2024 Volume 2 Issue 3 Pages 57-68
This study investigated the relationship between postpartum neck-upper extremity pain and specific childcare, housework, and daily activities. A survey of 312 Japanese women who gave birth in the past three years yielded 261 valid responses (mean age 32.2 ± 4.4 years). Pain intensity was measured using the Numerical Rating Scale (NRS), and pain location was identified through a multiple-choice body schema. Activities contributing to pain were identified from a predefined list, including childcare, housework, and daily living. Descriptive statistics and linear regression analyses explored these relationships. Results showed that 224 women (85.8%) reported neck-upper extremity pain, with a mean NRS score of 5.5 ± 2.2. Significant associations were found between specific activities and pain locations: baby carrier use with ulnar wrist pain; breastfeeding, washing the baby’s head, changing clothes, diapering, carrying heavy shopping bags, dishwashing, hanging clothes, and using a whipper with radial wrist pain; changing clothes with thumb carpometacarpal joint pain; feeding with a baby bottle and bathing with thumb metacarpophalangeal joint pain; carrying and picking up the baby from the floor and smartphone use with neck pain; smartphone use with shoulder pain; and using a baby stroller and changing the baby’s clothes with lateral elbow pain. In summary, many women experience moderate neck-upper extremity pain postpartum, related to specific childcare, housework, and daily activities. This study confirms that certain postpartum neck-upper extremity pains are associated with particular movements and activities.
Women often experience minor problems during pregnancy and childbirth, including joint motor system, digestive system, and urinary and reproductive system symptoms1). Approximately 10% report neck, shoulder, and elbow pain during pregnancy, while 30% experience finger to wrist pain2). Postpartum, many women have neck and wrist pain3). 30% to 40% of women report wrist pain4), particularly around 1–2 months postpartum, with the thumb and radial side of the wrist being common sites4). “Baby wrist”5) often due to repetitive carrying, moving, or breastfeeding, exemplified by de Quervain’s tenosynovitis6), can lead to chronic pain, reduced function, and quality of life. Surgical treatment is recommended after 4–6 months if conservative therapy is ineffective7).
However, postpartum women rarely visit medical institutions due to busy schedules, long hospital waits, and childcare responsibilities3,8).
Despite the recommendation for self-care and pain prevention education3), prevention of upper extremity pain is often neglected9). A Japanese survey revealed only 0.9% received tendonitis prevention teaching, though 22.6% requested it3).
Chronic postpartum pain can lead to upper extremity dysfunction and a decrease in quality of life, but low consultation rates and inadequate preventive guidance remain issues. Morino et al. identified movements causing low back pain during the prenatal and postpartum periods, suggesting pain management strategies10). However, specific movements causing postpartum upper extremity pain and preventive guidelines remain unexplored. This study aims to clarify postpartum neck-upper extremity symptoms and associated living difficulties, emphasizing the need for preventive guidelines to improve outcomes.
This study followed the Declaration of Helsinki guidelines and received approval from the Ethics Committee of Fukuyama City Hospital (approval number: 741).
1) Study designWe conducted a cross-sectional study using a self-administered, anonymous web-based questionnaire.
2) Making the questionnaireWe used Google Forms® to design the questionnaire. Three occupational therapists specializing in hand therapy and two with childcare experience reviewed the content, referring to previous studies and surveys on postpartum upper extremity pain3,4,11). A preliminary survey was conducted with five non-medical women postpartum for less than three years to ensure the questions elicited the desired responses.
3) ParticipantsParticipants were women who had given birth within the last three years and consented to the study. We obtained informed consent at the study’s start. Exclusion criteria included those unable to consent, those who had given birth more than three years ago, those who had difficulty understanding the questionnaire, and those involved in the preliminary survey. The study ran from August 5, 2023, to January 5, 2024.
We recruited participants through acquaintances of the authors and nursery schools and facilities in various regions of Japan.
