Journal of Manipulative and Physiological Therapeutics
Volume 32, Issue 8 , Pages 616-624 , October 2009

Outcome of Pregnancy-Related Lumbopelvic Pain Treated According to a Diagnosis-Based Decision Rule: A Prospective Observational Cohort Study

  • Donald R. Murphy, DC

      Affiliations

    • Clinical Director, Rhode Island Spine Center, Pawtucket, Rhode Island
    • Clinical Assistant Professor, Department of Community Health, Warren Alpert Medical School of Brown University, Providence, Rhode Island
    • Adjunct Associate Professor, Department of Research, New York Chiropractic College, Seneca Falls, NY
    • Corresponding Author InformationSubmit requests for reprints to: Donald R. Murphy, DC, Rhode Island Spine Center, 600 Pawtucket Avenue, Pawtucket, RI 02860
  • ,
  • Eric L. Hurwitz, DC, PhD

      Affiliations

    • Associate Professor of Epidemiology, Department of Public Health Sciences and Epidemiology, John A. Burns School of Medicine, University of Hawaii, Manoa, Hawaii
  • ,
  • Ericka E. McGovern, DC

      Affiliations

    • Staff Chiropractic Physician, Rhode Island Spine Center, Pawtucket, Rhode Island

Received 28 March 2008 ,Revised 20 February 2009 ,Accepted 6 April 2009.

