Abstract
BackgroundMany women develop pelvic girdle pain (PGP) during pregnancy and about 10% have chronic pain several years after delivery. Self-administered pain provocation tests are one way to diagnose and evaluate this pain. Their validity in post-partum women is not yet studied.The purpose of this study was to evaluate the validity of self-administered test for assessment of chronic pregnancy-related PGP several years after delivery.MethodsWomen who previously have had PGP during pregnancy and who participated in one of three RCT studies were invited to a postal follow up of symptoms including performance of self-administered tests after two, 6 or 11 years later, respectively. In total, 289 women returned the questionnaire and the test-results. Of these, a sub-group of 44 women with current PGP underwent an in-person clinical examination. Comparisons were made between test results in women with versus without PGP but also, in the sub-group, between the self-administered tests and those performed during the clinical examination.ResultsFifty-one women reported PGP affecting daily life during the last 4 weeks, and 181 reported pain when performing at least one of the tests at home. Those with chronic PGP reported more positive tests (p < 0.001). There was no significant difference between diagnosis from the self-administered tests compared to tests performed during the in-person clinical examination (p = 0.305), either for anterior or posterior PGP. There were no significant differences of the results between the tests performed self-administered vs. during the clinical examination.ConclusionA battery of self-administered tests combined with for example additional specific questions or a pain-drawing can be used as a screening tool to diagnose chronic PGP years after delivery. However, the modified SLR test has limitations which makes its use questionable.
Highlights
Many women develop pelvic girdle pain (PGP) during pregnancy and about 10% have chronic pain several years after delivery
More than half of all pregnant women develop pelvic girdle pain (PGP) and/or lumbar pain during or after pregnancy, prevalence reported varies greatly depending on diagnostic criteria [1,2,3]
The prevalence for chronic PGP after delivery varies, with ranges from 8.5 to 37% and it may persist for decades [5, 6]
Summary
Many women develop pelvic girdle pain (PGP) during pregnancy and about 10% have chronic pain several years after delivery. Self-administered pain provocation tests are one way to diagnose and evaluate this pain Their validity in post-partum women is not yet studied. The high level of the hormone relaxin makes the pelvic joints more flexible in preparation for delivery This flexibility increases the demands on muscles and ligaments and increases the risk of pain in the area when muscles do not sufficiently compensate for the increased flexibility [3]. Chronic PGP has major consequences such as reduced ability to perform daily activities and work as well as decreased health-related quality of life [6, 7] They have more problems with sleep and higher levels of anxiety, depression, and pain-catastrophizing thoughts [6]
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