Evaluation and Management of Musculoskeletal and Pelvic Disorders of Pregnancy

Gender-specific care of musculoskeletal impairments is an increasingly important topic in women's health. It is estimated that virtually all women experience some degree of musculoskeletal discomfort during pregnancy, and 25% have at least temporarily disabling symptoms. Lower back pain is the most common impairment, affecting 50% of pregnant women. Other common disorders include pelvic pain, upper and lower extremity pain, peripheral neuropathy, and pelvic floor dysfunction. This review provides a guide for appropriate differential diagnosis, evaluation, and management of these regional musculoskeletal and peripheral neurologic disorders that affect women during pregnancy and the postpartum period. To accomplish this, we present the relevant regional musculoskeletal anatomy, the hormonal and biochemical changes of pregnancy, specific conditions and their management, as well as recommendations for exercise and physical therapeutics. The article reviews the current knowledge and evidence-based medical research available on the topic of musculoskeletal diagnoses in pregnancy. Much of the available literature is based on case series and on expert opinion from clinical practice experience. Given the high prevalence of these diagnoses, it is imperative for physicians treating musculoskeletal disorders to be very familiar with appropriate management.