4) Assessment itemsThe self-administered web-based questionnaire collected: (1) basic attributes (age, previous postpartum experience, number of children, history of upper extremity pain before pregnancy, and whether the respondent has support for childcare and household chores); (2) presence of postpartum neck-upper extremity pain; (3) sites of pain postpartum (selective and free description using a body schema); (4) intensity of postpartum pain; (5) time of pain onset; and (6) activities in childcare, housework, and activities of daily living that cause pain. Age, number of years since last childbirth, and number of children were filled in freely. Respondents indicated if they had a baby in the past, a history of upper extremity pain before pregnancy, and a supporter for childcare and housework with “Yes” or “No.” They also answered “Yes” or “No” for postpartum upper extremity pain. Pain locations included “thumb Carpometacarpal (CM) joint,” “thumb Metacarpophalangeal (MP) joint,” “thumb Interphalangeal (IP) joint,” “Proximal Interphalangeal (PIP) joint,” “neck and scapular joints,” “ulnar wrist joints,” “radial wrist joints,” “shoulder joint,” “lateral elbow joint” and “medial elbow joint.” Respondents selected one or more areas using checkboxes and could describe pain in other areas in an open-ended format. Pain intensity was measured using the Numerical Rating Scale (NRS)12,13), an 11-point scale where NRS >0 indicated pain. Pain onset times were categorized into 13 items from 0 to 12 months postpartum, 1 to 1.5 years postpartum, 1.5 to 2 years postpartum, 2 to 2.5 years postpartum, and 2.5 to 3 years postpartum which this classification was created in consultation with authors, with reference to previous study3,4). Respondents selected one of 17 checkboxes. For activities causing pain, 31 items were listed, and respondents used checkboxes to select applicable activities, with an option for open-ended responses. For each pain sites, respondents indicated the intensity of pain, time of onset, and causing activities
5) Statistical analysisFrom the obtained responses, the distribution of postpartum upper extremity pain by site was compiled using descriptive statistics. This analysis included responses indicating the site of pain that occurred after childbirth, excluding those who reported pain onset before childbirth. Descriptive statistics were used to summarize the distribution of pain by site. To analyzed the association between the site of pain and specific activities causing pain, multiple linear regression analysis was used.
The dependent variable was the “intensity of pain in the upper extremity” as measured by the Numerical Rating Scale (NRS). “Previous postpartum experience” and “previous experience or history of pain in the upper extremities before pregnancy,” was expressed as a dummy variables as 1 or 0, respectively, and were also used the independent variable to take it into account as risk factor. “ Activities in childcare, housework, and activities of daily living that cause pain” was expressed as a dummy variable, 0 or 1, and specified as the independent variable in the analysis. Statistical analysis was performed using jamovi (version 2.3.28) with a significance threshold set at 0.05.
Responses were obtained from 312 women who consented to participate in the study. Analysis was conducted on 261 participants, excluding those who reported pain onset “since before childbirth,” those who indicated other pain sites such as lumber and lower extremity, those with inappropriate responses and those with missing data points in the responses.
Table 1 presents the basic information on the participants included in the analysis, and the prevalence and intensity of postpartum upper extremity pain. The mean age of the participants was 32.2 ± 4.4 years. Among them, 111 (42.5%) were first-time mothers, and 150 (57.5%) were experienced mothers. The mean number of children was 1.8 ± 0.9, and the mean duration since the last postpartum period was 0.7 ± 0.8 years. 75 (28.7%) participants had a history of pain and injury. A total of 224 (85.8%) women reported experiencing postpartum neck-upper extremity pain, while 37 (14.2%) did not report such pain. The mean NRS pain score was 5.5 ± 2.2.
