Effect of Transcutaneous Electrical Nerve Stimulation on Symphysis Pubis Dysfunction During Pregnancy

Background: Symphysis pubis dysfunction (SPD) is a pain-ful and debilitating condition that mostly happens during preg-nancy. It has a negative impact on quality of life that can lead to severe complications such as depression. Transcutaneous electrical nerve stimulation (TENS) is a marvelous intervention that can relieve pain efficiently and faster than any other physi-cal therapy modalities, so it can give better quality of life for patient that has (SPD). TENS doesn’t hurt, it is safe, painless, non-invasive and it has no side effects like medications. It ena-bles the patient with SPD to have pain free in a very short time. TENS closes pain gait so, pain signals can’t reach to conscious level in the brain so pain is relieved. Additionally, it stimulates-release of opiate substances, endorphins and enkephalins which are the natural pain killers so, pain is relieved. Aim of Study: This study was conducted to investigate the effect of TENS on symphysis pubis dysfunction during preg-nancy. Patients and Methods: This study was carried out on forty primiparous pregnant women suffering from symphysis pubis dysfunction. They were selected randomly from the outpatient clinic of Obstetrics and Gynecology at the Military Hospital. Their ages were ranged from (25-35) years old, their body mass index didn’t exceed 30kg/m2. All patients were divided randomly into 2 groups equal in number, study group (A) & Control group (B). Study group (A) This group was consisted of 20 patients. Each patient in this group had received trans-cutaneous electrical nerve stimulation on her symphysis pubis joint for 30 minutes, 3 times/week for 4 weeks. Also, each pa-tient in this group was asked to perform strengthening exer-cises for abdominal & pelvic Floor muscles, posture correction and posterior pelvic tilting exercisers for 30 minutes, 3 times / week for 4 weeks. Additionally, to this, each patient was asked to wear a pelvic brace all day except during sleep or taking a shower throughout the treatment course. While Control group (group B): This group was consisted of 20 patients Each Pa-tient in this group was asked to perform strengthening exercises for abdominal & pelvic Floor muscles, posture corrections and posterior pelvic tilting exercises For 30 minutes, 3 times/week for 4 weeks as in group (A). Also, each patient was advised to wear pelvic brace all day except during sleep or taking a shower throughout the treatment course. Symphyseal pain was evaluated by Visual analogue scale (VAS) and measuring blood cortisol level in blood plasma before and after treatment. Results: The result of this study revealed that, both groups (A) & (B) showed statically (p-value <0.001) significant de-crease in VAS scores and decrease in serum cortisol level in blood plasma after treatment, but the percent of decrease in VAS scores and decrease in serum cortisol level in blood plas-ma was more pronounced and more noticeable in study group (group A) when compared with control group (group B). Conclusion: It was concluded that, Transcutaneous electri-cal nerve stimulation (TENS) is an effective physical therapy modality for relieve pain in symphysis pubis dysfunction dur-ing pregnancy.