Self-help may ease back pain from pregnancy

Lower back pain is common during and after pregnancy, but learning a few self-management techniques may ease the pain for many women, a study suggests.

In a clinical trial involving 126 women with lingering back pain after childbirth, Dutch researchers found that those who learned self-management measures from a physical therapist fared better than those given standard care.

Three months after delivery, they had less pain and fewer physical limitations, and had generally returned to work sooner than women in the standard-care group.

The findings, published in the online journal BMC Pregnancy and Childbirth, suggest that learning how to deal with back pain in day-to-day life can be more useful to women than typical medical care.

Women in the self-management group did not receive traditional physical therapy, where the therapist "has an expert role and sets the treatment goals," explained lead researcher Dr. Caroline H. G. Bastiaenen of Maastricht University.

Instead, she told Reuters Health, the physical therapist acted more as a teacher, and offered each patient advice on daily activities - such as the best way to hold the baby when back pain is flaring up.

The women also learned exercises for the lower spine and pelvis, but they were free to choose the ones they found most helpful. Patients set personal goals and the therapist helped to set up an action plan and to review progress.

Women in the standard-care group were given the choice of seeking advice from their doctor, having traditional physical therapy, or doing nothing.

At the three-month mark, women in the self-management group were more likely to have recuperated and returned to work.

There were no major differences between the groups after one year, but this was because most of the women had recovered by that point, Bastiaenen said.

She suggested that women who are still bothered by lower back pain four to six weeks after delivery try talking to a physical therapist about ways to manage the problem in their day-to-day lives.

Lower back pain does subside in most women after childbirth, and not everyone needs medical attention. Much depends on how concerning the pain is, according to Bastiaenen.

"Most of the time it is not the pain, but the worries about the pain, that restrain women from becoming active again," she noted.

Self-management techniques, she said, may focus women's minds on getting active, and away from the pain itself.

SOURCE: BMC Pregnancy and Childbirth, online May 30, 2008.