Study of the possibility of osteopathic correction inclusion in the complex therapy of pelvic pain syndrome in women at the late postpartum period

Abstract

Introduction. Pain during childbirth and pain after childbirth are unavoidable. Most often, the occurrence of pelvic pain syndrome after childbirth is associated with the manifestation of physiological changes in the joints and bones of the pelvis during pregnancy and during childbirth. The musculoskeletal system of a woman after childbirth passes to normal functioning gradually, and some stages of this process may be accompanied by pain syndrome of various localization and severity. In the late postpartum period and during lactation, non-drug treatment of pain syndrome is preferable. One of the promising non-drug approaches may be the timely application of osteopathic correction methods. However, the available scientific literature presents relatively few studies on the possibility of osteopathic methods using for the pelvic pain syndrome correction in women at the postpartum period.The aim of the study was to research the possibility of osteopathic correction inclusion in the complex therapy of pelvic pain syndrome in women at the late postpartum period.Materials and methods. A group of women after physiological childbirth was randomly formed homogeneous by age, parity of childbirth. The study involved 40 primiparous women aged 30–40 years with no organic diseases, and with the presence of pelvic pain syndrome, which first appeared in the late postpartum period (2–8 weeks after physiological birth through the natural birth canal). Two groups were formed by the randomization envelopes method: the main group (20 participants) and the control group (20 participants). In both groups, the patients received therapy in the form of applications of anesthetic ointments (gels), the use of the Lyapko applicator, elements of therapeutic physical culture (static gymnastic exercises in the supine position). Patients of the main group additionally received osteopathic correction (3 sessions with an interval of 10–14 days). Before and after treatment, osteopathic status, quality of life according to the MOS-SF-36 questionnaire, and intensity of pain syndrome according to the visual analog scale (VAS) were assessed in both groups.Results. Prior to the treatment start in the both groups, patients had biomechanical disorders of the neck region (structural component — in 50 % of the participants in the main group and 40 % of the control group), thoracic region (structural component — in 55 and 60 %, respectively), lumbar region (structural component — 95 and 55 %, and the visceral component — 45 and 20 %), the pelvic region (structural component — 100 and 95 %). In the main group, regional biomechanical disorders of the pelvic region were also detected, the visceral component — in 50 % of the participants. After the treatment, the patients of both groups had no regional biomechanical disorders of the thoracic region (structural component), the lumbar region (visceral component), and the pelvic region (visceral component). In the main group, in addition, there was a statistically significant (p<0,05) positive dynamics in relation to dysfunctions of the neck region (structural component), lumbar region (structural component), pelvic region (structural component). The groups began to differ significantly (p<0,05) in relation to the following regional disorders: lumbar region (structural component) and pelvic region (structural component). At the study start, the participants in the both groups were characterized by low quality of life, assessed by SF-36, and severe pain by VAS. After the treatment in both groups, there were statistically significant (p<0,05) positive dynamics in all of the above indicators: the pain syndrome severity decreased, and the life quality indicators increased; and in the main group the results were statistically significantly (p<0,05) more pronounced.Conclusion. Based on the obtained results, it is possible to recommend the inclusion of osteopathic correction in the complex therapy of pelvic pain syndrome in women at the late postpartum period. But also it is recommended to continue the study with the involvement of a larger number of participants.