Pregnancy-related low back/pelvic girdle pain: Prevalence, severity, and risk factors in Zhengzhou, China

Impact of Sacroiliac Interosseous Ligament Tension and Laxity on the Biomechanics of the Lumbar Spine: A Finite Element Study

OBJECTIVE

To investigate the influence of sacroiliac interosseous ligament tension and laxity on the biomechanics of the lumbar spine.

METHODS

A static analysis of a three-dimensional finite element model of the Lumbar-Pelvic is conducted to verify the model's effectiveness. Adjusting the sacroiliac ligament's elasticity modulus under a 10Nm lumbar flexion/extension moment, it simulates ligament tension/laxity to calculate vertebrae displacements, intervertebral disc stress and deformation, nucleus pulposus pressure, facet joint force, and ligament stress.

RESULTS

With the elastic modulus of the sacroiliac ligament changing by +50%, -50%, and -90%, the angular displacement of vertebra 3 in forward flexion changes by +1.64%, -4.84%, and -42.3%, and the line displacements change by +5.7%, -16.4%, and -144.9%, respectively; and the angular displacements in backward extension change by +0.2%, -0.6%, -5.9% and the line displacements change by +5.5%, -14.3%, and -125.8%. However, the angular displacement and center distance between adjacent vertebrae do not change, leading to no change in the maximum stress of the intervertebral disc and the maximum pressure in the nucleus pulposus. Flexion and extension directly affect the deformation and stress magnitude and distribution in the lumbar spine.

CONCLUSIONS

While sacroiliac interosseous ligament laxity and tension have little effect on disc deformation and stress, and nucleus pulposus pressure, they reduce the stability of the lumbar-sacral vertebrae. In a forward flexion state, the lumbar ligaments bear a large load and are prone to laxity, thereby increasing the risk of lumbar injury.

Lumbopelvic pain and sick leave during pregnancy: A comparison of Italy and Norway

BACKGROUND

Pregnancy-related lumbopelvic pain is a frequently reported musculoskeletal disorder, but few studies have compared data between countries.

OBJECTIVES

Examine prevalence, severity, and sick leave and explore potential risk factors associated with pregnancy-related lumbopelvic pain in Italian women and compare the results to a similar study in Norway, utilizing the same questionnaire.

DESIGN

Cross-sectional.

METHODS

Italian (n = 481) and Norwegian women (n = 435) were allocated from two public hospitals in Rome (Fatebenefratelli San Giovanni Calibita-Isola Tiberina) and Oslo (Oslo University Hospital), as well as four antenatal clinics in Modena (Italy). The questionnaire was completed between gestation weeks 32 and 36, addressing women's experiences of pregnancy-related lumbopelvic pain and sick leave in current week, and retrospectively for prepregnancy, first and second trimesters.

RESULTS

In Italy and Norway, 39% and 57% of pregnant women reported pregnancy-related lumbopelvic pain, respectively, with 11% and 25% experiencing severe pregnancy-related lumbopelvic pain. Pregnancy-related lumbopelvic pain was associated with sick leave in Norway (p < 0.01), but not in Italy (p = 0.66) at late gestation. In both countries, women with pregnancy-related lumbopelvic pain versus those with no pregnancy-related lumbopelvic pain were more likely to be multiparous (Italy: 40% versus 31%, p = 0.06 and Norway: 53% versus 38%, p < 0.01), and have gestational weight gain above guidelines (Italy: 21% versus 13%, p = 0.02% and Norway: 27% versus 14%, p < 0.01) and previous experience of pregnancy-related lumbopelvic pain (Italy: 15% versus 2%, p < 0.01 and Norway: 31% versus 4%, p < 0.01). Maternal exercise (⩾2 times weekly) was associated with less pregnancy-related lumbopelvic pain (Italy: odds ratio = 0.33, 95% confidence interval = 0.11-1.0, p = 0.05 and Norway: odds ratio = 0.55, 95% confidence interval = 0.29-1.0, p = 0.06).

CONCLUSION

We observed high rates of pregnancy-related lumbopelvic pain in Italy and Norway, with Norwegian women reporting the highest prevalence and severity level. While both countries had similar rates of sick leave in late gestation, an association between pregnancy-related lumbopelvic pain and sick leave was observed among Norwegian women only. Health care providers should be proactive in addressing pregnancy-related lumbopelvic pain through open communication and seeking input from pregnant individuals. However, it is essential to acknowledge that the current evidence on effective treatments remains limited and inconclusive, highlighting the need for further research in this field.