The Efficacy of Cryotherapy in Pregnancy Related Pelvic Girdle Pain

Overview

The findings from this project may result in pain reduction and improved mobility in pregnant women with pelvic girdle pain in their second and third trimester.

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: January 1, 2025

Detailed Description

The primary objective of this unblinded randomized controlled trial is to determine whether superficial cryotherapy results in improved Numeric Pain Rating Scale (NPRS) scores among pregnant women with posterior pelvic girdle pain. The investigators hypothesize that superficial cryotherapy, in addition to receipt of an educational pamphlet, will result in improved NPRS scores compared to receipt of an educational pamphlet alone. This study will include English-speaking pregnant women presenting to Loyola University Medical Center obstetrics or rehabilitation clinics in their second or third trimester with posterior pelvic girdle pain, defined as an NPRS score > 2 onset within the past 3 months and pain experienced between the posterior iliac crest and the gluteal fold, particularly in the vicinity of the sacroiliac joints (SIJ). The pain may radiate in the posterior thigh and can also occur in conjunction with/or separately in the [pubic] symphysis. NPRS scores will be measured as a continuous, numerical integer ranging from a value of 0 (No pain) to a value of 10 (Worst possible pain).

Interventions

  • Other: Cryotherapy
    • intervention group will receive a 20-minute topical cryotherapy treatment (using Medline Deluxe Cold Pack) The education portion will consist of a handout that will be provided to each patient describing specific exercises. These exercises include descriptive information along with pictures on ways to improve posture and protect the lower back in pregnancy good posture
  • Other: Education
    • The education portion will consist of a handout that will be provided to each patient describing specific exercises. These exercises include descriptive information along with pictures on ways to improve posture and protect the lower back in pregnancy good posture

Arms, Groups and Cohorts

  • Experimental: cryotherapy + education
    • intervention group will receive a 20-minute topical cryotherapy treatment (using Medline Deluxe Cold Pack) The education portion will consist of a handout that will be provided to each patient describing specific exercises. These exercises include descriptive information along with pictures on ways to improve posture and protect the lower back in pregnancy good posture
  • Active Comparator: education alone
    • The education portion will consist of a handout that will be provided to each patient describing specific exercises. These exercises include descriptive information along with pictures on ways to improve posture and protect the lower back in pregnancy good posture

Clinical Trial Outcome Measures

Primary Measures

  • Change in pelvic girdle pain using the Numeric Pain Rating Scale
    • Time Frame: On day 6
    • The change in the Numeric Pain Rating Scale (NPRS) from baseline to day 6 (i.e., the delta value of NPRS) will be compared between the two groups. NPRS scores range from 0 (no pain) to 10 (worst possible pain).
  • Change in pelvic girdle pain using the Pelvic Girdle Questionnaire
    • Time Frame: On day 6
    • The change in the the Pelvic Girdle Questionnaire (PGQ) from baseline to day 6 (i.e., the delta value of PGQ) will be compared between the two groups. The PGQ measures problems with carrying out daily activities and ranges from 0 (no problem at all) to 100 (experiences problems to a large extent).

Participating in This Clinical Trial

Inclusion Criteria

  • English speaking pregnant women presenting in their second or third trimester with acute posterior PGP (occurring within the last 3 months). Trimester will be determined from the date of last menses or ultrasound date. – Current VAS pain score between 2-4 – Written informed consent Exclusion Criteria:

  • Non-English speaking pregnant women <18 or >50 years old – Women presenting with low back pain, or posterior pelvic pain in the first trimester (<13 weeks gestation). – Women with acute low back pain in 2nd and 3rd trimester – Women with anterior pelvic girdle pain (pubic symphysis) alone – Chronic low back pain (current or past history, defined as > 6 weeks of low back pain) – History of lumbar or pelvic fracture; degenerative disc disease; neoplasm; inflammatory disease; active urogenital infection or active gastrointestinal illness; previous surgery of the lumbar spine, pelvic girdle, hip joint or femur – History or signs of radiculopathy or other systemic neurologic disease – Narcotic medication use

Gender Eligibility: Female

Minimum Age: 18 Years

Maximum Age: 50 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Loyola University
  • Provider of Information About this Clinical Study
    • Principal Investigator: Colleen M. Fitzgerald, MD, MS, MD, Professor – Loyola University
  • Overall Official(s)
    • Colleen Fitzgwerald, MD, Principal Investigator, Loyola Medical Center
  • Overall Contact(s)
    • Mary Tulke, RN, 708-476-2186, mtulke@luc.edu

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