Tóm tắt
Đau lưng vùng thấp trong thai kỳ là một vấn đề về cơ xương khớp phổ biến mà thai phụ phải đối mặt do nhiều yếu tố gây ra. Đau lưng trong thai kỳ có thể được chẩn đoán sớm, tuy không điều trị được triệt để nhưng góp phần làm giảm các triệu chứng. Cần có sự chẩn đoán sớm và phân biệt giữa đau thắt lưng và đau vùng chậu vì có các hướng quản lý điều trị khác nhau. Các lựa chọn điều trị bao gồm tập thể dục, vật lý trị liệu, đai ổn định, kích thích thần kinh, điều trị bằng thuốc, châm cứu, xoa bóp, thư giãn và yoga, có thể cá thể hóa điều trị cho từng trường hợp.
Từ khóa
Tài liệu tham khảo
1. Vleeming A, Albert HB, Ostgaard HC, Sturesson B, Stuge B. European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J. 2008; 17: 794-819
2. Ostgaard HC, Zetherstrom G, Roos-Hansson E, Svanberg B. Reduction of back and posterior pelvic pain in pregnancy. Spine (Phila Pa 1976). 1994; 19: 894-900.
3. 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: 65-70.
4. Carvalho MECC, Lima LC, de Lira Terceiro CA, Pinto DRL, Silva MN, Cozer GA, Couceiro TCM. Lombalgia na gestação [Low back pain during pregnancy. Rev Bras Anestesiol. 2017 May-Jun;67(3):266-270. Portuguese. doi: 10.1016/j.bjan.2016.03.002. Epub 2016 May 21. PMID: 27220735.
5. 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: 416-422.
6. Pool-Goudzwaard AL, Slieker ten Hove MC, Vierhout ME, Mulder PH, Pool JJ, Snijders CJ, Stoeckart R. Relations between pregnancy-related low back pain, pelvic floor activity and pelvic floor dysfunction. Int Urogynecol J Pelvic Floor Dysfunct. 2005 Nov-Dec;16(6):468-74. doi: 10.1007/s00192-005-1292-7. Epub 2005 Apr 1. PMID: 15803285.
7. Sabino J, Grauer JN. Pregnancy and low back pain. Curr Rev Musculoskelet Med. 2008; 1: 137-141.
8. Mens JM, Damen L, Snijders CJ, Stam HJ. The mechanical ef- fect of a pelvic belt in patients with pregnancy-related pelvic pain. Clin Biomech (Bristol, Avon). 2006; 21: 122-127
9. Padua L, Padua R, Bondi R, Ceccarelli E, Caliandro P, D’Amico P, et al. Patient-oriented assessment of back pain in pregnancy. Eur Spine J. 2002; 11: 272-275.
10. Mogren IM. Does caesarean section negatively influence the post-partum prognosis of low back pain and pelvic pain during pregnancy? Eur Spine J. 2007; 16: 115-121.
11. Wuytack F, O'Donovan M. Outcomes and outcomes measurements used in intervention studies of pelvic girdle pain and lumbopelvic pain: a systematic review. Chiropr Man Therap. 2019 Nov 5;27:62. doi: 10.1186/s12998-019-0279-2. PMID: 31700607; PMCID: PMC6829811.
12. Morkved S, Salvesen KA, Schei B, Lydersen S, Bo K. Does group training during pregnancy prevent lumbopelvic pain? A randomized clinical trial. Acta Obstet Gynecol Scand. 2007; 86: 276-282.
13. Elden H, Gutke A, Fagevik-Olsen M, Kjellby-Wendt G, Ostgaard H. Predictors of long-term pelvic girdle pain and its consequences on health and function after pregnancy with a classified PGP: a longitudinal follow-up study. Pain practice. 2016;16:76.
14. Katonis P, Kampouroglou A, Aggelopoulos A, Kakavelakis K, Lykoudis S, Makrigiannakis A, Alpantaki K. Pregnancy-related low back pain. Hippokratia. 2011 Jul;15(3):205-10. PMID: 22435016; PMCID: PMC3306025
15. Liddle SD, Pennick V. Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database Syst Rev 2015; :CD001139.
16. Shiri R, Coggon D, Falah-Hassani K. Exercise for the prevention of low back and pelvic girdle pain in pregnancy: A meta-analysis of randomized controlled trials. Eur J Pain 2018; 22:19.
17. Khalednezhad M., Tavafian S. S., The effect of Exercise Training on Disability due to Low Back Pain in Pregnant Women referred to the Health Centers of Karaj, Iran. IJMPP 2017; V2, N1. P: 223-229.
