Back pain in women post-partum is not a unitary concept.
OBJECTIVE
At least half of all pregnant women experience back pain at some time during pregnancy and some of them also have persisting back pain post-partum. The aim of the present study was to identify and classify back problems in women post-partum by use of different pain provocation tests and define their relationship to spinal sagittal configuration and mobility.


METHODS
One hundred and nineteen women with back pain persisting two months after delivery were interviewed and examined, on average 7.2 months post-partum. Ten clinical pain provocation tests were performed. The first was performed to identify hip pain, the second to identify radiating pain and the other eight tests were performed to provoke pain in the areas of the posterior pelvic/sacroiliac joints, the symphysis pubis and the lumbar spine. The spinal sagittal configuration and mobility were measured in the thoracic and lumbar spine, respectively, with Debrunner's kyphometer (Protek AG, Berne, Switzerland).


RESULTS
Twenty-seven per cent of women had pain in the area of the posterior pelvic/sacroiliac joints, 18% in the area of the lumbar spine, 39% both in the area of the posterior pelvic/sacroiliac joints and in the lumbar spine, and in 16% no pain could be provoked. There were no statistically significant differences between the four groups with respect to the spinal sagittal configuration or the mobility in the thoracic or lumbar spine.


CONCLUSIONS
Back pain post-partum is not a unitary concept. Based on the clinical tests, women with back pain post-partum can be separated into groups with different pain localizations. The measuring of the spinal sagittal configuration and mobility did not help to further identify or classify post-partum back pain.
Nilsson-Wikmar
L
L
Department of Physical Therapy, Karolinska Institutet, Stockholm, Sweden. lena.nilsson-wikmar@gym.ki.se
Harms-Ringdahl
K
K
Pilo
C
C
Pahlbäck
M
M
D000328:Adult; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000209:etiology; D010147:Pain Measurement; D010808:Physical Examination; D011247:Pregnancy; D011248:Pregnancy Complications; D011644:Puerperal Disorders / Q000175:diagnosis* / Q000209:etiology