Back and pelvic girdle pain from prepregnancy to postpartum: a new pain tracking method considering pain intensity and chronological patterns.

PURPOSE: To identify differences in severe pain levels during prepregnancy to four months postpartum among groups along with risk factors for residual pain early in pregnancy.

METHODS

We examined 298 patients who participated in the questionnaire. Pain intensity was evaluated using a numerical rating scale (NRS) monthly postpartum. Four patterns emerged: recovery group (n = 200), with NRS 0-3 at 4 months postpartum; keep-high group (n = 20), with NRS ≥ 6 every month after delivery; worse group (n = 28), where NRS increased ≥ 3 during months 1-4; and mixed group (n = 50). Age, body mass index (BMI), history of back pain, breastfeeding, feeding posture, depression, and postpartum stress factors were compared.

RESULTS

Overall, 15% patients had pain with NRS ≥ 4 before pregnancy and 33% at 4 months postpartum. NRS score of the keep-high group was the highest (4.18) before pregnancy, with a distinctive pain pattern. For participants with NRS ≥ 4 before pregnancy, the odds ratio of NRS ≥ 7 in the final month was 5.56 [95% confidence interval: 2.52-12.58, p < 0.001]. All three groups compared with the recovery group demonstrated significant differences in the questionnaires for depression (p < 0.01) and postpartum stress factors (p < 0.05). The combination of lower back and back pain was an early indicator of severe postpartum pain.

CONCLUSION

Higher NRS scores before pregnancy and at multiple pain sites are early indicators of severe postpartum pain. All three groups, except the recovery group, showed a tendency for depression. However, the mixed group exhibited features similar to the recovery group.