| (N = 261) | |
|---|---|
| Age (Years) | 32.2 ± 4.4 |
| Number of first-time mothers (%) | 111 (42.5) |
| Number of experienced mothers (%) | 150 (57.5) |
| Number of children | 1.8 ± 0.9 |
| Duration since last postpartum (years) | 0.7 ± 0.8 |
| Number of women who had history of upper extremity musculoskeletal desease (%) | 75 (28.7) |
| Number of women who had Postpartum upper extremity pain (%) | 224 (85.8) |
| NRS pain score | 5.5 ± 2.2 |
Mean ± SD or N (%)
Table 2 shows the descriptive statistics for movements causing pain in each region. The most common pain sites were the neck/scapula (114 participants, 50.9%), followed by radial wrist joint (79, 35.2%), shoulder joint (36, 16.1%), thumb CM joint (35, 15.6%), lateral elbow joint (31, 13.8%), wrist ulnar joint (27, 12.1%), finger PIP joint (20, 7.7%), thumb MP joint (12, 5.5%), medial elbow joint (11, 4.9%), and thumb IP joint (4, 1.8%). Pain during breastfeeding was most common in the neck/scapula and radial wrist joint. Continuous carrying activities, like lifting the child from the floor, moving while carrying, or working in carrying, frequently caused pain in the radial and ulnar wrist, shoulder joint, and thumb MP and CM joints. Ulnar wrist flexion, like holding a frying pan or pot, often causes pain in the radial and ulnar wrist joints and thumb MP joint. Heavy lifting for shopping most caused pain in the thumb CM joint, lateral elbow joint, and ulnar wrist. Operating a smartphone most frequently causes pain in the thumb MP joint.
| Associated activities | Number of women who had pain (%) | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Neck/Scapula | Radial Wrist | Shoulder | Thumb CM | Lateral elbow | Ulnar wrist | Finger PIP | Thumb MP | Medial elbow | Thumb IP | |||||||||||
| (N = 114) | (N = 79) | (N = 36) | (N = 35) | (N = 31) | (N = 27) | (N = 20) | (N = 12) | (N = 11) | (N = 4) | |||||||||||
| Breastfeeding | 88 | (77.2) | 41 | (51.9) | 17 | (47.2) | 14 | (40.0) | 11 | (35.5) | 13 | (48.1) | 7 | (35.0) | 5 | (41.7) | 2 | (18.2) | 2 | (50.0) |
| Bottlefeeding | 27 | (23.7) | 9 | (11.4) | 10 | (27.8) | 8 | (22.9) | 4 | (12.9) | 5 | (18.5) | 2 | (10.0) | 1 | (8.3) | 2 | (18.2) | 1 | (25.0) |
| Taking babyfood | 2 | (1.8) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 1 | (3.2) | 0 | (0.0) | 1 | (5.0) | 1 | (8.3) | 0 | (0.0) | 0 | (0.0) |
| Carrying from the floor | 49 | (43.0) | 57 | (72.2) | 21 | (58.3) | 13 | (37.1) | 21 | (67.7) | 20 | (74.1) | 9 | (45.0) | 8 | (66.7) | 8 | (72.7) | 2 | (50.0) |
| Carrying from the bed | 23 | (20.2) | 35 | (44.3) | 17 | (47.2) | 17 | (48.6) | 14 | (45.2) | 13 | (48.1) | 3 | (15.0) | 5 | (41.7) | 2 | (18.2) | 2 | (50.0) |
| Moving in carrying | 54 | (47.4) | 35 | (44.3) | 20 | (55.6) | 19 | (54.3) | 24 | (77.4) | 14 | (51.9) | 5 | (25.0) | 2 | (16.7) | 8 | (72.7) | 1 | (25.0) |
| Carrying in baby career | 44 | (38.6) | 2 | (2.5) | 14 | (38.9) | 0 | (0.0) | 3 | (9.7) | 3 | (11.1) | 1 | (5.0) | 0 | (0.0) | 1 | (9.1) | 1 | (25.0) |
