Improved function in women with persistent pregnancy-related pelvic pain after a single corticosteroid injection to the ischiadic spine: A randomized double-blind controlled trial

• Published in: Physiotherapy theory and practice 2013-07, Vol.29 (5), p.371-378
• Main Authors: Torstensson, Thomas, Lindgren, Anne, Kristiansson, Per
• Format: Article
• Language: English
• Subjects: Adrenal Cortex Hormones - administration & dosage; Adult; Anesthetics, Local - administration & dosage; Corticosteroids; Delayed-Action Preparations; Disability Evaluation; Double-Blind Method; Female; Gait - drug effects; Humans; Injections, Spinal; Lidocaine - administration & dosage; Muscle Strength - drug effects; Pain; Pain Measurement; Pelvic pain; Pelvic Pain - diagnosis; Pelvic Pain - drug therapy; Pelvic Pain - physiopathology; Physical Endurance - drug effects; Predictive Value of Tests; Pregnancy; Pregnancy Complications - diagnosis; Pregnancy Complications - drug therapy; Pregnancy Complications - physiopathology; Pregnant women; Recovery of Function; Self Report; Severity of Illness Index; Short term; Sweden; Time Factors; Treatment Outcome; Triamcinolone - administration & dosage; Women
• ISSN: 0959-3985; 1532-5040; 1532-5040
• DOI: 10.3109/09593985.2012.734009

Background: Pregnancy-related low back and pelvic pain is a worldwide problem. A large proportion of women still experience disabling daily back pain 2 years after childbirth, resulting in major changes in activities and general well-being. In spite of this, the source of pain and effective treatment are uncertain. Objective: To evaluate the short-term effects on function of a single corticosteroid injection treatment to the ischiadic spine in women with persistent pregnancy-related pelvic pain (PPPP). Methods: Thirty-six women were allocated to injection treatment with slow-release triamcinolone and lidocain or saline and lidocain, given once at the sacrospinous ligament insertion on the ischiadic spine bilaterally with follow-up at 4 weeks. Outcome measures were Disability Rating Index (DRI), self-rated functional health (SF-36), gait speed and endurance (6MWT), and strength and endurance of trunk muscles (isometric trunk extensor and flexor tests). Results: Women in the triamcinolone group showed significantly improved DRI (p  =  0.046), 6MWT (p  =  0.016), and isometric trunk extensor tests (p  =  0.004), as compared with the saline group. Close co-variation was shown between improved function and reduced pain intensity. Conclusions: Improved function was achieved among women with PPPP after a single injection treatment with slow-release corticosteroid. The effect was positively correlated to the reduced pain intensity.