• Title/Summary/Keyword: Postpartum low back pain

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A Review of Pregnancy Related Low Back Pain (임신 중 요통에 관한 고찰)

  • Cho Mi-sook;Park Rae-joon
    • The Journal of Korean Physical Therapy
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    • v.15 no.4
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    • pp.431-441
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    • 2003
  • Pregnancy and puerperium are associated with significant changes in pschological and physiologic health status. Back and pelvic pain is common in pregnancy with prevalence figures in the range of $48\%-90\%$. The pain starts during pregnancy and often disappears soon after childbirth. But the prevalence of such pain four to six months post postpartum is report to be $25-40\%$. In $10-15\%$ of the case the pain become chronics, that is persisting for more than three months after childbirth. Low back pain and pelvic pain maybe caused by several factors related to changes that occur naturally during pregnancy. Changes in the center of gravity can create a strain on weight-bearing structures in bone. Pregnancy related hormones, relaxin, create general laxity of collagenous tissue. Another factor found to be a possible primary or contributing cause for law back and hip symptoms are leg length inequality, weight gain and changes in foot function. This article outlines the physiological and biomechanical changes that occur during pregnancy which have been reported to be possible causes of low back and pelvic pain And then, examination, diagnosis, evaluation and treatment of the woman during pregnancy are described. Standard treatment for low back pain and pelvic pain in pregnancy includes education in anatomy and kinesiology, back-strengthening exercise, training of the abdominal muscles and body posture correction. So, most woman during pregnancy require individual consultation and physiotherapist.

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Effects of the Gluteus Muscle Exercise combined with the Lumbar Stabilization Exercise on Pain, ODI, and Postpartum Depression in Women with Chronic Back Pain After C-section Delivery (허리 안정화 운동과 병행한 엉덩근육 강화 운동이 제왕절개 분만 후 만성허리통증을 가진 여성의 통증, 기능장애지수, 산후우울증에 미치는 영향)

  • Min-Ji Son;Myoung-Ho Lee;Myoung-Kwon Kim
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.29 no.3
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    • pp.31-42
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    • 2023
  • Background: This study aimed to investigate the effects of combining the lumbar stabilization exercise with the gluteal muscle strength exercise on pain, the dysfunction index, and postnatal depression in women experiencing chronic low back pain after a cesarean section. Methods: The study used a randomized design with two groups: one group (n=15) performed the lumbar stabilization exercise along with the gluteal muscle strength exercise, while the other group (n=15) only did the lumbar stabilization exercise. The intervention consisted of 30 minute exercise sessions, twice a week, for 6 weeks. The pain was assessed using the visual analog scale (VAS), the dysfunction index with the Oswestry disability index (ODI), and postnatal depression using the edinburgh postnatal depression scale-Korean version (EPDS-K). Results: Both groups showed significant improvements in their VAS, ODI, and EPDS-K scores within their respective groups (p<.05). Additionally, the between-group analysis revealed significant differences in post-test results (p<.05). Conclusion: The combination of the lumbar stabilization exercise and the gluteal muscle strength exercise proved to be more effective in reducing pain, improving the dysfunction index, and alleviating postnatal depression in women with chronic low back pain after a cesarean section. Therefore, incorporating these exercises could be beneficial as an intervention program for women experiencing chronic low back pain after a cesarean section.

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A Research Analysis of Current Trends in Manual Therapy for Low Back and Pelvic Girdle Pain as Regards Pregnancy (임신과 관련하여 발생한 요통 및 골반통에서 수기요법에 관한 국내외 연구동향)

  • Park, Na-Ri;Lee, Yun-Jin;Chu, Hui-Yeong;An, Hee-Duk;Yang, Doo-Hwa
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.15 no.1
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    • pp.101-114
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    • 2020
  • Objectives : This study aimed to determine the current trends in manual therapy for low back and pelvic girdle pain as regards pregnancy. Methods : Using 7 online databases, we searched for appropriate clinical studies. Results : Eighteen studies were selected from online databases. The included studies consisted of 8 randomized controlled trials, 6 uncontrolled trials, 4 case reports, and 1 non-randomized controlled trial. Four studies were performed in pregnant patients, while others were in postpartum patients. The majority of studies used relaxing or rubbing of soft tissue and some of the studies were manipulated. The visual analog scale (VAS) was the most frequently used outcome, with the effective rate second. Conclusions : This study demonstrates that manual therapy may be a promising therapeutic option low back and pelvic girdle pain for patients as regards pregnancy or postpartum.

