HIP, KNEE, AND FOOT PAIN DURING PREGNANCY AND THE POSTPARTUM PERIOD

Background. Although much has been written about low back pain during pregnancy, there are few studies regarding leg, foot, and hip pain. Th e purpose of this study was to investigate the prevalence and characte rize the nature of lower extremity pain in women of child-bearing age and to assess the impact of recent pregnancy on these symptoms. Method s. In this case-control study, 107 consecutive postpartum women (case subjects) and 91 nulliparous women (controls) completed a questionnair e regarding hip, knee, and foot pain and potentially influencing facto rs. Results. Postpartum subjects had more symptoms of leg and foot pai n than did the controls (56% vs 37%; odds ratio [OR] = 2.3; 95% confid ence interval [CI], 1.2 to 4.7). A significant majority of pain (82%, P < .05) began during the second and third trimesters. Postpartum subj ects also had a significantly higher prevalence of hip pain (38% vs 23 %; OR = 3.2; 95% CI, 1.4 to 7.0) and foot pain (31% vs 22%; OR = 2.2; CI, 1.1 to 4.5). History of previous pain complaints also vi ere found to be risk factors for lower extremity pain during pregnancy for case subjects and in the past year for controls. There was a trend toward older age as a risk factor as well. Multiple pain complaints were more common among case subjects than among controls. Conclusions. Lower ex tremity pain is common in women of childbearing age. Pregnant and post partum women are more likely to develop new lower extremity symptoms t han are nulliparous women. The timing of symptom onset in mid- to late pregnancy may suggest that biomechanical factors play a larger role t han hormonal influences. Regular exercise appears to be neither protec tive against nor a risk factor for lower extremity pain during pregnan cy.