Eur Spine J. 2025 Jun 4. doi: 10.1007/s00586-025-08954-2. Online ahead of print.
ABSTRACT
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.
PMID:40464933 | DOI:10.1007/s00586-025-08954-2
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