Abstract
Background: Pregnancy-related low back pain is common during pregnancy and can result in functional impairment. There is a lack of literature describing the diagnosis and management of lumbar instability in this patient population. The purpose of this case report is to describe the physical therapy differential diagnosis and management of pregnancy-related low back pain due to lumbar instability.
Study Design: A single-subject case report.
Case Description: This case highlights the physical therapy examination, intervention, and outcomes of a 32-year-old, 26 weeks' gestation, complaining of low back pain. Information gathered from the history and administration of special tests played a vital role in the identification of lumbar instability as the underlying cause of the patient's symptoms. The plan of care included patient education, specific static and dynamic spinal stabilization exercises, and gentle graded mobilization.
Outcomes: After 12 physical therapy visits and a daily home exercise program, the patient reported a 0/10 pain on the Numeric Pain Rating Scale and scored a 5/50 on the Oswestry Disability Index. She was able to tolerate prolonged sitting and standing at work without experiencing pain. She was discharged with instructions to continue her exercises at home.
Discussion: Lumbar instability should remain among the musculoskeletal differential diagnosis as a source of low back pain during pregnancy. In addition, early intervention consisting of patient education, spinal stabilization exercises, and gentle mobilization is effective in managing symptoms and preventing future complications.