Abstract
Background: Pain in the lumbar and thoracic spine is common during pregnancy, and can significantly impair function. Vasovagal response has been found in the prenatal population during later stages of pregnancy. Literature describing physical therapy management of thoracic pain and vasovagal episodes in pregnant women has not been identified. The purpose of this case report is to describe the successful physical therapy management of a primigravida with thoracic and lumbar pain and episodes of vasovagal response.
Study Design: This case describes a single-subject design case report.
Case Description: The patient was a 37-year-old primigravida diagnosed with thoracic and lumbar pain, and complaints of dyspnea and dizziness. Physical therapy intervention included manual therapy, therapeutic exercises, relaxation techniques, postural reeducation, body mechanics, and prophylactic self-management of vasovagal symptoms.
Outcomes: At discharge she was free of pain in the thoracic and lumbar spine, and had not had a vasovagal episode in several weeks. All selected outcome measures demonstrated significant improvement. She was discharged during the ninth week of treatment following onset of premature labor.
Discussion: Following a course of physical therapy, the patient demonstrated improved postural awareness, symmetry in the pelvis and ribcage, and proper body mechanics. She was independent with early identification of potential triggers and with prophylactic management of symptoms of vasovagal response. With the assistance of her partner, she was independent with self-management techniques for her pain symptoms. At the final session, she was pain-free in the lumbar and thoracic regions, and had no recurrence of vasovagal symptoms.