The term lower back and pelvic pain (LBPP) is defined as the recurrent or continuous pain experienced between the posterior iliac crest and gluteal fold (Bergstrom et al., 2014). It is considered a common complication of pregnancy and often poorly treated and understood, affecting daily activities and mode of birth (University of Queensland, 2014). Therefore, it is important for midwives to identify and diagnose the pain early, with appropriate management to decrease discomfort and impact on the woman’s quality of life (Katonis et al., 2011). This assignment will provide information on the aetiology and underlying pathophysiology of LBPP, its relation to randomised controlled trials and how to recognise and support women with this …show more content…
Lastly, reproductive hormones have been found to be related with LBPP (Katonis et al., 2011). Levels of the hormone ‘relaxin’ significantly increases during pregnancy. The hormone is heavily induced in the pelvic joints to increase mobility for preparation upon delivery. However, this can cause instability of the ligaments and muscles due to stress, leading to pain in the lower back and pelvis (Olsen et al., 2009).
The pathogenic mechanisms leading to the development of LBPP remain poorly understood. However, ongoing research is advancing the understanding on the pathophysiology and many explanations have been advocated. Studies suggest that low back pain is commonly caused by disorders of the vertebrae and intervertebral joints, back muscles and ligaments, and spinal mechanics (Porth, 2011). The lower back (lumbar) is made up of five vertebrae (L1-L5) containing fibro cartilaginous discs to prevent the vertebrae from colliding, and protecting the spinal cord. The spine is stabilised by the multifidous muscles and ligaments of the back and abdomen. Additionally, facet joints support and enable spinal movement (Hughes et al., 2012) (Salzberg, 2012). An intervertebral disc consists of a gelatinous core covered by a fibrous ring (Hughes et al., 2012). Normally, the blood vessels and nerves flows outside of the disc, however if the discs loses its ability to manage physical forces, it
(3) spondylolishesis is the lumbar slippage of the vertebra between L4-L5 and L5 and S1 which causes the compression of the spinal nerves 4) degenerative joint disease related to aging is also responsible for the cause of sciatica, there is a malformation involvement in the spine and dehydration resulting to disc herniation and severe inflammation in the vertebral bodies causing the compression and irritation of the spinal nerve roots 4) degenerative joint disease related to aging is also responsible for the cause of sciatica . Sciatica evolves between the age of forty to sixty years old and commonly occurs more in male as compared to female (Fuller & Goodman, 2015). Also, genetic cause also plays a significant role in etiology aside from infection, the vast amount of load of the vertebral column causing the protuberance of the disc(Fuller & Goodman, 2015). Moreover, malignancy or arthritic spine within the vertebra or trauma implicates the cause of sciatic nerve irritation or compression (Fuller & Goodman,
Herniated disc - the disc is the spongy cartridge that provides support and protection between the five vertebrae in the lower back and protects the spinal cord from injury. As the disc degenerates - any injury to the ligaments could cause pain to the affected area. Most herniated disc occurs between the fourth or fifth vertebrae in the lower back in efforts to support the upper back. This could cause major pain when standing and sitting throughout the day.
with diagnosis, treatment, and follow-up of IC patients. With this in mind, I feel my research can help in getting the word out there about IC/PBS, and Chronic Pelvic Pain (CPP).
Pain in the pelvic region and at the back can surface whilst pelvic numbness is also a concern at this week. The numbness at the pelvic zone is primarily due to the fact that the pelvic nerves get exterted and stressed at this point. This will continue till childbirth.
11/13/14 MRI of the lumbar spine showed 4mm left paracentral and foraminal disc protrusion at L4-5, which mildly impinges upon the thecal sac and the proximal left L5 nerve root. The disc protrusion also moderately narrows the left foramen and lateral recess. There was also a 2mm posterior central disc protrusion at L5-S1. A 2mm disc bulge at L2-3 was seen. There was a mild degenerative facet and ligament flava hypertrophy at L4-5 and
Low back pain (LBP) is one of the leading causes of disability and work absence globally, affecting not just the individual, but also extending to families, communities and society at large. Whilst the prevalence of LBP is high, with over 70 percent of people experiencing some LBP at some point during their lives, most will resolve within a few months (Campbell et al, 2013). Problems arise when pain persists beyond the expected period of healing or when it exceeds 12 weeks in duration. An estimated 40 percent of people who present with acute LBP continue to report symptoms after 3 months and
Low back pain (LBP) is a common condition worldwide; approximately 50-80% of adults suffer from LBP at least once during their lives [1, 2]. LBP represents a major health problem because of its prevalence, high probability of recurrence, consequences, and healthcare cost [3-6]. LBP has physical, psychological, and economic impacts on individuals. Furthermore, LBP is still the primary cause of absenteeism and disability in every industrialized society [226].
