Gebelikte Kas-İskelet Sistemi Ağrılarının Non-Farmakolojik Yönetimi

Öz

Derginizin 13 Eylül 2024 tarihli 33. Cilt 2. Sayısında, Sayın Tırmıkçıoğlu tarafından kaleme alınan "Gebelikte Ağrı Tedavisi: Farmakolojik Yaklaşımlar" başlıklı derlemeyi büyük bir ilgiyle okudum. Kas iskelet sistemi ile ilgilenen hekimleri yakından ilgilendiren, oldukça önemli olan bu konuya değerli katkıları için yazara teşekkür ederim. Bu derlemenin, gebelikte ağrı yönetiminde farmakolojik seçenekleri değerlendirirken önemli bir bilgi kaynağı sunduğunu düşünüyorum. Gebelikte, birçok ilacın fetüs üzerindeki potansiyel yan etkileri göz önüne alındığında, non-farmakolojik yaklaşımlar da önem kazanmaktadır. Bu konuda fiziyatrist bakış açısıyla katkı sunmak ve bilgilerimi paylaşmak istiyorum.

Anahtar Kelimeler

• Gebelik
• ağrı
• non-farmakolojik tedavi

Non-pharmacological Management of Musculoskeletal Pain During Pregnancy

Öz

I read with great interest the review titled “Pain Treatment in Pregnancy: Pharmacological Approaches” written by Mr. Tırmıkçıoğlu in Volume 33, Issue 2 of your journal dated 13 September 2024: Pharmacological Approaches’ with great interest. I would like to thank the author for his valuable contribution to this very important subject, which is closely related to physicians interested in the musculoskeletal system. I think that this review provides an important source of information when evaluating pharmacological options in the management of pain in pregnancy. Considering the potential side effects of many drugs on the fetus in pregnancy, non-pharmacological approaches also gain importance. I would like to contribute and share my knowledge on this subject from the perspective of a physiatrist.

Anahtar Kelimeler

• Pregnancy
• pain
• non-pharmacological treatment

Kaynakça

1. Tırmıkçıoğlu Z. Gebelikte ağrı tedavisi: Farmakolojik yaklaşımlar. Sürekli Tıp Eğitimi Dergisi. 2024;33(2):157-63.
2. Endresen EH. Pelvic pain and low back pain in pregnant women – an epidemiological study. Scandinavian Journal of Rheumatology. 1995;24(3):135-41.
3. Onyekere CP, Emmanuel GN, Ozumba BC, Igwesi-Chidobe CN. Minimal-contact physical interventions for pregnant women with musculoskeletal disorders: A systematic review of randomised and non-randomised clinical trials. Journal of Obstetrics and Gynaecology. 2022;42(6):1679-92.
4. Keskin EA, Onur O, Keskin HL, Gumus II, Kafali H, Turhan N. Transcutaneous electrical nerve stimulation improves low back pain during pregnancy. Gynecologic and Obstetric Investigation. 2012;74(1):76-83.
5. Garshasbi A, Faghih Zadeh S. The effect of exercise on the intensity of low back pain in pregnant women. International Journal of Gynaecology and Obstetrics. 2005;88:271–5.
6. Suputtitada A, Wacharapreechanont T, Chaisayan P. Effect of the ‘sitting pelvic tilt exercise’ during the third trimester in primigravidas on back pain. Journal of the Medical Association of Thailand. 2002;85:S179.
7. Field T, Figueiredo B, Hernandez-Reif M, Diego M, Deeds O, Ascencio A. Massage therapy reduces pain in pregnant women, alleviates prenatal depression in both parents, and improves their relationships. Journal of Bodywork and Movement Therapies. 2008;12(2):146-50.
8. El-Hosary E, Abbas Soliman HF, El-Homosy S. Effect of therapeutic massage on relieving pregnancy discomforts. IOSR Journal of Nursing and Health Science. 2016;5(04):57-64.

9. Wedenberg K, Moen B, Norling Å. A prospective randomized study comparing acupuncture with physiotherapy for low-back and pelvic pain in pregnancy. Acta Obstetricia et Gynecologica Scandinavica. 2000;79:331–5.
10. Kvorning Ternov N, Grennert L, Åberg A, Algotsson L, Åkeson J. Acupuncture for low-back pain in late pregnancy. Pain Medicine. 2001;2:204–7.
11. Kvorning N, Holmberg C, Grennert L, Åberg A, Åkeson J. Acupuncture relieves pelvic and low‐back pain in late pregnancy. Acta Obstetricia et Gynecologica Scandinavica. 2004;83(3):246-50.
12. Lin JG, Kotha P, Chen YH. Understandings of acupuncture application and mechanisms. American Journal of Translational Research. 2022;14(3):1469.
13. Quittan M, Bily W, Crevenna R, Fialka-Moser V, Grestenberger W, Hofer C, et al. Transcutaneous electrical nerve stimulation (TENS) in patients with pregnancy-induced low back pain and/or pelvic girdle pain. Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin. 2016;26(02):91-5.
14. Dowswell T, Bedwell C, Lavender T, Neilson JP. Transcutaneous electrical nerve stimulation (TENS) for pain relief in labour. The Cochrane Database of Systematic Reviews. 2009;15(2):CD007214
15. Franisia CA, Dahlan FM, Suralaga C. The effectiveness of prenatal yoga on back pain in third trimester pregnant women at the Depok Clinic in 2022. Science Midwifery. 2022;10(3):2075-81.
16. Martins RF, Pinto e Silva JL. Treatment of pregnancy-related lumbar and pelvic girdle pain by the yoga method: A randomized controlled study. The Journal of Alternative and Complementary Medicine. 2014;20(1):24-31.
17. Kinser PA, Pauli J, Jallo N, Shall M, Karst K, Hoekstra M, Starkweather A. Physical activity and yoga-based approaches for pregnancy-related low back and pelvic pain. Journal of Obstetric, Gynecologic & Neonatal Nursing. 2017;46(3):334-46.