GEBELİKLE İLİŞKİLİ BEL AĞRISI

Year 2019, Volume: 2 Issue: 3, 13 - 25, 07.01.2020

Rojjin Mamuk , Nevin Hotun Şahin

Abstract

Bel ağrısı, gebe kadınlarda sık görülen, yaşam kalitesini olumsuz yönde etkileyen ve kronikleşebilen bir sağlık problemdir. Yapılan çalışmalar gebelikle ilişkili bel ağrısına dair farklı insidans hızları ve etyolojik faktörlerin varlığına işaret etmektedir. Fizyoterapinin altın standardı oluşturduğu tedavide, stabilizasyon kayışları, akupunktur, masaj ve relaksasyon yöntemleri kullanılmaktadır. Bununla birlikte koruyucu yaklaşımların gebelikle ilişkili bel ağrısını önleyebileceği gibi tedavi sürecini de olumlu yönde etkilediği bildirilmektedir. Koruyucu yaklaşımlar ise prekonsepsiyonel dönemden başlayarak risk gruplarının belirlenmesi, yapılacak egzersiz programları ile gebelik ve doğum sürecine bel bölgesinin hazırlanması ayrıca kadınların konuya yönelik bilinçlendirilmesine dayanmaktadır. Doğum sonrası dönemde ise bel ağrısı devam edenlerin ileri tanı ve tedavi yöntemlerine yönlendirilerek ağrının kronikleşmesi önlenmelidir. Buradan yola çıkarak bu derlemede, antenatal ve postnatal izlemlerde kadınlarla sürekli temas halinde olan birinci basamakta görevli sağlık profesyonellerinde konuya yönelik farkındalık oluşturmak amaçlanmıştır.

Keywords

Gebelik, bel ağrısı, ağrı kontrolü, ebelik, hemşirelik

LOW BACK PAIN ASSOCIATED WITH PREGNANCY

Abstract

Low back pain is a common health problem of pregnant women that affects quality of life negatively and that may become chronic. Studies indicate the presence of different incidence rates and etiologic factors for low back pain associated with pregnancy. Physiotherapy is a gold standard for the treatment, and besides, stabilization belts, acupuncture, massage, relaxation methods are also used. However, it has been reported that preventive approaches can prevent the development of pregnancy-related low back pain and also affect the treatment process positively. Preventive approaches are based on the determination of risk groups starting from the preconceptional period, preparation of the exercise programs to be performed, preparation of the waist region for the pregnancy and delivery period, and raising awareness of women about the issue. In the postpartum period, it should be tried to prevent chronic pain by directing those who continue to have low back pain to advanced diagnosis and treatment methods. From this point of view, it has been aimed in this compilation to raise awareness of the primary health care professionals who are constantly in contact with women during antenatal and postnatal follow-up about this issue.

