Improved function in women with persistent pregnancy-related pelvic pain after a single corticosteroid injection to the ischiadic spine: A randomized double-blind controlled trial

Background: Pregnancy-related low back and pelvic pain is a worldwide problem. A large proportion of women still experience disabling daily back pain 2 years after childbirth, resulting in major changes in activities and general well-being. In spite of this, the source of pain and effective treatment are uncertain. Objective: To evaluate the short-term effects on function of a single corticosteroid injection treatment to the ischiadic spine in women with persistent pregnancy-related pelvic pain (PPPP). Methods: Thirty-six women were allocated to injection treatment with slow-release triamcinolone and lidocain or saline and lidocain, given once at the sacrospinous ligament insertion on the ischiadic spine bilaterally with follow-up at 4 weeks. Outcome measures were Disability Rating Index (DRI), self-rated functional health (SF-36), gait speed and endurance (6MWT), and strength and endurance of trunk muscles (isometric trunk extensor and flexor tests). Results: Women in the triamcinolone group showed significantly improved DRI (p = 0.046), 6MWT (p = 0.016), and isometric trunk extensor tests (p = 0.004), as compared with the saline group. Close co-variation was shown between improved function and reduced pain intensity. Conclusions: Improved function was achieved among women with PPPP after a single injection treatment with slow-release corticosteroid. The effect was positively correlated to the reduced pain intensity.