| Working in carrying | 45 | (39.5) | 28 | (35.4) | 16 | (44.4) | 14 | (40.0) | 18 | (58.1) | 11 | (40.7) | 4 | (20.0) | 4 | (33.3) | 6 | (54.5) | 2 | (50.0) |
| Attaching baby career | 9 | (7.9) | 5 | (6.3) | 4 | (11.1) | 3 | (8.6) | 2 | (6.5) | 1 | (3.7) | 1 | (5.0) | 2 | (16.7) | 0 | (0.0) | 0 | (0.0) |
| Pushing a stroller | 1 | (0.9) | 4 | (5.1) | 1 | (2.8) | 0 | (0.0) | 2 | (6.5) | 0 | (0.0) | 1 | (5.0) | 2 | (16.7) | 1 | (9.1) | 0 | (0.0) |
| Changing cloth a baby | 9 | (7.9) | 12 | (15.2) | 6 | (16.7) | 3 | (8.6) | 2 | (6.5) | 2 | (7.4) | 7 | (35.0) | 2 | (16.7) | 0 | (0.0) | 1 | (25.0) |
| Bathing a infant | 26 | (22.8) | 24 | (30.4) | 10 | (27.8) | 9 | (25.7) | 6 | (19.4) | 11 | (40.7) | 2 | (10.0) | 2 | (16.7) | 1 | (9.1) | 1 | (25.0) |
| Wahing hair and body a baby | 14 | (12.3) | 10 | (12.7) | 6 | (16.7) | 14 | (40.0) | 8 | (25.8) | 2 | (7.4) | 1 | (5.0) | 2 | (16.7) | 1 | (9.1) | 0 | (0.0) |
| Changing diapers on floor | 15 | (13.2) | 14 | (17.7) | 8 | (22.2) | 3 | (8.6) | 1 | (3.2) | 3 | (11.1) | 2 | (10.0) | 3 | (25.0) | 0 | (0.0) | 1 | (25.0) |
| Changing diapers in bed | 6 | (5.3) | 9 | (11.4) | 6 | (16.7) | 1 | (2.9) | 1 | (3.2) | 3 | (11.1) | 3 | (15.0) | 3 | (25.0) | 0 | (0.0) | 1 | (25.0) |
| Breast milking | 0 | (0.0) | 2 | (2.5) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) |
| Cutting with knife | 9 | (7.9) | 23 | (29.1) | 4 | (11.1) | 13 | (37.1) | 3 | (9.7) | 6 | (22.2) | 10 | (50.0) | 6 | (50.0) | 1 | (9.1) | 1 | (25.0) |
| Mixing with whipers | 3 | (2.6) | 12 | (15.2) | 1 | (2.8) | 4 | (11.4) | 4 | (12.9) | 5 | (18.5) | 4 | (20.0) | 4 | (33.3) | 1 | (9.1) | 1 | (25.0) |
| Manipulating a pan or pot | 17 | (14.9) | 41 | (51.9) | 6 | (16.7) | 17 | (48.6) | 9 | (29.0) | 17 | (63.0) | 8 | (40.0) | 9 | (75.0) | 3 | (27.3) | 1 | (25.0) |
| Washing dishes | 13 | (11.4) | 12 | (15.2) | 6 | (16.7) | 12 | (34.3) | 3 | (9.7) | 3 | (11.1) | 4 | (20.0) | 5 | (41.7) | 1 | (9.1) | 0 | (0.0) |
| Drying/undrying clothes | 27 | (23.7) | 9 | (11.4) | 14 | (38.9) | 6 | (17.1) | 7 | (22.6) | 3 | (11.1) | 1 | (5.0) | 3 | (25.0) | 1 | (9.1) | 1 | (25.0) |
| Folding the laundry | 7 | (6.1) | 4 | (5.1) | 5 | (13.9) | 2 | (5.7) | 3 | (9.7) | 0 | 0.0 | 2 | (10.0) | 1 | (8.3) | 0 | (0.0) | 0 | (0.0) |
| Vaccuming | 6 | (5.3) | 7 | (8.9) | 4 | (11.1) | 2 | (5.7) | 4 | (12.9) | 1 | (3.7) | 3 | (15.0) | 3 | (25.0) | 0 | (0.0) | 0 | (0.0) |
| Wiping tables and floor | 5 | (4.4) | 12 | (15.2) | 3 | (8.3) | 5 | (14.3) | 4 | (12.9) | 2 | (7.4) | 2 | (10.0) | 1 | (8.3) | 0 | (0.0) | 0 | (0.0) |
| Carrying heavy objects when shopping | 46 | (40.4) | 31 | (39.2) | 16 | (44.4) | 21 | (60.0) | 17 | (54.8) | 15 | (55.6) | 4 | (20.0) | 4 | (33.3) | 5 | (45.5) | 1 | (25.0) |
| Driving a car | 16 | (14.0) | 8 | (10.1) | 4 | (11.1) | 3 | (8.6) | 1 | (3.2) | 3 | (11.1) | 2 | (10.0) | 3 | (25.0) | 1 | (9.1) | 0 | (0.0) |
| Riding a bicycle | 1 | (0.9) | 0 | (0.0) | 2 | (5.6) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 1 | (5.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) |