Effects of a Postpartum Back Pain Relief Program for Korean Women

  • Oh, Hyun-Ei;Lee, Young-Sook;Shim, Mi-Jung;Kim, Jin-Sun
    • Journal of Korean Academy of Nursing
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    • v.37 no.2
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    • pp.163-170
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    • 2007
  • Purpose. Despite the high prevalence of back pain and its subsequent effects in post-partum women, intervention programs are scarce. The purpose of this study was to test the effects of a back-pain-reducing program on post-partum women who experienced low-back pain during pregnancy. Methods. A non-equivalent control-group pretest-posttest design was used. Pregnant women who attended a hospital for prenatal check-ups and experienced back pain participated in an intervention program (n=27), and the results were compared with women in a control group from another hospital (n=25). Results. At 8 weeks post-partum, the pain intensity, functional limitations were lower in the intervention group than in the control group. However, differences in mean change of the pain intensity and functional limitations between 36 and 39 weeks of gestation and at 8 weeks post-partum were not statistically significant between the groups. Moreover, the flexibility, post-partum functional status, and post-partum depression did not differ significantly between the groups. Conclusions. A back-pain-relief program in this study was not effective to reduce the back-pain intensity in post-partum women and to decrease the associated functional limitations. The implications for nursing practice and directions for future research are discussed.

Combination Therapy of Conventional and Korean Medicine for Multiple Vertebral Compression Fractures Associated with Postpartum Osteoporosis: A Case Report

  • Lee, Ki-Beom;Yang, Kyu-Jin;Gi, Yu-Mi;Kim, Tae-Gyu;Jo, Hooin;Choi, Jongho
    • Journal of Acupuncture Research
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    • v.35 no.4
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    • pp.244-247
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    • 2018
  • Multiple vertebral compression fractures are a rare condition and are a serious consequence of postpartum osteoporosis. This report describes the case of a 35-year-old woman who had given birth to her first child 2 months before the onset of pain. Magnetic resonance imaging showed compression fractures of 7 vertebrae. The patient was treated with both conventional, and Korean medicine methods including acupuncture and herbal prescriptions. The patient's progress was assessed using self-reported symptoms, scale scores and laboratory test results. Her pain was gradually alleviated and biochemical inflammation marker levels improved, but her functional status remained severely impaired. Clinical practitioners who treat women in the postpartum period must be aware of osteoporosis and potential vertebral fractures and need to consider Korean medicine as an alternative therapy to help such patients.

A study on the survey for the Application Status and the Improvement of Oriental Medical Health Insurance for the Ob & Gy Disease (부인과 질환에 대한 한방건강보험 적용실태 및 개선방안에 대한 조사연구 1)