References 

  1. Wang SH, 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
  2. Rost C, Jacqueline J, Kaiser A, Verhagen AP, Koes BW. Pelvic pain during pregnancy. Spine. 2004;29:2567–2572
  3. Padua L, Caliandro P, Aprile I, Pazzaglia C, Padua R, Calistri A, et al. Back pain in pregnancy: 1-year follow-up of untreated cases. Eur Spine J. 2005;14:151–154
  4. Skaggs C, Nelson M, Prather H, Gross G. Documentation and classification of musculoskeletal pain in pregnancy. J Chiropr Educ. 2004;18:83–84
  5. Borg-Stein J, Gruber J, Dugan S. Musculoskeletal aspects of pregnancy. Am J Phys Med Rehabil. 2005;84:180–192
  6. Diakow PRP, Gadsby TA, Gadsby JB, Gleddie JG, Leprich DL, Scales AM. Back pain during pregnancy and labor. J Manipulative Physiol Ther. 1991;14:116–118
  7. Noren L, Ostgaard S, Johansson G, Ostgaard HC. Lumbar back and posterior pelvic pain during pregnancy: a 3-year follow-up. Eur Spine J. 2002;11:267–271
  8. Murphy DR, Hurwitz EL. A theoretical model for the development of a diagnosis-based clinical decision rule for the management of patients with spinal pain. BMC Musculoskelet Disord. 2007;8:75
  9. Murphy DR, Hurwitz EL, Gregory AA, Clary R. A nonsurgical approach to the management of patients with cervical radiculopathy: a prospective observational cohort study. J Manipulative Physiol Ther. 2006;29:279–287
  10. Murphy DR, Hurwitz EL, Gregory AA, Clary R. A non-surgical approach to the management of lumbar spinal stenosis: a prospective observational cohort study. BMC Musculoskelet Disord. 2006;7:16
  11. Murphy DR, Hurwitz EL, McGovern EE. A nonsurgical approach to the management of lumbar radiculopathy secondary to disc herniation: a prospective observational cohort study. In:  Haldeman S,  Maltezopoulos V,  Phillips R editor. Proceedings of the World Federation of Chiropractic 9th Biennial Congress; 2007. Vilamoura, Portugal: World Federation of Chiropractic; 2007;p. 167–168
  12. McWilliams GD, Hill MJ, Dietrich CS. Gynecologic emergencies. Surg Clin North Am. 2008;88:265-83, vi.
  13. Young S, Aprill C, Laslett M. Correlation of clinical examination characteristics with three sources of chronic low back pain. Spine J. 2003;3:460–465
  14. McKenzie RA, May S. The lumbar spine: mechanical diagnosis and therapy. 2nd ed.. Waikenae (NZ): Spinal Publications; 2003;
  15. Laslett M, Aprill CN, McDonald B, Oberg B. Clinical predictors of lumbar provocation discography: a study of clinical predictors of lumbar provocation discography. Eur Spine J. 2006;15:1473–1484
  16. Laslett M, Young SB, Aprill CN, McDonald B. Diagnosing painful sacroiliac joints: a validity study of a McKenzie evaluation and sacroiliac provocation tests. Aus J Physiother. 2003;49:89–97
  17. Laslett M, Aprill CN, McDonald B, Young SB. Diagnosis of sacroiliac joint pain: validity of individual provocation tests and composites of tests. Man Ther. 2005;10:207–218
  18. Laslett M, McDonald B, Aprill CN, Tropp H, Oberg B. Clinical predictors of screening lumbar zygopophyseal joint blocks: development of clinical prediction rules. Spine J. 2006;6:370–379
  19. Lurie J. What diagnostic tests are useful for low back pain?. Best Pract Res Clin Rheumatol. 2005;19:557–575
  20. Shacklock M. Clinical neurodynamics. a new system of musculoskeletal treatment. Edinburgh: Elsevier; 2005;
  21. Simons DG. Diagnostic criteria of myofascial pain caused by trigger points. J Musculoskel Pain. 1999;7:111–120
  22. Panjabi MM. A hypothesis of chronic back pain: ligament subfailure injuries lead to muscle control dysfunction. Eur Spine J. 2006;15:668–676
  23. Murphy D, Byfield D, McCarthy P, Humphreys K, Gregory A, Rochon R. Interexaminer reliability of the hip extension test for suspected impaired motor control of the lumbar spine. J Manipulative Physiol Ther. 2006;29:374–377
  24. Hicks GE, Fritz JM, Delitto A, Mishock J. Interrater reliability of clinical examination measures for identification of lumbar segmental instability. Arch Phys Med Rehabil. 2003;84:1858–1864
  25. Mens JMA, Vleeming A, Snijders CJ, Stam HJ. Active straight leg raising test: a clinical approach to the load transfer function of the pelvic girdle. In:  Vleeming A,  Mooney V,  Snijders CJ,  Dorman TA,  Stoeckart R editor. Movement, stability and low back pain the essential role of the pelvis. New York: Churchill Livingstone; 1997;p. 425–431
  26. Woolf CJ, Salter MW. Neuronal plasticity: increasing the gain in pain. Science. 2000;288:1765–1768
  27. Fishbain DA, Cole B, Cutler RB, Lewis J, Rosomoff HL, Rosomoff RS. A structured evidence-based review on the meaning of nonorganic physical signs: Waddell signs. Pain Med. 2003;4:141–181
