Improved function in women with persistent pregnancy-related pelvic pain after a single corticosteroid injection to the ischiadic spine: a randomized double-blind controlled trial

Physiother Theory Pract. 2013 Jul;29(5):371-8. doi: 10.3109/09593985.2012.734009.

Abstract

Background: Pregnancy-related low back and pelvic pain is a worldwide problem. A large proportion of women still experience disabling daily back pain 2 years after childbirth, resulting in major changes in activities and general well-being. In spite of this, the source of pain and effective treatment are uncertain.

Objective: To evaluate the short-term effects on function of a single corticosteroid injection treatment to the ischiadic spine in women with persistent pregnancy-related pelvic pain (PPPP).

Methods: Thirty-six women were allocated to injection treatment with slow-release triamcinolone and lidocain or saline and lidocain, given once at the sacrospinous ligament insertion on the ischiadic spine bilaterally with follow-up at 4 weeks. Outcome measures were Disability Rating Index (DRI), self-rated functional health (SF-36), gait speed and endurance (6MWT), and strength and endurance of trunk muscles (isometric trunk extensor and flexor tests).

Results: Women in the triamcinolone group showed significantly improved DRI (p = 0.046), 6MWT (p = 0.016), and isometric trunk extensor tests (p = 0.004), as compared with the saline group. Close co-variation was shown between improved function and reduced pain intensity.

Conclusions: Improved function was achieved among women with PPPP after a single injection treatment with slow-release corticosteroid. The effect was positively correlated to the reduced pain intensity.

Trial registration: ClinicalTrials.gov NCT00757016.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage*
  • Adult
  • Anesthetics, Local / administration & dosage
  • Delayed-Action Preparations
  • Disability Evaluation
  • Double-Blind Method
  • Female
  • Gait / drug effects
  • Humans
  • Injections, Spinal
  • Lidocaine / administration & dosage
  • Muscle Strength / drug effects
  • Pain Measurement
  • Pelvic Pain / diagnosis
  • Pelvic Pain / drug therapy*
  • Pelvic Pain / physiopathology
  • Physical Endurance / drug effects
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Complications / diagnosis
  • Pregnancy Complications / drug therapy*
  • Pregnancy Complications / physiopathology
  • Recovery of Function
  • Self Report
  • Severity of Illness Index
  • Sweden
  • Time Factors
  • Treatment Outcome
  • Triamcinolone / administration & dosage*

Substances

  • Adrenal Cortex Hormones
  • Anesthetics, Local
  • Delayed-Action Preparations
  • Triamcinolone
  • Lidocaine

Associated data

  • ClinicalTrials.gov/NCT00757016