title: Pregnancy is characterized by widespread deep-tissue hypersensitivity independent of lumbopelvic pain intensity, a facilitated response to manual orthopedic tests, and poorer self-reported health.
abstract: Lumbopelvic pain is common in pregnancy but the sensitization factors underlying the condition are largely unknown. This study characterized the somatosensory profile of pregnant and nonpregnant women and the relationship between pain, hypersensitivity, and commonly used manual clinical tests. Thirty-nine pregnant and 22 nonpregnant women were included. Although lumbopelvic pain was not an inclusion criterion, the pregnant women were divided into low- and high-pain groups following data collection. The sensitivity to light brush, pin-prick, and pressure pain was assessed bilaterally at 3 sites in the lumbopelvic region, at the shoulder, and in the lower leg. Responses to the active straight leg raise test and pain provocation tests of the sacroiliac joint were recorded. Participants completed questionnaires addressing emotional and physical well-being and rated disability using the Pelvic Girdle Questionnaire. Compared with controls, the high-pain group rated the active straight leg raise test as more difficult (P < .05), and both pain groups had more positive pain provocation tests (P < .05). The pregnant groups demonstrated significantly lower pressure pain thresholds at most assessment sites compared with controls (P < .05), but self-reported disability and pain were not correlated with pressure pain thresholds within pregnant participants. The high-pain group reported worse emotional health and poorer sleep quality than controls (P < .05).
  
  
  CONCLUSIONS
  This article presents the somatosensory profile of a healthy pregnant cohort. The results indicate that pain sensitivity increases during pregnancy possibly owing to the physical changes the body undergoes during pregnancy but also owing to changes in emotional health. This should be accounted for in clinical management of pregnant women with lumbopelvic pain.
authors.affiliation: Laboratory for Musculoskeletal Pain and Motor Control, Center for Sensory-Motor Interaction, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Denmark. Electronic address: tgn@hst.aau.dk.
authors.forename: Thorvaldur Skuli
authors.initials: TS
authors.lastname: Palsson
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
authors.forename: Darren
authors.initials: D
authors.lastname: Beales
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Slater
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: O'Sullivan
authors.affiliation: Laboratory for Musculoskeletal Pain and Motor Control, Center for Sensory-Motor Interaction, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Denmark.
authors.forename: Thomas
authors.initials: T
authors.lastname: Graven-Nielsen
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000503:physiopathology / Q000523:psychology; D017116:Low Back Pain / Q000503:physiopathology / Q000523:psychology; D008875:Middle Aged; D010147:Pain Measurement; D017288:Pain Threshold / Q000523:psychology; D059388:Pelvic Girdle Pain / Q000503:physiopathology / Q000523:psychology; D010808:Physical Examination; D010812:Physical Stimulation; D011247:Pregnancy / Q000502:physiology / Q000523:psychology; D011594:Psychometrics; D011601:Psychophysics; D057566:Self Report; D012890:Sleep; D011795:Surveys and Questionnaires; D055698:Touch Perception; D055815:Young Adult
keywords: Pelvic girdle pain; clinical tests; hyperalgesia; pregnancy