Effective Physical Therapy Treatment of Post-Cesarean Section Low Back Pain – Case Report

Abstract

Introduction: Treatment of low back pain after cesarean section has been studied with exercise programs, but there has been little with a full physical therapy treatment plan involving manual therapy and therapeutic exercise. Case: 38 year old female 2.5 years after cesarean section. Presenting with a previous history of low back pain treated by laminectomy. Patient reported marked difficulty lifting her child due to low back pain. Interventions: Manual therapy was performed, involving soft tissue manipulation, to abdominal muscles, gluteal muscles, and SI joints. Therapeutic exercise involved strengthening the abdominals and gluteus medius muscles. Patient was treated 7 times over 5 weeks. Outcomes: Pain on Verbal Numeric rating scale (VNRS) decreased from 6-7/10 to 0/10.  Objective measure by Focus on Therapeutic Outcomes (FOTO) lumbar scale showed improvement from 59 to 82, with an increase of 8 points being a clinically significant improvement.  Patient was able to lift her child pain-free. Conclusions: A physical therapy treatment plan combining manual therapy and therapeutic exercise was very effective in treating a patient with low back pain after a cesarean section.