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Manual Therapy and Core Stabilization Exercises With Postpartum Pelvic Girdle Pain and Meralgia Paresthetica: A Case Report

Renard, Jodi A. PT; Abraham-Justice, Karen PT, PhD

Journal of Women's Health Physical Therapy: January/April 2012 - Volume 36 - Issue 1 - p 35–43
doi: 10.1097/JWH.0b013e31824e0c1d
Case Reports

Background and Purpose: The incidence of peripartum and postpartum posterior pelvic pain is high. However, meralgia paresthetica or lateral femoral cutaneous neuropathy is considered rare and presents with a loss of the anterolateral thigh sensation. The purpose of this case report was to present the successful treatment of musculoskeletal impairments in a postpartum patient with the primary diagnosis of meralgia paresthetica and poor functional mobility with pain.

Case Description: This case describes a postpartum patient with anterolateral thigh sensory loss and posterior pelvic pain. Medical history included an 8-year-old history of low back pain. The patient with a right anterior inominate, hip weakness, and iliopsoas length restrictions was seen for 14 physical therapy treatment sessions consisting of manual therapy and core stabilization exercise.

Outcomes: After physical therapy management, the patient reported decreased pelvic girdle pain and the patient-specific functional scale score improved from a score of 13 to 42. Upon discharge, the patient ambulated without a device and was able to care for her newborn child.

Discussion: Manual therapy techniques and core stabilization exercises were interventions applied to manage a postpartum client with paresis and paresthesia in bilateral lower extremities causing functional mobility impairments. Manual techniques to improve joint alignment, mobility, and soft tissue flexibility improved symptoms. Further studies will be beneficial to determine the prevalence of sacral/pelvic alignment dysfunction in patients with lateral femoral cutaneous neuropathy and associated musculoskeletal impairments. In addition, research is needed to determine the most effective manual therapy techniques for patients with pregnancy-related neuropathies.

Shenandoah University, Winchester, Virginia.

This study was presented in partial fulfillment of the requirements for the degree of doctor of physical therapy in the Graduate School of the Shenandoah University.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (http://www.womenshealthpt.org).

The authors declare no conflicts of interest.

Copyright © 2012 Section on Women's Health, American Physical Therapy Association
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