Abstract
Background and Purpose: Developing low back pain while pregnant is very common. Risk factors for developing pregnancy-related low back pain include pre-pregnancy activity level, history of low back pain prior to pregnancy and during previous pregnancies, and number of previous pregnancies. Exercise has been shown to lessen the degree of pregnancy-related low back pain; however, many women still do not partake in exercise while pregnant. The purpose of this case report is illustrate the effects of a physical therapy treatment program that integrated Pilates in order to enhance treatment outcomes in a pregnant female with low back pain. Case Description: The patient was a 34-year-old female that was 21 weeks pregnant with her fourth child. She presented to physical therapy with recent onset of low back pain. This patient had a history of chronic low back pain that had been managed well in the past with physical therapy. At the time of the initial evaluation, the patient presented with bilateral radiating leg pain, reporting intensity of low back pain and leg pain as 7 to 8/10. The patient reported having the greatest difficulty with walking, transitional movements, sitting, standing, reaching, twisting, lifting, and rolling in bed. Outcome measures included the modified Oswestry Low Back Pain Disability Questionnaire and the numeric pain rating scale. Treatment interventions included myofascial manipulation, body mechanics, muscle energy techniques, joint mobilization, range of motion, Pilates core stabilization exercises, and core strengthening exercises for a period of 7 weeks. Outcomes: The Modified Oswestry score improved from 84% to 22%, and the numeric pain rating scale improved from 7 to 8/10 to 2/10. After completing five physical therapy treatment sessions, the patient demonstrated an improved gait pattern and was able to return to work. Discussion: This case report has shown how a multi-modal physical therapy treatment that incorporated manual therapy, core strengthening, and core stabilization using Pilates exercise was used to decrease pain and improve function in a 34-year-old pregnant female with a one-week history of acute low back pain. Further research is warranted to investigate the effects of incorporating Pilates based exercises in the management of pregnancy related low back pain.