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Impact of postpartum lumbopelvic pain on disability, pain intensity, health-related quality of life, activity level, kinesiophobia, and depressive symptoms

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Abstract

The majority of women recover from pregnancy-related lumbopelvic pain within 3 months of delivery. Since biomechanical and hormonal changes from pregnancy are largely reversed by 3 months postpartum, consequently, it is assumed that other factors might interfere with recovery. Relative to the fear-avoidance model and with reference to previous studies, we chose to investigate some pre-decided factors to understand persistent lumbopelvic pain. The evaluation of lumbopelvic pain postpartum is mostly based on self-administered questionnaires or interviews. Clinical classification of the lumbopelvic pain may increase our knowledge about postpartum subgroups. Two hundred and seventy-two consecutively registered pregnant women evaluated at 3 months postpartum, answered questionnaires concerning disability (Oswestry disability index), pain intensity on visual analog scale, health-related quality of life (HRQL, EQ5D), activity level, depressive symptoms (Edinburgh postnatal Depression Scale) and kinesiophobia (Tampa Scale for Kinesiophobia). Women were classified into lumbopelvic pain subgroups according to mechanical assessment of the lumbar spine, pelvic pain provocation tests, standard history, and pain drawings. Multiple linear regression analysis was performed to explain the variance of disability. Thirty-three percent of postpartum women were classified with lumbopelvic pain; 40% reported moderate to severe disability. The impacts were similar among subgroups. Pain intensity, HRQL and kinesiophobia explained 53% of postpartum disability due to lumbopelvic pain. In conclusion, one of three postpartum women still had some lumbopelvic pain and the impacts were equivalent irrespective of symptoms in lumbar or pelvic areas. The additional explanations of variance in disability by HRQL and kinesiophobia were minor, suggesting that pain intensity was the major contributing factor.

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Acknowledgments

This study was supported by grants from The Swedish Research Council, The Vardal Foundation, and Foundation of the Region Västra Götaland, Trygg Hansa Research Foundation. The authors thank Henrik Magnusson for assisting in statistical analyses.

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Authors and Affiliations

  1. Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, 581 83, Linköping, Sweden

    Annelie Gutke & Birgitta Öberg

  2. Division of Occupational Orthopedics, Department of Orthopedics, Sahlgrenska University Hospital, Göteborg University, Göteborg, Sweden

    Mari Lundberg

  3. Department of Orthopedic Surgery, Sahlgrenska University Hospital, Mölndal, Sweden

    Hans Christian Östgaard

Authors
  1. Annelie Gutke
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  2. Mari Lundberg
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  3. Hans Christian Östgaard
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  4. Birgitta Öberg
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Correspondence to Annelie Gutke.

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Gutke, A., Lundberg, M., Östgaard, H.C. et al. Impact of postpartum lumbopelvic pain on disability, pain intensity, health-related quality of life, activity level, kinesiophobia, and depressive symptoms. Eur Spine J 20, 440–448 (2011). https://doi.org/10.1007/s00586-010-1487-6

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  • DOI: https://doi.org/10.1007/s00586-010-1487-6

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