  • Choi, Min-Sun;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.20 no.1
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    • pp.239-257
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    • 2007
  • Purpose : In the part of Ob & Gy disease, the health insurance application is very limited. This study has been performed for gaining the basic data of enlargement of insurance coverage and reform of the insurance system corresponded with real clinical conditions. Methods : The survey has been practiced twice, the subjective questionnaire was used at the first survey. Then the questionnaire written using the results of first survey was distributed to the Korean medical doctors(KMD) who participated in the autumn symposium of the society of Oriental Obstetrics & Gynecology. Results : 1. The main Ob & Gy disease that the acupuncture treatment has been used actually or thought be positively necessary on the clinic were Dysmenorrhea(including premenstrual syndrome), Climacteric syndrome, Menstrual disorder, Postpartum Pain syndrome. Amenorrhea, Low back pain with pregnancy, JingHa(pelvic tumor), Infertility etc. 2. The main additional complex the sick and wounded names given to visiting patients for Ob & Gy disease as the limits of acupuncture items of insurance coverage were Low back Pain(J10), Qi-stasis(B13.0), SimHwaHangYeom(C2l.1). 3. Suitable the sick and wounded name of Ob & Gy disease thought be added in BokGangNae(Intra-abdominal acupuncture: CV13 ${\cdot}$CV16${\cdot}$CV10). TuJa(Puncture each adjoining acu-points in one insertion : SP6-GB39), TuJa(PC6-TE5) among acupuncture items of insurance coverage were Dysmenorrhea(K05). Menstrual disorder(K02) and Dysmenorrhea(K05), Hyperemesis(K16.0). 4. Climacteric syndrome(K04) and Dysmenorrhea(K05) should be added as suitable the sick and wounded name of TuJa(SP6-GB39), and Postpartum pain syndrome(K29) as KwanJeolGangNea(Intra-articular acupuncture: S35, LE201). Conclusion : Standing on this study, additional survey to general KMD should be continued. And the academic verifications through the oriental medical literatures and RCT papers on acupuncture should be also required.

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A Case Report of Lumbar Spine Failed Back Surgery Syndrome (FBSS) Patient Treated with Korean Medicine: Long-Term Progress Including Postpartum Aggravation (보존적 한방치료를 시행한 척추 수술 실패 증후군 환자 증례보고 : 출산 후 악화를 포함한 장기 경과 관찰)

  • Roh, Ji-ae;Lee, Ji-won;Byun, Da-young;Hong, Jung-soo;Kim, Dong-jin
    • The Journal of Internal Korean Medicine
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    • v.40 no.1
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    • pp.126-135
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    • 2019
  • Background: Because of fear of reoperation and low efficiency, some patients with failed back surgery syndrome (FBSS) opt for Korean medicine treatment. Gold standard treatment is not present for FBSS, therefore both surgical and non-surgical treatment are possible. Studies of Korean conservative medicine for FBSS had a short duration of treatment and mainly pre- and post-treatment comparisons. And case of female patients who have worsened after childbirth is rare. The purpose of this study was to report long-term follow-up and rare cases of FBSS. Case summary: A 33-year-old female patient diagnosed with lumbar disc herniation complained with low back pain and radicular pain in the left leg after surgery in 2011. Acupuncture and decoction (Cheongpa-jeon, GCSB-5) were administered to her twice a day for about 6 years and 6 months. The patient's complaints improved with each hospitalization, and Magnetic Resonance Imaging (MRI) showed a slight decrease in the size of the recurrent disc (L4/5) and a newly developed disc (L5/S1) that had deteriorated after delivery. Conclusion: Korean medicine could be used to manage the pain of lumbar spine FBSS patients for 6-7 years and to alleviate lumbago after delivery.

A Case Report of Separation of Symphysis Pubis after Delivery (분만 후 치골결합분리 환자 1례의 임상보고)

  • Jo, Hyun-Jung;Gu, Hui-Jun;Yang, Seung-Jeong;Park, Kyung-Mi;Cho, Seong-Hee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.21 no.2
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    • pp.263-272
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    • 2008
  • Purpose: Separation of symphysis pubis during delivery is a rare condition. The separation might cause pubic pain, radiating pain of both leg, inguinal pain, and gait disturbance. The purpose of this case was to report the clinical effectiveness of Traditional Korean Treatment on decreasing those symptoms. Methods: The patient in this case was 34-year-old female, The chief complains were pubic pain(right side was severe), radiating pain of right inguinal pain, gait disturbance and low back pain. She was treated by Traditional Korean medicine, acupuncture, and Placenta Herbal Acupuncture. The progress of symptoms were evaluated by visual analogue scale. Results: After those Traditional Korean therapy, most symptoms were improved. But width of symphysis pubis remained unchanged. Conclusion: This case shows that Traditional Korean therapy might be effective in decreasing symptoms on separation of symphysis pubis during delivery.

