Pregnancy-Related Musculoskeletal Pain: Current Management, Influence on Biopsychosocial Health, and Patient-Reported Satisfaction With Care

IMPORTANCE: Musculoskeletal (MSK) pain is common during pregnancy but referral rates to physical therapy and the influence of MSK pain management on satisfaction with prenatal care are unknown. OBJECTIVE: The objective was to obtain patient reports of pain during pregnancy, its impact on biopsychosocial wellbeing, health care management of pain (including referral to physical therapy), and the influence of pain management on satisfaction with prenatal care. DESIGN: The study design was an internet survey. SETTING: An e-survey was distributed internationally via social media, word-of-mouth, and flyers. PARTICIPANTS: Six hundred seventy-one female respondents from 6 continents who had given birth <25 months before survey completion participated in the study. INTERVENTIONS OR EXPOSURES: No interventions or exposures were included in this study. MAIN OUTCOMES & MEASURES: Presence and description of pain, influence of pain on daily life, pain management, birth experiences, and patient satisfaction were reported. Descriptive statistics were used to report frequencies. Comparisons between care provider types were made using non-parametric statistics (Fisher Exact Test, 2-tailed; or Fisher-Freedman-Halton Exact Test, 2-tailed). RESULTS: MSK pain was reported by 90% of participants, with more than 50% reporting pain in multiple body regions. Those who saw an Obstetrician-gynecologist were more likely to report pain, though both provider groups had high pain rates (92.7% vs 85%). Thermal therapy was the most common pain management recommendation (33.7%); physical therapy was recommended to only 29.4% of individuals with pregnancy-related musculoskeletal pain. Pain caused negative feelings/emotions in 77.2% of respondents and difficulty with performance of physical activity, household, and childcare tasks in approximately 50% of respondents. Care providers' response to pain influenced patient satisfaction in 49% of respondents. CONCLUSIONS AND RELEVANCE: Pregnancy MSK pain influences physical functioning, psychosocial wellbeing, and satisfaction with prenatal care. Patients report poor pain management by perinatal care providers, highlighting needs for better education, more pain management options, and multidisciplinary care. Physical therapists need to develop working relationships with prenatal care providers to improve care during pregnancy.