Lumbopelvic Pain, Pregnancy, & the Yoga Method

Lumbopelvic pain is a common diagnosis in pregnancy that can be challenging for both the patient and the provider. A recent study assessed the effectiveness of 10 weeks of Hatha yoga in women between 12-32 weeks of gestation. 60 pregnant women ages 14-40 were divided into two groups, with the intervention group being guided in yoga exercises, and the control group instructed in postural activities. Nine pregnant women in the yoga group and six women in the control group were lost to withdrawal, obstetric complications, or refusal to participate. Excluded were women with twin pregnancies, medical restrictions, women using analgesics or those participating in physical therapy. Outcomes included a Visual Analog Scale (VAS) to measure pain intensity, and tests of lumbar and posterior pelvic pain. Lumbar provocation tests used in the study included trunk flexion and circumduction, paraspinal muscle palpation, and pelvic tests included the posterior pelvic pain provocation test.

Yoga intervention included weekly one hour sessions including 34 poses. The sessions focused on, in this order, breathing and joint warm-ups (10 minutes), poses and breathing exercises (40 minutes), and meditation and relaxation (10 minutes.) Pain intensity was assessed at the beginning and end of each session. Control group participants were instructed in typical postural changes during pregnancy as well as suggested postural support for various positions.

Results of the research include lower pain scores in the yoga group, with the authors concluding that yoga is an effective intervention for women who have pelvic girdle pain in pregnancy. A final VAS score of no pain, or "0" was reported in 71% of the yoga group and in 21% of the control group. The women in this study also reported emotional benefits of tranquility, lowered stress, "an easy mind," mental balance, and increased sense of closeness to the baby. While the lumbar provocation tests improved in both groups in response to intervention, pelvic girdle provocation tests remained positive in both groups at conclusion of the study even in those who had lowered pain scores.

This brings up interesting questions about the nature of the causative factors for the patient's pain. Also of interest is that in the control, or "postural orientation" group, lumbar provocation tests were improved even when reports of pain were not noted. You can discuss this research and more at the upcoming Yoga for Pelvic Pain course taking place in California in March with Dustienne Miller, yoga therapist and physical therapist.