| Operating a laptop | 19 | (16.7) | 5 | (6.3) | 1 | (2.8) | 0 | (0.0) | 2 | (6.5) | 2 | (7.4) | 2 | (10.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) |
| Operating a smartphone | 31 | (27.2) | 27 | (34.2) | 6 | (16.7) | 17 | (48.6) | 7 | (22.6) | 7 | (25.9) | 7 | (35.0) | 7 | (58.3) | 2 | (18.2) | 0 | (25.0) |
| Bathing | 24 | (21.1) | 24 | (30.4) | 10 | (27.8) | 10 | (28.6) | 7 | (22.6) | 6 | (22.2) | 7 | (35.0) | 3 | (25.0) | 1 | (9.1) | 2 | (50.0) |
| Making up | 5 | (4.4) | 12 | (15.2) | 3 | (8.3) | 3 | (8.6) | 3 | (9.7) | 3 | (11.1) | 4 | (20.0) | 0 | (0.0) | 0 | (0.0) | 1 | (25.0) |
| Changing clothes | 20 | (17.5) | 15 | (19.0) | 8 | (22.2) | 6 | (17.1) | 4 | (12.9) | 5 | (18.5) | 2 | (10.0) | 3 | (25.0) | 0 | (0.0) | 2 | (50.0) |
| Writing | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 1 | (2.9) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) |
Table 3 shows the results of the multiple linear regression analysis. Neck and scapular pain was significantly associated with “carrying from the floor” (β = 0.519, 95% CI [0.14–0.90], p = 0.008), “changing the infant” (β = 1.001, 95% CI [0.06–0.88], p = 0.004), and “operating a smartphone” (β = 0.47, 95% CI [0.06–0.88], p = 0.025). Radial wrist pain was significantly associated with “breastfeeding” (β = 0.490, 95% CI [0.05–0.93], p = 0.030), “changing diapers in bed” (β = 0.764, 95% CI [0.07–1.46], p = 0.031), “washing dishes” (β = 0.820, 95% CI [0.17–1.47], p = 0.014), “drying/undrying clothes” (β = 1.226, 95% CI [0.56–1.90], p < 0.01), “carrying heavy objects when shopping” (β = 0.568, 95% CI [0.11–1.03], p = 0.016), and “changing clothes” (β = 0.776, 95% CI [0.22–1.33], p = 0.007). Shoulder pain was significantly associated with “working while carrying” (β = 0.820, 95% CI [0.05–1.59], p = 0.037), “manipulating a pan or pot” (β = 0.982, 95% CI [0.07–1.89], p = 0.035), “carrying heavy objects when shopping” (β = 0.919, 95% CI [0.18–1.66], p = 0.016), and “bathing” (β = 0.812, 95% CI [0.04–1.59], p = 0.040). Thumb CM joint pain was significantly associated with “changing clothes” (β = 1.254, 95% CI [0.48–2.02], p = 0.002). Lateral elbow pain was significantly associated with “pushing a stroller” (β = 1.497, 95% CI [0.03–2.96], p = 0.046) and “changing baby” (β = 1.497, 95% CI [0.03–2.96], p = 0.046). Ulnar wrist pain was significantly associated with “carrying in a baby carrier” (β = 1.421, 95% CI [0.11–2.73], p = 0.035). Thumb MP joint pain was significantly associated with “feeding (bottle)” (β = 2.657, 95% CI [0.42–4.90], p = 0.026) and “baby bathing” (β = 1.942, 95% CI [0.23–3.65], p = 0.031). No movement was significantly associated with hand PIP joint, medial elbow joint, and thumb IP joint pain. Table 4 shows the timing of pain onset. Most pain occurred between 0 and 3 months postpartum and was more frequent up to 6 months postpartum. Pain incidence decreased after 7 months postpartum. This trend was consistent across all sites.