18. Flack N. A. M. S., Hay-Smith E. J. C., Stringer M. D., Gray A. R., Woodley S. J. Adherence, tolerance and effectiveness of two different pelvic support belts as a treatment for pregnancy-related symphyseal pain - a pilot randomized trial. BMC Pregnancy and Childbirth. 2015;15(1):p. 36.
19. National Guideline Alliance (UK). Management of pelvic girdle pain in pregnancy: Antenatal care: Evidence review U. London: National Institute for Health and Care Excellence (NICE); 2021 Aug. (NICE Guideline, No. 201).
20. Quintero Rodriguez C, Troynikov O. The Effect of Maternity Support Garments on Alleviation of Pains and Discomforts during Pregnancy: A Systematic Review. J Pregnancy. 2019 Aug 1;2019:2163790. doi: 10.1155/2019/2163790. PMID: 31467715; PMCID: PMC6699320
21. Close C, Sinclair M, Liddle SD, et al. A systematic review investigating the effectiveness of Complementary and Alternative Medicine (CAM) for the management of low back and/or pelvic pain (LBPP) in pregnancy. J Adv Nurs 2014; 70:1702.
22. Pennick V, Liddle SD. Interventions for preventing and treating pelvic and back pain in pregnancy. Cochrane Database Syst Rev 2013; :CD001139.
23. Granath AB, Hellgren MS, Gunnarsson RK. Water aerobics reduces sick leave due to low back pain during pregnancy. J Obstet Gynecol Neonatal Nurs 2006; 35:465.
24. Perna A, Ricciardi L, Barone G, Tamburrelli FC, Proietti L, Pola E. Medical management of acute non-specific low back pain: comparison of different medical treatments, one center's retrospective analysis. J Biol Regul Homeost Agents. 2018 Nov-Dec;32(6 Suppl. 1):121-129. PMID: 30644292.
25. Vleeming A, Albert HB, Ostgaard HC, Sturesson B, Stuge B. European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J. 2008 Jun;17(6):794-819. doi: 10.1007/s00586-008-0602-4. Epub 2008 Feb 8. PMID: 18259783; PMCID: PMC2518998.
26. Shah S, Banh ET, Koury K, Bhatia G, Nandi R, Gulur P. Pain Management in Pregnancy: Multimodal Approaches. Pain Res Treat. 2015;2015:987483. doi: 10.1155/2015/987483. Epub 2015 Sep 13. PMID: 26448875; PMCID: PMC4584042.
27. Antonucci R, Zaffanello M, Puxeddu E, Porcella A, Cuzzolin L, Pilloni MD, Fanos V. Use of non-steroidal anti-inflammatory drugs in pregnancy: impact on the fetus and newborn. Curr Drug Metab. 2012 May 1;13(4):474-90. doi: 10.2174/138920012800166607. PMID: 22299823.
28. de Brito Cançado TO, Omais M, Ashmawi HA, Torres ML. Chronic pain after cesarean section. Influence of anesthetic/surgical technique and postoperative analgesia. Rev Bras Anestesiol. 2012 Nov-Dec;62(6):762-74. doi: 10.1016/S0034-7094(12)70177-0. PMID: 23176985.
29. Howell CJ, Dean T, Lucking L, Dziedzic K, Jones PW, Johanson RB. Randomised study of long term outcome after epidural versus non-epidural analgesia during labour. BMJ. 2002 Aug 17;325(7360):357. doi: 10.1136/bmj.325.7360.357. Erratum in: BMJ 2002 Sep 14;325(7364):580. PMID: 12183305; PMCID: PMC117883.
30. Russell R, Dundas R, Reynolds F. Long term backache after childbirth: prospective search for causative factors. BMJ. 1996 Jun 1;312(7043):1384-8. doi: 10.1136/bmj.312.7043.1384a. PMID: 8646094; PMCID: PMC2351110.
31. Wang CH, Cheng KW, Neoh CA, Tang S, Jawan B, Lee JH. Comparison of the incidence of postpartum low back pain in natural childbirth and cesarean section with spinal anesthesia. Acta Anaesthesiol Sin. 1994 Dec;32(4):243-6. PMID: 7894920.
32. Kazdal H, Kanat A, Ozdemir B, Ozdemir V, Guvercin AR. Does the anesthesia technique of cesarean section cause persistent low back pain after delivery? A retrospective analysis. Eur Spine J. 2022 Dec;31(12):3640-3646. doi: 10.1007/s00586-022-07388-4. Epub 2022 Oct 5. PMID: 36197511; PMCID: PMC9533274.
