Low Back Pain and Pelvic Girdle Pain in Pregnancy

J Am Acad Orthop Surg. 2015 Sep;23(9):539-49. doi: 10.5435/JAAOS-D-14-00248. Epub 2015 Aug 13.

Abstract

Pregnancy has a profound effect on the human body, particularly the musculoskeletal system. Hormonal changes cause ligamentous joint laxity, weight gain, and a shift in the center of gravity that leads to lumbar spine hyperlordosis and anterior tilting of the pelvis. In addition, vascular changes may lead to compromised metabolic supply in the low back. The most common musculoskeletal complaints in pregnancy are low back pain and/or pelvic girdle pain. They can be diagnosed and differentiated from each other by history taking, clinical examination, provocative test maneuvers, and imaging. Management ranges from conservative and pharmacologic measures to surgical treatment. Depending on the situation, and given the unique challenges pregnancy places on the human body and the special consideration that must be given to the fetus, an orthopaedic surgeon and the obstetrician may have to develop a plan of care together regarding labor and delivery or when surgical interventions are indicated.

Keywords: low back pain; lumbopelvic pain; pelvic girdle pain; pregnancy.

Publication types

  • Review

MeSH terms

  • Delivery, Obstetric / methods
  • Female
  • Humans
  • Low Back Pain / therapy*
  • Obstetric Labor Complications / etiology
  • Obstetric Labor Complications / surgery
  • Patient Care Team
  • Pelvic Girdle Pain / etiology
  • Pelvic Girdle Pain / therapy*
  • Pregnancy
  • Pregnancy Complications / therapy*