya. Pestryakov ◽  
V. V. Shepelev ◽  
V. A. Byvaltsev
Keyword(s):  
Lumbar Spine ◽  
Surgical Techniques ◽  
Degenerative Changes ◽  
Lumbar Pain ◽  
Group Iii ◽  
Pain Syndromes ◽  
Group I ◽  
Neuroimaging Data ◽  
Group Ii ◽  
Stimulation Of

Background. Pain syndromes developing as a result of degeneration of the lumbar segments of the spine constitute a significant problem in modern vertebrology. The results of the application of preoperative diagnostic provocative tests are contradictory, and therefore the mixed effectiveness of puncture surgical techniques is recorded.Objective. To develop an algorithm for the clinical and instrumental diagnosis of non-compression lumbar pain syndromes to optimize the use of puncture surgical techniques.Material and Methods. The study included 923 patients who underwent provocative diagnostic techniques on the intervertebral disk (IVD) and the arched joints (AJ) between 2012 and 2017. Taking into account clinical and instrumental data, the following are made: in group I (n=246) – laser IVD nucleoplasty, in group II (n = 287) – laser denervation of FJ, in group III (n = 390) – simultaneous use of laser exposure to IVD and AJ. We analyzed the dynamics of the level of pain in the lumbar spine and lower extremities according to The Visual Analogue Scale and quality of life according to The Short Form-36 (SF-36) questionnaire.Results. When performing provocative diagnostic tests, the minimum number of adverse effects was recorded: 3.2% in group I, 2.4% in group II, and 2.1% in group III. After puncture methods of surgical treatment, a significant persistent decrease in the severity of preoperative pain was observed both in the lumbar spine (p = 0.002, p = 0.005 and p = 0.004, respectively) and in the lower extremities (p = 0.003, p = 0.001 and p = 0.005, respectively) A significant improvement in the physical and psychological components of health was also established in group I (p = 0.02 and p = 0.01, respectively), in group II (p = 0.01 and p = 0.03, respectively) and group III (p = 0.03 and p = 0.02, respectively).Conclusion. In the presence of neuroimaging parameters of IVD according to C. Pfirrmann III–IV and protrusion size 4–6 mm, minimal degenerative changes in the AJ according to A. Fujiwara I–II and D. Weishaupt I–II, as well as a positive disruption test, it is possible to perform laser nucleoplasty. In case of detection of neuroimaging data of IVD according to C. Pfirrmann I–II and protrusion size less than 4 mm, moderately pronounced degenerative changes in the AJ according to A. Fujiwara II–III and D. Weishaupt II–III, as well as positive paraarticular stimulation of AJ, laser denervation of AJ is recommended. When determining, according to neuroimaging data, moderate degenerative changes in IVD according to C. Pfirrmann over III and protrusion size 4–6 mm, as well as degeneration of AJ according to A. Fujiwara more than II and D. Weishaupt more than II, positive of samples and paraarticular stimulation of AJ, it is advisable to perform simultaneous surgical intervention in the volume of laser IVD nucleoplasty and laser denervation of AJ.

scholarly journals European guidelines for the diagnosis and treatment of pelvic girdle pain

2008 ◽  
Vol 17 (6) ◽  
pp. 794-819 ◽  
Author(s):  
Andry Vleeming ◽  
Hanne B. Albert ◽  
Hans Christian Östgaard ◽  
Bengt Sturesson ◽  
Britt Stuge
Keyword(s):  
Pelvic Girdle ◽  
Diagnosis And Treatment ◽  
Pelvic Girdle Pain ◽  
European Guidelines

Pelvic Girdle Pain and Lumbar Pain in Relation to Postpartum Depressive Symptoms

Spine ◽  
2007 ◽  
Vol 32 (13) ◽  
pp. 1430-1436 ◽  
Author(s):  
Annelie Gutke ◽  
Ann Josefsson ◽  
Birgitta Öberg
Keyword(s):  
Depressive Symptoms ◽  
Pelvic Girdle ◽  
Pelvic Girdle Pain ◽  
Lumbar Pain ◽  
Postpartum Depressive Symptoms