33. Drew MK, Sibbritt D, Chiarelli P. No association between previous Caesarean-section delivery and back pain in mid-aged Australian women: an observational study. Aust J Physiother. 2008;54(4):269-72. doi: 10.1016/s0004-9514(08)70006-0. PMID: 19025507.
34. MacEvilly M, Buggy D. Back pain and pregnancy: a review. Pain. 1996 Mar;64(3):405-414. doi: 10.1016/0304-3959(95)00184-0. PMID: 8783303.
2. Ostgaard HC, Zetherstrom G, Roos-Hansson E, Svanberg B. Reduction of back and posterior pelvic pain in pregnancy. Spine (Phila Pa 1976). 1994; 19: 894-900.
3. 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: 65-70.
4. Carvalho MECC, Lima LC, de Lira Terceiro CA, Pinto DRL, Silva MN, Cozer GA, Couceiro TCM. Lombalgia na gestação [Low back pain during pregnancy. Rev Bras Anestesiol. 2017 May-Jun;67(3):266-270. Portuguese. doi: 10.1016/j.bjan.2016.03.002. Epub 2016 May 21. PMID: 27220735.
5. 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: 416-422.
6. Pool-Goudzwaard AL, Slieker ten Hove MC, Vierhout ME, Mulder PH, Pool JJ, Snijders CJ, Stoeckart R. Relations between pregnancy-related low back pain, pelvic floor activity and pelvic floor dysfunction. Int Urogynecol J Pelvic Floor Dysfunct. 2005 Nov-Dec;16(6):468-74. doi: 10.1007/s00192-005-1292-7. Epub 2005 Apr 1. PMID: 15803285.
7. Sabino J, Grauer JN. Pregnancy and low back pain. Curr Rev Musculoskelet Med. 2008; 1: 137-141.
8. Mens JM, Damen L, Snijders CJ, Stam HJ. The mechanical ef- fect of a pelvic belt in patients with pregnancy-related pelvic pain. Clin Biomech (Bristol, Avon). 2006; 21: 122-127
9. Padua L, Padua R, Bondi R, Ceccarelli E, Caliandro P, D’Amico P, et al. Patient-oriented assessment of back pain in pregnancy. Eur Spine J. 2002; 11: 272-275.
10. Mogren IM. Does caesarean section negatively influence the post-partum prognosis of low back pain and pelvic pain during pregnancy? Eur Spine J. 2007; 16: 115-121.
11. Wuytack F, O'Donovan M. Outcomes and outcomes measurements used in intervention studies of pelvic girdle pain and lumbopelvic pain: a systematic review. Chiropr Man Therap. 2019 Nov 5;27:62. doi: 10.1186/s12998-019-0279-2. PMID: 31700607; PMCID: PMC6829811.
12. Morkved S, Salvesen KA, Schei B, Lydersen S, Bo K. Does group training during pregnancy prevent lumbopelvic pain? A randomized clinical trial. Acta Obstet Gynecol Scand. 2007; 86: 276-282.
13. Elden H, Gutke A, Fagevik-Olsen M, Kjellby-Wendt G, Ostgaard H. Predictors of long-term pelvic girdle pain and its consequences on health and function after pregnancy with a classified PGP: a longitudinal follow-up study. Pain practice. 2016;16:76.
14. Katonis P, Kampouroglou A, Aggelopoulos A, Kakavelakis K, Lykoudis S, Makrigiannakis A, Alpantaki K. Pregnancy-related low back pain. Hippokratia. 2011 Jul;15(3):205-10. PMID: 22435016; PMCID: PMC3306025
15. Liddle SD, Pennick V. Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database Syst Rev 2015; :CD001139.
16. Shiri R, Coggon D, Falah-Hassani K. Exercise for the prevention of low back and pelvic girdle pain in pregnancy: A meta-analysis of randomized controlled trials. Eur J Pain 2018; 22:19.
17. Khalednezhad M., Tavafian S. S., The effect of Exercise Training on Disability due to Low Back Pain in Pregnant Women referred to the Health Centers of Karaj, Iran. IJMPP 2017; V2, N1. P: 223-229.
18. Flack N. A. M. S., Hay-Smith E. J. C., Stringer M. D., Gray A. R., Woodley S. J. Adherence, tolerance and effectiveness of two different pelvic support belts as a treatment for pregnancy-related symphyseal pain - a pilot randomized trial. BMC Pregnancy and Childbirth. 2015;15(1):p. 36.
19. National Guideline Alliance (UK). Management of pelvic girdle pain in pregnancy: Antenatal care: Evidence review U. London: National Institute for Health and Care Excellence (NICE); 2021 Aug. (NICE Guideline, No. 201).