| Associated activities | Neck/Scapula | Radial Wrist | Shoulder | Thumb CM | Lateral elbow | Ulnar wrist | Finger PIP | Thumb MP | Lateral elbow | Thumb IP | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| (N = 114) | (N = 79) | (N = 36) | (N = 35) | (N = 31) | (N = 27) | (N = 20) | (N = 12) | (N = 11) | (N = 4) | |||||||||||||||||||||
| RC | 95% CI | p-value | RC | 95% CI | p-value | RC | 95% CI | p-value | RC | 95% CI | p-value | RC | 95% CI | p-value | RC | 95% CI | p-value | RC | 95% CI | p-value | RC | 95% CI | p-value | RC | 95% CI | p-value | RC | 95% CI | p-value | |
| Breastfeeding | -0.129 | -0.55–0.30 | 0.201 | 0.490 | 0.05–0.93 | 0.030 | 0.701 | -0.14–1.42 | 0.054 | -0.827 | -0.76–0.59 | 0.805 | -0.023 | -0.84–0.79 | 0.953 | 0.419 | -0.40–1.24 | 0.299 | 0.450 | -0.69–1.59 | 0.943 | 1.166 | -0.42–2.75 | 0.128 | 0.835 | -0.64–2.31 | 0.223 | NaN | NaN | NaN |
| Bottlefeeding | 0.407 | -0.03–0.84 | 0.067 | 0.092 | -0.63–0.81 | 0.798 | 0.722 | -0.04–1.48 | 0.062 | -0.792 | -1.58–0.00 | 0.050 | -0.209 | -1.36–0.94 | 0.711 | -0.119 | -1.20–0.96 | 0.821 | -0.288 | -2.08–1.50 | 0.737 | 2.657 | 0.42–4.90 | 0.026 | -0.222 | -2.15–1.71 | 0.793 | NaN | NaN | NaN |
| Taking babyfood | 0.558 | -0.87–1.99 | 0.441 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | -0.727 | -2.83–1.38 | 0.484 | 0 | 0 | 0 | -1.299 | -3.64–1.04 | 0.257 | 0.818 | -2.23–3.86 | 0.553 | 0 | 0 | 0 | 0 | 0 | 0 |
| Carrying from the floor | 0.519 | 0.14–0.90 | 0.008 | -0.043 | -0.55–0.46 | 0.866 | -0.344 | -1.07–0.38 | 0.342 | 0.224 | -0.48–0.93 | 0.520 | 0.522 | -0.27–1.32 | 0.189 | 0.100 | -0.89–1.09 | 0.100 | -0.307 | -1.33–0.72 | 0.534 | -0.072 | -1.73–1.59 | 0.922 | -0.298 | -1.80–1.20 | 0.653 | NaN | NaN | NaN |
| Carrying from the bed | 0.409 | -0.06–0.88 | 0.084 | 0.212 | -0.24–0.66 | 0.356 | 0.498 | -0.21–1.20 | 0.160 | 0.187 | -0.48–0.86 | 0.571 | 0.289 | -0.46–1.04 | 0.433 | 0.444 | -0.42–1.31 | 0.301 | 0.357 | -1.11–1.82 | 0.613 | 0.129 | -1.58–1.83 | 0.866 | -0.88 | -2.56–0.81 | 0.259 | NaN | NaN | NaN |