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A Review of the Domestic Study Trends on Obstetrics & Gynecological Diseases with Chuna Manual Therapy (한방여성의학에서 추나요법을 활용한 국내 연구 동향 분석)

  • Lee, Jin-Wook;Hwang, Young-Sik;Kim, Gyu-Tae;Park, Seung-Hyeok;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bok;Hwang, Deok-Sang
    • The Journal of Korean Obstetrics and Gynecology
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    • v.32 no.2
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    • pp.87-99
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    • 2019
  • Objectives: The aim of this study was to analyse the domestic trends of Chuna manual therapy on Obstetrics and Gynecological Diseases in Korean literature. Methods: We searched for papers which had Chuna manual therapy through 2 related journals and 5 Korean web databases. All relevant papers were selected and extracted to be analyzed according to their study designs, academic journals, and target disease. Results: Nine papers belonged to four types of study designs, systematic review, randomized or non-randomized controlled trial and case report. And they were published in four kinds of academic journals. There were four papers about postpartum pain, two low back pain during pregnancy, and a stress urinary incontinence. The exact Chuna techniques were explained in only seven papers. All of papers have been shown that Chuna manual therapy is useful for obstetrics and gynecological diseases. Conclusions: It has been identified that Chuna manual therapy could be a good treatment for obstetrics and gynecological diseases. However, more clinical and well-designed studies with Chuna manual therapy will be needed.

Effects of one-to-one Labor Support on Labor Pain, Labor Stress Response, Childbirth Experience and Neonatal Status for Primipara (일대일 분만지지간호가 초산모의 분만동통, 분만스트레스 반응, 분만경험 및 신생아 상태에 미치는 효과)

  • Hur, Myung-Haeng
    • Women's Health Nursing
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    • v.7 no.2
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    • pp.188-202
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    • 2001
  • This study was designed to investigate the effect of one-to-one labor support on labor pain, labor stress response, childbirth experience and neonatal status for primipara by a quasi experiment (nonequivalent control group pretest-posttest design), from April 30, 1999 to February 20, 2000. The subjects of this experiment consisted of eighty two primipara with single gestation, full term, uncomplicated pregnancies. Forty one were in the experimental group and forty one in the control group. Their mean age was 25.95 years, their mean gestation period was 39.9 weeks. A caring package of one-to-one labor support had three components. Physical support consisted of massage, back pressure, touch. Emotional support was provided by a continuous nurse's presence, acceptance and encouragement. Informational support involved teaching breathing skills, relaxation skills and knowledge about the labor process. Data assessed labor pain, pulse rate and blood pressure to measure labor stress response. Also, in measuring the value of labor stress response, plasma epinephrine, plasma norepinephrine and serum cortisol were measured. In the 24 hours after birth, the data for the postpartum mother's childbirth experiences was collected. Umbilical cord arterial blood pH, one minute and five minute Apgar score were measured after birth. Data was analyzed by t-test, $x^2$-test, repeated measures ANOVA, ANCOVA with SAS Program. The results were as follows; 1. Labor pain was significantly low in the experimental group(P=.016). 2. No significant group effects were found, but significant time effects were found for plasma epinephrine, norepinephrine, serum cortisol, pulse rate and blood pressure. 3. The childbirth experience of the experimental group was significantly more positive than the control group (P = .005). 4. The umbilical cord arterial blood pH of the experimental group was significantly higher than the control group(P=.014). There was no significant difference between the two groups in neonatal one minute and five minute Apgar scores. In conclusion, these findings indicate that one-to-one labor support could be effective in decreasing labor pain, and increasing positive childbirth experiences, also increasing the neonatal umbilical cord arterial blood pH for primipara. So, one-to-one labor support could be applied as an effective nursing treatment for primipara.

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