Back Pain in Pregnant Women: Its Origins, Peculiarities of Pathogenesis and Biomechanics

Abstract

The problem of the back pain in pregnant women is one of the most important in modern medicine. 65–90 % of pregnant women complain of the back pain. The women may have the back pain from the early stages of pregnancy, or it may occur with the growth of the fetus.The causes of the pain during pregnancy are late reproductive age, high body mass index, physical strain, pain during previous pregnancies. Vertebrogenic and pelvic pain in pregnant women can first appear at the beginning of the gestational period. According to various authors, the frequency of such pain is 30–35 %. As a rule, painful neurologic manifestations begin in the third trimester, on average at the 18 th –22 nd week of pregnancy. About a half of women with early manifestation of lumbosacral pain during the pregnancy keep suffering from pain for a year after giving birth. In 20 % of cases, symptomatic pain is felt for 3 years after the delivery. The primary factors causing the pain syndrome is the shift in the centre of gravity due to enlargement of the pregnant uterus of the postural balance. The localization of the pain depending on the peculiarities of the posture can be different. In most of cases the lower back, thoracolumbar passage, sacrum, with the occasional radiation to buttock or pelvic joint, are affected. One of the most common pain syndromes in gynecology is the myofascial syndrome characterized by hyper tonus of the muscles and fasciae and ligaments of the pelvic minor.