Keywords

Pregnancy, low back pain, pain management, midwifery, nursing

References

• 1. Wang SM, Dezinno P, Maranets I, Berman MR, Caldwell-Andrews AA, Kain ZN. Low back pain during pregnancy: Prevalence, risk factors, and outcomes. Obstet Gynecol. 2004; 104 (1): 65-70.
• 2. Tucer B, Yalçın BM, Öztürk A, Mazıcıoğlu MM, Yılmaz Y, Kaya M. Bir Türk örnekleminde bel ağrısı için risk faktörleri ve ağrıya bağlı kısıtlılık ve depresyonla ilişkisi. Turkish Neuro surgery. 2009; 19(4): 327-332.
• 3. Öztürk C, Hepgüler S. Mekanik Bel Ağrısı. Erdine S. (editör). Ağrı. 3. Baskı. İstanbul: Nobel Matbaacılık; 2007. s. 425-433.
• 4. Kutsal YG. Bel ağrıları. Hacettepe Tıp Dergisi. 2008; 39: 180-193.
• 5. Katonis P, Kampouroglou A, Aggelopoulos A, Kakavelakis K, Lykoudis S, Makrigiannakis A, Alpantaki K. Pregnancy – related low back pain. Hippokratia. 2011; 15(3): 205-210.
• 6. Sabino J, Grauer JN. Pregnancy and low back pain. Curr Rev Musculoskelet Med. 2008; 1: 137–141.
• 7. Beyaz EA, Özcan E. Gebelikte görülen kas iskelet sistemi kaynaklı ağrılar ve tedavi yaklaşımları. Türk Fiz Tıp Rehab Derg. 2005; 51(2): 65-68.
• 8. Mens JM, Vleeming A, Stoeckart R, Stam HJ, Snijders CJ. Understanding peripartum pelvic pain. Implications of a patient survey. Spine. 1996; 21(11): 1363-1369.
• 9. Mogren IM. BMI, pain and hyper-mobility are determinants of long-term outcome for women with low back pain and pelvic pain during pregnancy. Eur Spine J. 2006; 15(7): 1093–102.
• 10. Stapleton DB, MacLennan AH, Kristiansson P. The prevalence of recalled low back pain during and after pregnancy: a South Australian population survey. Aust N Z J Obstet Gynaecol. 2002; 42(5): 482–485.
• 11. Fast A, Shapiro D, Ducommun EJ, Friedmann LW, Bouklas T, Floman Y. Low back pain in pregnancy. Spine. 1987; 12(4): 368–371.
• 12. Manyozo SD, Nesto T, Bonongwe P, Muula AS. Low back pain during pregnancy: Prevalence, risk factors and association with daily activities among pregnant women in urban Blantyre, Malawi. Malawi Med J. 2019; 31(1): 71-76.
• 13. Khan MJ, Israr A, Bashart I, Shoukat A, Mushtaq N, Farooq H. Prevalence of pregnancy related low back pain in third trimester and its impact on quality of life and physical limitation. JIIMC. 2017; 12(1): 39-43.
• 14. Gharaibeh A, Al Wadiya A, Qdhah E, Khadrawi M, Abu Slaih A, Qaoud Y. Prevalence of low back pain in pregnant women and the associated risk factors. J Ortho Bone Disord. 2018; 2(2):1-7.
• 15. Saxena AK, Chilkoti GT, Singh A, Yadav, G. Pregnancy-induced low back pain in indian women: Prevalence, risk factors, and correlation with serum calcium levels. Anesth Essays Res. 2019; 13(2): 395-402.
• 16. Köstü B, Kültür T, Ercan Ö, Bakacak M. Gebelikte egzersizin bel ağrıları ve lordoz üzerine etkisi. KSU Tıp Fak Der. 2015; 10(3): 18-20.
• 17. Mogren IM, Pohjanen AI. Low back pain and pelvic pain during pregnancy: Prevalence and risk factors. Spine. 2005; 30(8): 983–991.
• 18. Sencan S, Ozcan-Eksi EE, Cuce I, Guzel S, Erdem B. Pregnancy-related low back pain in women in Turkey: Prevalence and risk factors. Annals of Physical and Rehabilitation Medicine. 2018; 61(1): 33-37.
• 19. Kovacs FM, Garcia E, Royuela A, González, L, Abraira V. Prevalence and factors associated with low back pain and pelvic girdle pain during pregnancy. Spine. 2012; 37(17): 1516-1533.
• 20. Gutke A, Östgaard HC, Öberg B. Predicting persistent pregnancy-related low back pain. Spine. 2008; 33(12): 386-393.
• 21. Forrester M. Low back pain in pregnancy. Acapuncture in Medicine. 2003; 21: 36-41.
• 22. Terzi H, Terzi R, Altınbilek T. Pregnancy-related lumbopelvic pain in early postpartum period and risk factors. Int J Res Med Sci. 2015; 3(7): 1617-1621.
