From the Guidelines
Musculoskeletal pain with cough in pregnancy should be evaluated with consideration of the patient's overall health, including any pre-existing respiratory or musculoskeletal conditions.
Evaluation Considerations
- A thorough medical history and physical examination are essential to identify any underlying conditions that may be contributing to the musculoskeletal pain and cough, such as skeletal dysplasia or respiratory disorders 1.
- The evaluation should also consider the biomechanical and anatomical factors associated with pregnancy, such as changes in joint laxity and the center of gravity, which can increase the risk of musculoskeletal pain and injury 1.
- For patients with severe respiratory disorders, such as chronic obstructive pulmonary disease or restrictive lung disease, prenatal physical activity may need to be modified or avoided to prevent exacerbation of symptoms and potential harm to the fetus 1.
- In patients with musculoskeletal pain and cough, it is essential to assess for any red flags, such as fever, chest pain, or shortness of breath, which may indicate a more serious underlying condition requiring immediate medical attention.
Management
- The management of musculoskeletal pain with cough in pregnancy should be individualized based on the patient's specific needs and medical history.
- For patients with well-controlled, mild-to-moderate respiratory diseases, regular moderate-intensity prenatal physical activity may be beneficial in reducing the risk of complications and improving overall health 1.
- In patients with skeletal dysplasia or other musculoskeletal conditions, careful attention to pain management and modification of physical activity may be necessary to prevent exacerbation of symptoms and ensure a safe pregnancy and delivery 1.
From the Research
Evaluation of Musculoskeletal Pain with Cough in Pregnancy
- Musculoskeletal pain is a common complaint during pregnancy, with low back pain being the most frequent musculoskeletal symptom 2, 3.
- The evaluation of musculoskeletal pain in pregnancy should consider the physiological and anatomical changes that occur during pregnancy, as well as the potential risks and benefits of different treatment options 4, 5.
- A targeted therapeutic approach is needed to manage musculoskeletal pain in pregnancy, with a focus on non-pharmacological interventions such as exercise, rest, and alternative and complementary methods 4, 6.
- The most common musculoskeletal complaints during pregnancy include low back pain, back pain, hand-wrist pain, and hip pain, with the third trimester being the most common time for these complaints to occur 2.
- Minimal-contact physical interventions, such as education and multimodal home exercises, have been shown to be effective in reducing pain intensity and disability in pregnant women with musculoskeletal disorders 6.
- Conservative management of low back pain in pregnancy is recommended, with physical exercise, minimising activities that exacerbate pain, and analgesics being used to manage symptoms 3.
Musculoskeletal Pain Management
- Exercise and rest are the basis for treating chronic musculoskeletal pain in pregnancy, with side effects of physical therapy being rare and not contraindicated in pregnant women 4.
- Alternative and complementary methods, such as pelvic belts, transcutaneous electrical nerve stimulation, spinal manipulative therapy, acupuncture, and complementary therapy with yoga, have been shown to be safe and effective in managing musculoskeletal pain in pregnancy 6, 3.
- Education and self-management programs can also improve pain intensity, sick leave, and disability in pregnant women with musculoskeletal disorders 6.
Considerations for Evaluation
- The evaluation of musculoskeletal pain in pregnancy should take into account the potential impact on the mother and fetus, with treatment options being chosen to optimize non-pharmacological therapeutic options 4, 3.
- A detailed history and physical examination are necessary to distinguish between different types of musculoskeletal pain and to develop an effective treatment plan 3.
- Healthcare providers should be aware of the various musculoskeletal problems that can occur during pregnancy and be able to provide guidance on safe and effective treatment options 5, 3.