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Open Access Highly Accessed Open Badges Research article

Persistence of back pain symptoms after pregnancy and bone mineral density changes as measured by quantitative ultrasound - a two year longitudinal follow up study

William WK To1* and Margaret WN Wong2

  • * Corresponding author: William WK To

  • † Equal contributors

Author Affiliations

1 Department of Obstetrics & Gynaecology, United Christian Hospital, Hip Wo Street, Kwun Tong, Hong Kong, PR China

2 Department of Orthopaedics & Traumatology, Prince of Wales Hospital, Shatin, Hong Kong, PR China

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BMC Musculoskeletal Disorders 2011, 12:55  doi:10.1186/1471-2474-12-55

Published: 28 February 2011



Previous research has shown a loss of bone mineral density (BMD) during pregnancy. This loss has been correlated to the occurrence of back pain symptoms during pregnancy. The objective of this study was to evaluate whether persistence of back pain symptoms 2 years after pregnancy could be associated with BMD changes as measured by quantitative USG of the os calcis.


A cohort of patients who reported significant back pain symptoms during pregnancy were surveyed for persistent back pain symptoms 24 to 28 months after the index pregnancy. Os calcis BMD was measured by quantitative ultrasound and compared with the BMD values during pregnancy.


A cohort of 60 women who had reported significant back pain symptoms in their index pregnancy completed a 24-28 months follow-up survey and BMD reassessment. Persistence of significant back pain symptoms was seen in 24 (40%) of this cohort. These women had higher BMD loss during pregnancy compared to those without further pain (0.047 Vs 0.030 g/cm2; p = 0.03). Those that remained pain free after pregnancy appeared to have completely recovered their BMD loss in pregnancy, while those with persistent pain had lower BMD values (ΔBMD - 0.007 Vs - 0.025 g/cm2; p = 0.023) compared to their early pregnancy values.


Persistence of back pain symptoms after pregnancy could be related to an inability to recover fully from BMD loss during the index pregnancy.