• 23. Van De Pol G, Van Brummen HJ, Bruinse HW, Heintz AP, Van Der Vaart CH. Pregnancy-related pelvic girdle pain in the Netherlands. Acta Obstet Gynecol Scand. 2007; 86(4): 416-422.
• 24. Noren L, Östgaard S, Johansson G. Östgaard HC. Lumbar back and posterior pelvic pain during pregnancy: A 3-year follow-up. Eur Spine J. 2002; 11: 267–271.
• 25. Ostgaard HC, Zetherström G, Roos-Hansson E. Back pain in relation to pregnancy: A 6-year follow-up. Spine. 1976; 22(24): 2945-50.
• 26. Baydın S, Baydın SŞ, Emel E, Gündağ M, Alataş İ. Gebelik ve lomber disk herniasyonu. JOPP Derg. 2012; 4(3): 93-96.
• 27. Şenol N, Karaaslan T. Gebelikte bel ağrısı ve lomber disk hernisine yaklaşım. S.D.Ü. Tıp Fak. Derg. 2010; 17(2): 31-34.
• 28. Uemura Y, Yasui T, Horike K, Maeda K, Uemura H, Haku M. Factors related with low back pain and pelvic pain at the early stage of pregnancy in Japanese women. Int. J. Nurs. Midwifery. 2017; 9(1):1-9.
• 29. Carvalho MECC, Lima, LC, Terceiro CAL, Pinto DRL, Silva MN, Cozer GA. Low back pain during pregnancy. Rev Bras Anestesiol. 2017; 67(3): 266-270.
• 30. Khanna V, Khanna R, Gupta P. Low back pain during pregnancy. International Journal of Recent Surgical and Medical Sciences. 2016; 2(1): 23-27.
• 31. Ray-Griffith SL, Wendel MP, Stowe ZN, Magann EF. Chronic pain during pregnancy: A review of the literatüre. Int J of Women’s Health. 2018; 10: 153-164.
• 32. Abbasi S, Hamid M, Ahmed Z, Nawaz FH. Prevalence of low back pain experienced after delivery with and without epidural analgesia: A non-randomised prospective direct and telephonic survey. Indian J Anaesth. 2014; 58(2): 143–148.
• 33. Mohseni-Bandpei MA, Fakhri M, Ahmad-Shirvani M, Bagheri-Nessami M, Khalilian AR, Shayesteh-Azar M, Mohseni-Bandpei H. Low back pain in 1,100 Iranian pregnant women: Prevalence and risk factors. The Spine Journal. 2009;9: 795–801.
• 34. Bishop A, Holden, MA, Ogollah RO, Foster NE. Current management of pregnancy-related low back pain: anational cross-sectional survey of UK physiotherapists. Physiotherapy 2016; 102: 78–85.
• 35. Liddle SD, Pennick V. Interventions for preventing and treating low-back and pelvic pain during pregnancy (Review). Cochrane Database Syst Rev. 2015; 9:CD001139.
• 36. Mirmolaei ST, Ansari NN, Mahmoudi M, Ranjbar F. Efficacy of a physical training program on pregnancy related lumbopelvic pain. International Journal of Women’s Health and Reproduction Sciences. 2018; 6(2): 161-166.
• 37. Colla C, Paiva LL, Thomaz RP. Therapeutic exercise for pregnancy low back and pelvic pain: A systematic review. Fisioter Mov. 2017; 30(2): 399-411.
• 38. Wang SM, DeZinno P, Fermo L, William K, Caldwell-Andrews AA, Bravemen F, Kain ZN. Complementary and alternative medicine for low-back pain in pregnancy: A cross-sectional survey. J Alt Comp Medicine. 2005; 11(3): 459–64.
• 39. Mens JMA, Damen L, Snijders CJ, Stam HJ. The mechanical effect of a pelvic belt in patients with pregnancy-related pelvic pain. Clin Biomech. 2006; 21(2): 122–127.
• 40. Greenwood CJ, Stainton MC. Back pain / discomfort in pregnancy: Invisible and forgotten. The Journal of Perinatal Education. 2001; 1(1): 1-12.
• 41. Meran EP, Şahin NH. Kadın sağlığı alanında uzman hemşirelik eğitimi ve uzman hemşirelik rolleri: Amerika Birleşik Devletleri örneği. KASHED. 2014; 1(1):1-14.
• 42. Güngör İ, Rathfisch G, Beji NK. Kadın sağlığı hemşirelerinin rol yetki ve sorumluluklarının uluslararası düzeyde irdelenmesi. F.N. Hem. Derg. 2013; 21(1): 49-56.
• 43. Tzeng YL, Su TJ. Low back pain during labor and related factors. J Nurs Res. 2008; 16(3): 231-241.