The epidemiology of postpartum low back pain within the eThekwini Municipality area

Abstract

Background

Previous investigations into the epidemiology of low back pain (LBP) in South Africa were limited to various ethnic groups, student population and work-related activities. There have been many international studies on postpartum low back pain experienced by females which have shown varied results, largely attributed to the various time frames and risk factors. Consequently, there has been a remarkable increase in the use of epidural anaesthesia during delivery.

Aim

The aim of this study was to determine the prevalence of, and risk factors for, postpartum low back pain within the eThekwini Municipality.

Method

A quantitative paradigm and a cross sectional epidemiological design was used to survey 384 postpartum females in selected areas within the eThekwini Municipality, having 128 participants in each of the three suburbs (high-, medium- and low-income areas). A pre-validated questionnaire was used to collect data from the females who agreed to participate. The survey contained questions related to low back pain, pregnancy, socio-demographic, psycho-social, lifestyle and occupational factors. The data was analysed using the Statistical Program for the Social Sciences (SPSS) version 24.0.

Results

The prevalence of LBP was recorded as follows: Of the entire population a 41.1% prevalence for postpartum low back pain was reported, with 54.7% at La Lucia municipal clinic (high-income region), 36.7% at Bluff municipal clinic (low-income region) and 32% at Overport municipal clinic (middle-income region). 57% of the

participants who experienced postpartum LBP reported that it had an effect on their daily tasks with 62% stating that the pain presented with a slow/gradual onset. The most common type of pain was described as “sharp/poking” with “dull ache” being the second most common. Non-progression of LBP was reported by 46% of participants, while 26% reported a decrease in pain, 18% noted an increase in pain and 10% were unsure. 28% of the participants noted that the individual episodes of pain they experienced were usually 60 minutes or longer. The population group was split almost uniformly in quarters with regards to how frequently the individual pain episodes occurred i.e.: daily (23%), twice a week (24%), weekly (26%) and monthly (27%). A logistic regression model was fitted in order to establish which variables are associated with lower back pain. The significant variables (p<0.05) were stress levels, type of birth, clinic, race and whether lower back pain was experienced before pregnancy.

Conclusion

More studies are warranted on this group of individuals as the factors associated with the predisposition of postpartum LBP were in some instances not in keeping with the existing literature. Postpartum LBP has a significant impact on females and their quality of life and therefore effective strategies to prevent and manage postpartum LBP in females are obligatory.