Pelvic Girdle Pain and Lumbar Pain in Pregnancy: A Cohort Study of the Consequences in Terms of Health and Functioning

Spine ◽  
2006 ◽  
Vol 31 (5) ◽  
pp. E149-E155 ◽  
Author(s):  
Annelie Gutke ◽  
Hans Christian Östgaard ◽  
Birgitta Öberg
Keyword(s):  
Cohort Study ◽  
Pelvic Girdle ◽  
Pelvic Girdle Pain ◽  
Lumbar Pain ◽  
In Pregnancy

Making the Unaware Aware: Surface Electromyography to Unmask Tension and Teach Awareness

Biofeedback ◽  
2014 ◽  
Vol 42 (1) ◽  
pp. 16-23 ◽  
Author(s):  
Erik Peper ◽  
Annette Booiman ◽  
I-Mei Lin ◽  
Fred Shaffer
Keyword(s):  
Muscle Contraction ◽  
Surface Electromyography ◽  
Clinical Symptoms ◽  
Muscle Tension ◽  
Pelvic Girdle ◽  
Pelvic Girdle Pain ◽  
Somatic Awareness ◽  
Low Level ◽  
And Control

Poor awareness of covert low-level muscle tension and poor ergonomics can result in chronic muscle bracing and the development of clinical symptoms. This article introduces a simple exercise to teach awareness and control of residual muscle contraction, presents evidence of its effectiveness, and concludes with a case study in which this exercise contributed to the treatment of severe pelvic girdle pain. The authors warn against becoming “captured” by tasks and adjusting to bad ergonomics, and emphasize the importance of enhancing somatic awareness to correct dysponesis before it results in pain and disability.

scholarly journals Conceptual model of patho- and sanogenesis of the sacroiliac joint osteoarthritis

2021 ◽  
pp. 28-38
Author(s):  
Mykola Korzh ◽  
Volodymyr Staude
Keyword(s):  
Conceptual Model ◽  
Sacroiliac Joint ◽  
Response Pattern ◽  
Clinical Manifestations ◽  
Pelvic Girdle ◽  
Horizontal Axis ◽  
Pelvic Girdle Pain ◽  
Lumbar Pain ◽  
Functional Changes ◽  
Clinical Verification

Objective. To develop a conceptual model of patho- and sanogene­sis of the sacroiliac joint (SIJ) osteoarthritis on base of the known data about the SIJ, the results of our own biomechanical studies of this joint, its ligaments and stabilizing muscles by finite element modelling, data of clinical verification of these results. Methods. The object of the model is the SIJ as a link, which connects the spine and pelvis. The proposed conceptual model is based on the M. Panjabi hypothesis of chronic lumbar pain in the case of partial dama­ge to ligaments, which leads to muscle dysfunction. Results. A new conceptual model of SIJ osteoarthritis was developed. In this model we tried to take into account the limitations of the existing SIJ stability hypotheses and models of the appearance of the pelvic girdle pain, SIJ dysfunction and SIJ arthrosis. The model is based on the results of our own research. It was proved, that patients with SIJ osteoarthritis have an asymmetry of the width of the joint slits, the inclination of the sacrum and pelvis, sacral rotation, hyperlordosis in the LV–SI segment. These factors lead to a shift of the horizontal axis of sacral rotational mobility relative to the pelvic bones. This horizontal axis shift leads to the instabili­ty of the SIJ on one side of the joint, and to the functional block on another side. The results of these functional changes were damage of the SIJ ligaments-stabilizers, dysfunction of the SIJ muscles-stabilizers, degenerative changes of SIJ elements and pain. The deve­loped model allows to explain the distortion of muscular response pattern in patients with improper SIJ biomechanics in conditions of SIJ osteoarthritis. The increase of the SIJ biomechanics changes enlarges the the muscle response pattern distortion. Conclusions. The developed conceptual model explains many clinical manifestations of the SIJ osteoarthritis and will help to understand better the mechanics of the pelvic girdle pain in such conditions, will improve the results of diagnosis and treatment.

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