(2012) and Swain and Dahlen (2013) Australian studies used a quantitative methodology to obtain data. Each paper evidences the raw data, improving the transparency of the research (Department for International Development, 2014), allowing the reader to make comparisons between the data enabling the findings to be critiqued in terms of relevance and reliability (Wicherts, Bakker and Molenaar, 2011; Critical Appraisal Skills Program, 2013). As each of the studies are Australian the generalizability of the findings should be applied with caution to the UK population (Papaioannou, 2013). However, as Australian midwifery practice is similar to the UK's with midwives being the primary care providers for normal pregnancies (Nursing and Midwifery Board of Australia, 2015), and as pain is endured by the majority of women regardless of demographic location (Declercq et al, 2008), the findings are increasingly
Method: Eleven subjects ranging in age from 18 - 65 were selected based on diagnosis of leg and low back pain. Those who participated in this study reported pain no longer than six months and no less than one month. These patients were screened using a standardized lumbar spine evaluation. Patients AROM, flexibility, medical history, strength, gait, neurology, and soft tissue were also evaluated and measured prior to testing. The test was designed using an A-B-A design where A is the baseline condition and B was intervention with the use of the PBWS. The
Low back pain is a highly prevalent socioeconomic health issue in the world we live in today and one of the top causes of disability - affecting work performance and the overall quality of life for many. The 2010 Global Burden of Disease Study estimated that out of 289 health conditions, low back pain ranked number one in terms of disability (YLDs - Years Lived with Disability), and sixth in terms of overall burden (DALYs - Disability-Adjusted Life Years) (Lancet, 2012). It is estimated that 60% to 70% of the industrialized population will experience non-specific (most common type) low back pain in their lifetimes with a one-year prevalence of 15% to 45%, adults occurring 5% per year (Taimela, Kujala, Salminen, Viljanen, 1997, 1132-1136). Children and adolescents have a lower prevalence rate than adults, but is rapidly on the rise (Balague, Troussier, Salminen, 1999, 429-438).
During the pregnancy term, the human body releases a high dose of a hormone called Relaxin. The purpose of this hormone is, quite simply, to relax the joints and muscles in the pelvis and lower back--an obvious necessity for the process of child birth. By the time a woman is approximately 38 weeks pregnant, the amount of Relaxin that the body produces is approximately ten times higher than under normal circumstances.
Human spine consists of twenty six vertebrae separated by twenty four intervertebral disks. These disks absorb shock during everyday activities such as running, walking, sitting, turning, and bending. The intervertebral disks have two parts: an outside part called annulus fibrosus, which is made up of strong fibrous cartilage; and inner part called nucleus pulposus, which consists of water and collagen fibers and is often described as “gelatinous” substance. When outer annulus fibrosus thins out due to an injury or age-related weakening, the inner nucleus pulposus can slip out, causing pain and discomfort because it can press on the spinal cord and nerves. This condition is called herniated nucleus pulposus (HNP).
During the last 8 weeks of pregnancy symptoms may become more severe but surgery is avoided as it usually resolves after giving birth (Meems et al., 2015; Shi & MacDermid, 2011). Pregnancyrelated CTS (PRCTS) is believed to be caused by disruption in fluid balance or local oedema in the carpal tunnel as a result of hormonal changes, however further clinical research is needed. According to a recent review the prevalence of PRCTS is 31%-62% (Meems et al., 2015; Shi & MacDermid, 2011).
Central Idea: Pain management is an important aspect of childbirth that women need to educate themselves on so they can make an informed decision when choosing which method they will use.
Childbirth can be described as one of the most rewarding and also painful experiences in a woman’s life. Most women choose some type of method to ease pain, however, there has been a lot of controversy over with pain management method is the most effective. According to the CDC (Center for Disease Control), In 2013, there were 3,932,181 births recorded in the United States, 32.7% of those births were surgical procedures. In 2012, 1.36% of recorded births occurred out-of-hospital, meaning these births took place mostly in homes or birthing centers. Without the option of medicine that a hospital provides, how were these women able to manage their pain during labor and delivery. There are many different methods for easing pain during childbirth, some methods involve the use of medicine and surgery, and others include natural techniques, such as hypnosis, Lamaze, and many others. It is a personal preference of the parents over which method is right for the needs of the mother and child. This can be an overwhelming decision for new parents to make because they have to take into consideration the safety of the mother and child, pain management for the mother and desire for medical involvement.