20. Quintero Rodriguez C, Troynikov O. The Effect of Maternity Support Garments on Alleviation of Pains and Discomforts during Pregnancy: A Systematic Review. J Pregnancy. 2019 Aug 1;2019:2163790. doi: 10.1155/2019/2163790. PMID: 31467715; PMCID: PMC6699320
21. Close C, Sinclair M, Liddle SD, et al. A systematic review investigating the effectiveness of Complementary and Alternative Medicine (CAM) for the management of low back and/or pelvic pain (LBPP) in pregnancy. J Adv Nurs 2014; 70:1702.
22. Pennick V, Liddle SD. Interventions for preventing and treating pelvic and back pain in pregnancy. Cochrane Database Syst Rev 2013; :CD001139.
23. Granath AB, Hellgren MS, Gunnarsson RK. Water aerobics reduces sick leave due to low back pain during pregnancy. J Obstet Gynecol Neonatal Nurs 2006; 35:465.
24. Perna A, Ricciardi L, Barone G, Tamburrelli FC, Proietti L, Pola E. Medical management of acute non-specific low back pain: comparison of different medical treatments, one center's retrospective analysis. J Biol Regul Homeost Agents. 2018 Nov-Dec;32(6 Suppl. 1):121-129. PMID: 30644292.
25. Vleeming A, Albert HB, Ostgaard HC, Sturesson B, Stuge B. European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J. 2008 Jun;17(6):794-819. doi: 10.1007/s00586-008-0602-4. Epub 2008 Feb 8. PMID: 18259783; PMCID: PMC2518998.
26. Shah S, Banh ET, Koury K, Bhatia G, Nandi R, Gulur P. Pain Management in Pregnancy: Multimodal Approaches. Pain Res Treat. 2015;2015:987483. doi: 10.1155/2015/987483. Epub 2015 Sep 13. PMID: 26448875; PMCID: PMC4584042.
27. Antonucci R, Zaffanello M, Puxeddu E, Porcella A, Cuzzolin L, Pilloni MD, Fanos V. Use of non-steroidal anti-inflammatory drugs in pregnancy: impact on the fetus and newborn. Curr Drug Metab. 2012 May 1;13(4):474-90. doi: 10.2174/138920012800166607. PMID: 22299823.
28. de Brito Cançado TO, Omais M, Ashmawi HA, Torres ML. Chronic pain after cesarean section. Influence of anesthetic/surgical technique and postoperative analgesia. Rev Bras Anestesiol. 2012 Nov-Dec;62(6):762-74. doi: 10.1016/S0034-7094(12)70177-0. PMID: 23176985.
29. Howell CJ, Dean T, Lucking L, Dziedzic K, Jones PW, Johanson RB. Randomised study of long term outcome after epidural versus non-epidural analgesia during labour. BMJ. 2002 Aug 17;325(7360):357. doi: 10.1136/bmj.325.7360.357. Erratum in: BMJ 2002 Sep 14;325(7364):580. PMID: 12183305; PMCID: PMC117883.
30. Russell R, Dundas R, Reynolds F. Long term backache after childbirth: prospective search for causative factors. BMJ. 1996 Jun 1;312(7043):1384-8. doi: 10.1136/bmj.312.7043.1384a. PMID: 8646094; PMCID: PMC2351110.
31. Wang CH, Cheng KW, Neoh CA, Tang S, Jawan B, Lee JH. Comparison of the incidence of postpartum low back pain in natural childbirth and cesarean section with spinal anesthesia. Acta Anaesthesiol Sin. 1994 Dec;32(4):243-6. PMID: 7894920.
32. Kazdal H, Kanat A, Ozdemir B, Ozdemir V, Guvercin AR. Does the anesthesia technique of cesarean section cause persistent low back pain after delivery? A retrospective analysis. Eur Spine J. 2022 Dec;31(12):3640-3646. doi: 10.1007/s00586-022-07388-4. Epub 2022 Oct 5. PMID: 36197511; PMCID: PMC9533274.
33. Drew MK, Sibbritt D, Chiarelli P. No association between previous Caesarean-section delivery and back pain in mid-aged Australian women: an observational study. Aust J Physiother. 2008;54(4):269-72. doi: 10.1016/s0004-9514(08)70006-0. PMID: 19025507.
34. MacEvilly M, Buggy D. Back pain and pregnancy: a review. Pain. 1996 Mar;64(3):405-414. doi: 10.1016/0304-3959(95)00184-0. PMID: 8783303.
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