  28. Boersma K, Linton S. Psychological processes underlying the development of a chronic pain problem. A prospective study of the relationship between profiles of psychological variables in the fear-avoidance model and disability. Clin J Pain. 2006;22:160–166
  29. Waddell G, Newton M, Henderson I, Somerville D, Main CJ. A fear-avoidance beliefs questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain. 1993;52:157–168
  30. Gudavalli MR, Cox JM, Cramer GD, Baker JA, Patwardhan AG. Intervertebral disc pressure changes during a chiropractic procedure. BED- Adv Bioeng. 1997;36:215–216
  31. Gudavalli MR, Cambron JA, McGregor M, et al. A randomized clinical trial and subgroup analysis to compare flexion-distraction with active exercise for chronic low back pain. Eur Spine J. 2006;15:1070–1082
  32. Bronfort G, Haas M, Evans R, Kawchuk G, Dagenais S. Evidence-informed management of chronic low back pain with spinal manipulation and mobilization. Spine J. 2008;8:213–225
  33. Simons DG, Travell JG, Simons LS. Myofascial pain and dysfunction: the trigger point manual. vol 1. Baltimore: Williams and Wilkens; 1999;
  34. Richardson C, Jull G, Hodges P, Hides J. Therapeutic exercise for spinal segmental stabilization in low back pain. Scientific basis and clinical approach. Edinburgh: Churchill Livingstone; 1999;
  35. McGill S. Low back disorders. Evidence-based prevention and rehabilitation. Champaign (Ill): Human Kinetics; 2002;
  36. Staal JB, Hlobil H, Twisk JWR, Smid T, Koke AJA, van Mechelen W. Graded activity for low back pain in occupational health care. Ann Int Med. 2004;140:77–84
  37. Smeets R, Vlaeyen J, Kester A, Knottnerus J. Reduction of pain catastrophizing mediates the outcome of both physical and cognitive-behavioral treatment in chronic low back pain. J Pain. 2006;7:261–271
  38. Bolton JE, Breen AC. The Bournemouth Questionnaire. A short-form comprehensive outcome measure I: Psychometric properties in back pain patients. J Manipulative Physiol Ther. 1999;22:503–510
  39. Farrar JT, Young JP, LaMoreaux L, Werth JL, Poole RM. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001;94:149–158
  40. Hurst H, Bolton J. Assessing the clinical significance of change scores recorded on subjective outcome measures. J Manipulative Physiol Ther. 2004;27:26–35
  41. Sapsford R. Rehabilitation of pelvic floor muscles utilizing trunk stabilization. Man Ther. 2004;9:3–12
  42. Salvesen KA, Morkved S. Randomised controlled trial of pelvic floor muscle training during pregnancy. BMJ. 2004;329:378–380
  43. Lindstrom I, Ohlund C, Eek C, et al. The effect of graded activity on patients with subacute low back pain: a randomized prospective clinical study with an operant-conditioning behavioral approach. Phys Ther. 1992;72:279–290[discussion 91-3]
  44. Pennick VE, Young G. Interventions for preventing and treating pelvic and back pain in pregnancy. Cochrane Database Syst Rev. 2007;CD001139
  45. Ostgaard HC, Roos-Hansson E, Zetherstrom G. Regression of back and posterior pelvic pain after pregnancy. Spine. 1996;21:894–900
  46. Gutke A, Ostgaard HC, Oberg B. Pelvic girdle pain and lumbar pain in pregnancy: a cohort study of the consequences in terms of health and functioning. Spine. 2006;31:E149–E155
  47. Wu WH, Meijer OG, Mens JMA, van Dieen JH, Wuisman PIJM, Ostgarrd HC. Pregnancy-related pelvic girdle pain (PPP) I: terminology, clinical presentation and prevalence. Eur Spine J. 2004;13:575–589
  48. Senstad O, Leboeuf-Yde C, Borchgrevink C. Frequency and characteristics of side effects of spinal manipulative therapy. Spine. 1997;22:435–441
  49. Hurwitz EL, Morgenstern H, Vassilaki M, Chiang LM. Adverse reactions to chiropractic treatment and their effects on satisfaction and clinical outcomes among patients enrolled in the UCLA neck pain study. J Manipulative Physiol Ther. 2004;27:16–25
  50. Carey TS, Boden SD. A critical guide to case series reports. Spine. 2003;28:1631–1634
  51. Lisi AJ. Chiropractic spinal manipulation for low back pain of pregnancy: A retrospective case series. J Midwifery Womens Health. 2006;51:7–10
  52. Murphy DR, Hurwitz EL, McGovern EE. A nonsurgical approach to the management of lumbar radiculopathy secondary to disc herniation: a prospective observational cohort study with long term follow up. Spine J. 2008;8:161S

 Second prize at the 2008 ACC.

PII: S0161-4754(09)00238-3

doi: 10.1016/j.jmpt.2009.09.002

Journal of Manipulative and Physiological Therapeutics
Volume 32, Issue 8 , Pages 616-624 , October 2009