VIDEO 11. Lowback Pain in Postnatal Period

Chronic postpartum low back pain is defined as low back pain that starts within 3 months after delivery and lasts for at least 6 weeks. It most commonly involves the lumbar spine and sacroiliac joints.

Postpartum low back pain is influenced by various factors, such as a history of low back pain during pregnancy, younger age, and excessive body weight. Conversely, new-onset back pain post-childbirth is associated with increased weight and diminished stature relative to weight. Additionally, postpartum low back or pelvic pain may arise from pregnancy-induced muscle weakness and breastfeeding-related spinal osteoporosis. Within this demographic, common differential diagnoses encompass spinal or hip arthritis, sciatica, osteitis pubis, lumbar disc pathology, and spondylolisthesis. Less common considerations include urinary tract infection, lumbar stenosis, femoral venous thrombosis, osteomyelitis, cauda equina syndrome, or ruptured symphysis pubis.

Story taking and observational assessment (will be given in e-manual)

1)From the moment the patient first walks in the door, facial expression, gait and posture are examined for problems such as shoulder asymmetry or pelvic asymmetry.

2)Demographic information such as the patient’s age, height, weight and mode of birth are questioned.

3)When the patient first complained of pain is questioned.

4)The patient’s factors that increase or decrease the pain are questioned.

5)The area where the patient’s pain spreads and the type of pain are questioned.

6)The patient’s weight gain during pregnancy and whether she had pain during pregnancy are questioned.

7)The patient’s breastfeeding and child-carrying position is questioned; if it is not appropriate, awareness is raised and the correct position should be taught.

Evaluation of the individual with low back pain in the postnatal period (will be given in e manual)

1. The paravertebral muscles, ligaments and spinous processes are evaluated by palpation in the lumbar region. During palpation, muscle tone, spasm and the presence of trigger points are examined.
2. The range of motion of the lumbar region is evaluated, and attention is paid to whether the movements are painful and restricted during the evaluation.
3. Muscle strength of the lumbar region is evaluated.

Back extensors

Trunk Flexors

Trunk rotation

• Muscle Shortness assessment
• Tests for Sacroiliac Joint Examination