Lumbopelvic Pain and Catastrophizing in Pregnancy

As reported in Physical Therapy, the tendency to catastrophize may not be a stable one, as women demonstrated measurable changes across time during pregnancy and during the postpartum period. Pain catastrophizing, as described in this article, is "...an exaggerated negative orientation toward noxious stimuli." In this research, 242 women were assessed using the Pain Catastrophizing Scale during weeks 19-21, weeks 34-37, and at 6 months postpartum. You can learn more about the Scale by clickinghere. The Disability Rating Index was also utilized at 6 months postpartum to assess physical ability.

What the researchers found is that most of the women (57.9% ) did not catastrophize during any of the test scoring, while 10.3% reported catastrophizing during all test events. The remaining number of women had variable test scores towards pain catastrophizing, and they also reported higher levels of postpartum lumbopelvic pain as well as higher levels of activity restriction when compared to the women who did not catastrophize. Lumbopelvic pain included self-reported pain in the low back, anterior or posterior pelvis.

The authors point out that other research has correlated catastrophizing about labor with increased pain intensity during labor, and decreased social functioning and physical ability in the postpartum period. While other studies mentioned have reported a consistent response towards catastrophizing, this study identifies variation in catastrophizing that occurs for some women over the course of pregnancy.

Regarding the clinical implications of this research, the authors conclude that the study design does not allow for prediction of disability based on catastrophizing scores. It may be useful, however, to identify women who are catastrophizing their pain during pregnancy so that interventions may be offered. The authors of this study refer to interventions such as cognitive behavioral therapy, education, exercise, and treatment related to physical activity as ways to minimize physical disability. Certainly with the challenges a new mother faces, decreasing any potential physical limitations and improving social functioning would help in encouraging a healthier postpartum period.