Improved function in women with persistent pregnancy-related pelvic pain after a single corticosteroid injection to the ischiadic spine: a randomized double-blind controlled trial.

Abstract

BACKGROUND:

Pregnancy-related low back and pelvic pain is a worldwide problem. A large proportion of women still experience disabling daily back pain 2 years after childbirth, resulting in major changes in activities and general well-being. In spite of this, the source of pain and effective treatment are uncertain.

OBJECTIVE:

To evaluate the short-term effects on function of a single corticosteroid injection treatment to the ischiadic spine in women with persistent pregnancy-related pelvic pain (PPPP).

METHODS:

Thirty-six women were allocated to injection treatment with slow-release triamcinolone and lidocain or saline and lidocain, given once at the sacrospinous ligament insertion on the ischiadic spine bilaterally with follow-up at 4 weeks. Outcome measures were Disability Rating Index (DRI), self-rated functional health (SF-36), gait speed and endurance (6MWT), and strength and endurance of trunk muscles (isometric trunk extensor and flexor tests).

RESULTS:

Women in the triamcinolone group showed significantly improved DRI (p  =  0.046), 6MWT (p  =  0.016), and isometric trunk extensor tests (p  =  0.004), as compared with the saline group. Close co-variation was shown between improved function and reduced pain intensity.

CONCLUSIONS:

Improved function was achieved among women with PPPP after a single injection treatment with slow-release corticosteroid. The effect was positively correlated to the reduced pain intensity.

• Authors: Thomas Torstensson, Anne Lindgren, Per Kristiansson
• Journal: Physiotherapy theory and practice (Physiother Theory Pract) Vol. 29 Issue 5 Pg. 371-8 (Jul 2013) ISSN: 1532-5040 [Electronic] England
• PMID: 23713407 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Adrenal Cortex Hormones
• Anesthetics, Local
• Delayed-Action Preparations
• Triamcinolone
• Lidocaine

Topics

• Adrenal Cortex Hormones (administration & dosage)
• Adult
• Anesthetics, Local (administration & dosage)
• Delayed-Action Preparations
• Disability Evaluation
• Double-Blind Method
• Female
• Gait (drug effects)
• Humans
• Injections, Spinal
• Lidocaine (administration & dosage)
• Muscle Strength (drug effects)
• Pain Measurement
• Pelvic Pain (diagnosis, drug therapy, physiopathology)
• Physical Endurance (drug effects)
• Predictive Value of Tests
• Pregnancy
• Pregnancy Complications (diagnosis, drug therapy, physiopathology)
• Recovery of Function
• Self Report
• Severity of Illness Index
• Sweden
• Time Factors
• Treatment Outcome
• Triamcinolone (administration & dosage)