Pregnancy back pain

Women often experience pelvic and back pain during pregnancy. Systematic review suggests that water aerobics, pillows that support the abdomen, physiotherapy, and acupuncture... 

Otitis media is inflammation or infection of the middle ear and is not usually associated with back pain. Osteoporosis is a condition occurring mostly in postmenopausal women and is characterised by brittle bones caused by reduced bone mass. It is presented with pain. If it occurs in the vertebral structure the condition may be associated with chronic back pain. Pregnancy may be associated with back pain because of an increase in weight and the increased strain. 

Predisposing factors for low back pain include osteoporosis, trauma and pregnancy. 

Back pain may be associated with osteoporosis and pregnancy. Osteomalacia refers to insufficient mineralisation of the bones, resulting in soft bones. 

Hypersensitivity to sulfonamides or zonisamide skin rash pregnancy (FDA category C) sudden back pain abdominal pain or blood in the urine." Not approved for pediatric use. 

While lifetime prevalence of lower back pain (LBP) in the general population is 60%-90% in developed countries, LBP is one of the commonest musculo eletal problems during pregnancy. Prospective studies with moderately large samples showed that 50%-70% of pregnant women have experienced some form of LBP and that in some of these patients pain becomes chronic or recurrent. Of those who are affected by LBP, symptoms can range from mild (45%) to severe pain (2S%-33%), and some become severely disabled (8%) because of the pain . The pain often interferes with work daily activities and sleep . The National Institute for Occupational Safety and Health (NIOSH) has conservatively estimated the annual cost due to LBP in the general population to be 13 billion. ... 

G Berg, M Hammar, J Moller-Nielsen, U Linden and J Thorblad, Low back pain during pregnancy Obstet Gynecol, 1988 71 71-75. 

I M Mogren and A I Pohjanen, Low back pain and pelvic pain during pregnancy prevalence and risk factors Spine, 2005 30 983-991. 

S M Wang, P E)ezinno, I Maianets, M R Beiman, A A Caldwell-Andrews and Z N Kain, Low back pain during pregnancy prevalence, risk factors, and outcomes Obstetrics and Gynecology, 2004104 65-70. 

HIM Mogren, Perceived health, sick leave, psychosocial rituation, and sexual life in women with low back-pain and pelvic pain during pregnancy , Acta Obstetricia et Gynecologica Scandinavica, 2006 85 647-656. 

P Kristiansson, K Svardsudd and B von Schouhz, Back pain during pregnancy a prospective study , S ne, 1996 21 702-709. 

A Fast and G Hertz, Nocturnal low back pain in pregnancy polysomnographic iX>TK ditea ,Americal Journal of Reproductive Immunology, 1992 28251-253. 

J Perkins, R L Hammer and P V Loubert, Identification and management of pregnancy-related low back pain , J Nurse Midwifery, 1998 43 331-340. 

G Young and D Jewell, Interventions for preventing and treating pelvic and back pain in pregnancy , Cochrane Database SystRev, 2002 CDOOl 139. 

A J Lisi, Chiropractic spinal manipulation for low back pain of pregnancy A retrospective case series , J Midwifery Womens Health, 2006 51 e7-10. 

S M Wang, P Dezinno, L Fermo, K William, A A Caldwell-Andrews, F Bravemm and Z N Kain, Complementary and alternative medicine for low-back pain in pregnancy a cross-sectional survey , JAltem Complement Med, 200511459-464. 

Drug withdrawal A withdrawal syndrome has been described in a neonate born to a mother who was taking tramadol 400 mg/ day for chronic low back pain [179 ]. During the last weeks of pregnancy, the dose was reduced to 200 mg/day. At 35 hours of age, the neonate had signs of severe withdrawal. The symptoms occurred earlier... 

Fetotoxidty The use of cyclo-oxygenase inhibitors in pregnancy is associated with a risk of premature closure of the ductus arteriosus, as occurred after maternal self-medication with nimesulide for low back pain at 39 weeks of gestation [82 ]. 

The iliopsoas muscle is often considered the "mainstay" in the column support system. It therefore has the potential for a significant role in the back pain of pregnancy and in back pain... 

A clinical study showed that cyclobenzaprine use during late pregnancy should be considered a potential cause of early ductal closure. A proposed mechanism for cyclobenzaprine includes inhibition of norepinephrine and serotonin reuptake, factors known to inhibit prostaglandin and nitric oxide. These two factors are the leading causes of in utero ductal closure. A full-term male infant presented shortly after birth with respiratory distress. An echocardiogram done within the first hour of life showed an elevated pulmonary artery pressure and an associated right ventricular hypertrophy without a patent ductus arteriosus. Maternal history was unremarkable except for chronic low back pain treated with cyclobenzaprine [31]. 

There are a number of reasons to be concerned about the potential safety of such widespread use of CAHP. These products are frequently used by vulnerable populations, including older adults, those with chronic disorders, children, and women during pregnancy and lactation (5 10). These products are also used by patients to treat a variety of chronic disorders that are difficult to medically manage (e.g., anxiety, depression, dementia and memory impairment, headache, weight loss, back disorders, chronic pain, prostatic hypertrophy, and cancer) (1,11,12). Choice of a particular product for a particular condition is usually based on the claims made for the product and anecdotes of historical use, rather than conclusive scientific evidence that establishes the safety and efficacy of a particular product for a particular condition. 

Indications Chronic bi patterns, liver/kidney dual deficiency, qi and blood insufficiency. Chronic rheumatoid arthritis, osteoarthritis, rheumatic sciatica, lumbar strain, lumbar intervertebral disc herniation, pain in the midline and back during pregnancy, hemiplegia due to stroke, and the sequelae of poliomyelitis... 

H C Ostgaaid, G B Andersson and M Wennergcen, The impact of low back and pelvic pain in pregnancy on the pregnancy outcome , Acta Obstet Gynecol Scand, 1991 7021-24. 

H C Ostgaard, E Roos-Hansson and G Zetherstrom, Regression of back and posterior pelvic pain after pregnancy , Spine, 1996 212777-2780. 

L Noren, S Os aard, G Johansson and H C Os aard, Lumbar back and posterior pelvic pain during pregnancy a 3-year foUow-iqi , European Spine Journal, 2002 11 267-271. 

B Sti e, O Hilde and N Vollestad, Physical therapy for pregnancy-related low back and pelvic pain a systematic review , Acta Obstet Gynecol Scand, 2003 82 983-990. 

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