From the Guidelines
Joint Pains Postpartum Causes
The primary cause of joint pains postpartum is not explicitly stated in the provided evidence, but it can be inferred that hormonal changes, physical stress, and inflammation may contribute to joint pain after childbirth 1.
Potential Causes
- Hormonal fluctuations: The sudden drop in estrogen and progesterone levels after delivery can lead to joint pain and inflammation.
- Physical stress: Childbirth can cause physical stress on the joints, particularly in the pelvis, hips, and lower back.
- Inflammation: The postpartum period can be associated with inflammation, which can contribute to joint pain.
Evidence Limitations
The provided evidence primarily focuses on patient-reported outcome measures for postpartum pain, rather than the causes of joint pain specifically 1. However, it can be inferred that the causes of joint pain postpartum are multifactorial and may involve a combination of hormonal, physical, and inflammatory factors.
Clinical Implications
In clinical practice, identifying the underlying cause of joint pain is crucial for effective management. A thorough medical history, physical examination, and diagnostic tests may be necessary to determine the cause of joint pain postpartum. Treatment options may include pain management medications, physical therapy, and lifestyle modifications to reduce inflammation and promote joint health.
From the Research
Causes of Joint Pains Postpartum
The causes of joint pains postpartum can be attributed to various factors, including:
- Hormonal changes, such as the release of relaxin and estrogen, which can cause symphysiolysis and lead to pelvic girdle pain 2
- Biomechanical mechanisms, such as increased weight, change in posture, and increased abdominal and intrauterine pressure, which can cause sacroiliac joint dysfunction 2
- Pelvic girdle pain (PGP), which can affect almost half of all pregnant women and may persist for up to two years postpartum 2, 3
- Rheumatoid arthritis (RA) and other chronic arthritides, which may have an increased onset postpartum 4
Specific Joint-Related Issues
Specific joint-related issues that may contribute to postpartum joint pain include:
- Sacroiliac joint dysfunction, which can be caused by increased mobility and laxity of the spine and pelvic structures 2
- Symphysiolysis, which can cause pain in the pubic symphysis and may be related to hormonal changes 2, 3
- Pelvic girdle syndrome, which can cause pain in all three pelvic joints and may have a worse prognosis than other classification groups 3
Prevalence and Prognosis
The prevalence and prognosis of postpartum joint pain can vary depending on the specific condition and classification group, with:
- Around 8-10% of women with PGP continuing to experience pain for up to two years postpartum 2
- The majority (62.5%) of women in the four classification groups experiencing disappearance of pain within a month after delivery 3
- Persistence of pain varying significantly from one classification group to another, with pelvic girdle syndrome having a markedly worse prognosis than other groups 3