Pain is part of this life whether we like it or not lucky people have less of it, others a lot
Sanjeeta's Story
Sanjeeta is a 28 year old woman who has been referred to a physiotherapist by a Midwife because she was suffering from severe pregnancy related lumbo pelvic pain/ symphysis pubis dysfunction. Sanjeeta was diagnosed with Joint Hypermobility syndrome by a physiotherapist several years ago and has had back pain on and off for as long as she can remember. She works for a marketing company and in the last six weeks has found her symptoms are severely interfering with her ability to engage with work, drive a car and do the shopping. She lives with her partner who is supportive, but he travels a lot with his job is not always at home.
Her main concern is the effect the pain will have on her unborn child. She also reports that until she met her current midwife her symptoms were dismissed and she was told she would need to put up with the pain until after delivery. She has had more time off work than at any time before in her working career and she is concerned that she might lose her job.
Ann was surprised that health professionals did not appear to know or understand the pain she was experiencing, she had not been given a diagnosis and the professionals she met did not offer any suggestions on how this could be treated.
She suffers from sharp pain that radiates from her pelvis down her leg and/or towards her pubis symphysis when she tries to walk up stairs, getting in and out of a car and turning over in bed.
Read the following paper and consider the following questions
file:///C:/Users/Carol/Downloads/Pregnancy%20related%20lumbopelvic%20pain%20Clark%20et%20al%202013.pdf
Her main concern is the effect the pain will have on her unborn child. She also reports that until she met her current midwife her symptoms were dismissed and she was told she would need to put up with the pain until after delivery. She has had more time off work than at any time before in her working career and she is concerned that she might lose her job.
Ann was surprised that health professionals did not appear to know or understand the pain she was experiencing, she had not been given a diagnosis and the professionals she met did not offer any suggestions on how this could be treated.
She suffers from sharp pain that radiates from her pelvis down her leg and/or towards her pubis symphysis when she tries to walk up stairs, getting in and out of a car and turning over in bed.
Read the following paper and consider the following questions
file:///C:/Users/Carol/Downloads/Pregnancy%20related%20lumbopelvic%20pain%20Clark%20et%20al%202013.pdf
- What is pregnancy related lumbo pelvic pain?
- What other names have been used to describe this type of pain in pregnancy?
- What could be causing the pain reported by Sanjeeta?
- What advice would you give Sanjeeta or any health professionals involved in meeting Sanjeeta during:-
a) Pregnancy?
b) Delivery?
c) Post Partum?
- What are the risk factors for pregnancy related pain continuing after delivery?
Pregnancy Related Lumbo-Pelvic Pain
Pregnancy related lumbo-pelvic pain is common affecting up to 1 in 6 women of childbearing age (NHS Choices 2014a).
Pre-existing chronic pelvic pain may increase in severity during pregnancy. The reasons for this may be mechanical as a result of changes in pregnancy which lead to postural changes in posture as shown in the video clip below (Keriakos et al 2011).
However, pain is multifactorial and perceptions of long term continuing pain may be influenced by anxiety, emotions, mood, pain beliefs and coping mechanisms (Pincus et al 2002). For those with pregnancy related lumbo-pelvic pain a fear of injury or fear of the effects on the unborn child may also contribute to pain perception.
View the clip below and and consider the postural changes that occur in the lumbar, thoracic and cervical spine and how these changes may affect the underlying tissues and contribute to feelings of 'discomfort'.
Pre-existing chronic pelvic pain may increase in severity during pregnancy. The reasons for this may be mechanical as a result of changes in pregnancy which lead to postural changes in posture as shown in the video clip below (Keriakos et al 2011).
However, pain is multifactorial and perceptions of long term continuing pain may be influenced by anxiety, emotions, mood, pain beliefs and coping mechanisms (Pincus et al 2002). For those with pregnancy related lumbo-pelvic pain a fear of injury or fear of the effects on the unborn child may also contribute to pain perception.
View the clip below and and consider the postural changes that occur in the lumbar, thoracic and cervical spine and how these changes may affect the underlying tissues and contribute to feelings of 'discomfort'.