| Moving in carrying | 0.08 | -0.30–0.46 | 0.680 | -0.009 | -0.48–0.46 | 0.969 | 0.820 | 0.05–1.59 | 0.037 | 0.182 | -0.49–0.86 | 0.586 | 0.025 | -0.93–0.98 | 0.957 | -0.957 | -0.95–0.76 | 0.818 | 0.232 | -1.20–1.66 | 0.735 | -0.506 | -2.73–1.71 | 0.614 | -0.672 | -1.25–2.59 | 0.435 | NaN | NaN | NaN |
| Carrying in baby career | 0.119 | -0.27–0.50 | 0.543 | 0.858 | -0.57–2.29 | 0.236 | 0.344 | -0.37–1.06 | 0.333 | 0 | 0 | 0 | 0.211 | -1.07–1.49 | 0.737 | 1.421 | 0.11–2.73 | 0.035 | -1.299 | -3.64–1.04 | 0.257 | 0 | 0 | 0 | -0.43 | -2.78–1.92 | 0.677 | NaN | NaN | NaN |
| Working in carrying | 0.135 | -0.25–0.52 | 0.489 | 0.088 | -0.39–0.56 | 0.714 | 0.661 | -0.05–1.37 | 0.066 | 0.155 | -0.55–0.86 | 0.657 | 0.121 | -0.66–0.90 | 0.754 | 0.499 | -0.38–1.38 | 0.251 | 0.292 | -1.04–1.63 | 0.649 | 0.042 | -1.66–1.74 | 0.956 | 0.892 | -0.20–1.98 | 0.094 | NaN | NaN | NaN |
| Attaching baby career | 0.372 | -0.33–1.07 | 0.295 | 0.362 | -0.57–1.30 | 0.443 | 0.894 | -0.22–2.00 | 0.110 | 0.630 | -0.53–1.79 | 0.278 | 1.013 | -0.45–2.47 | 0.165 | -0.525 | -2.77–1.72 | 0.633 | -1.30 | -3.64–1.04 | 0.257 | -0.675 | -2.69–1.34 | 0.462 | 0 | 0 | 0 | NaN | NaN | NaN |
| Pushing a stroller | 0.941 | -1.08–2.96 | 0.358 | -0.284 | -1.33–0.76 | 0.588 | 0.865 | -1.39–3.11 | 0.439 | 0 | 0 | 0 | 1.497 | 0.03–2.96 | 0.046 | 0 | 0 | 0 | -1.30 | -3.64–1.04 | 0.257 | -0.049 | -2.53–2.43 | 0.965 | 0.714 | -1.66–3.09 | 0.500 | 0 | 0 | 0 |
| Changing cloth a baby | 1.001 | 0.32–1.68 | 0.004 | 0.373 | -0.25–1.00 | 0.239 | 0.305 | -0.64–1.25 | 0.516 | 0.204 | -0.99–1.39 | 0.730 | 1.497 | 0.03–2.96 | 0.046 | -1.291 | -2.79–0.21 | 0.088 | -0.032 | -1.14–1.08 | 0.952 | 0.861 | -1.29–3.01 | 0.382 | 0 | 0 | 0 | NaN | NaN | NaN |
| Bathing a infant | 0.100 | -0.35–0.55 | 0.658 | -0.151 | -0.65–0.35 | 0.551 | 0.392 | -0.44–1.22 | 0.344 | 0.509 | -0.26–1.28 | 0.187 | -0.522 | -1.47–0.43 | 0.270 | -0.533 | -1.36–0.29 | 0.194 | -0.524 | -2.39–1.34 | 0.560 | 1.942 | 0.23–3.65 | 0.031 | -1.20 | -3.57–1.17 | 0.271 | NaN | NaN | NaN |
| Wahing hair and body a baby | 0.139 | -0.43–0.71 | 0.630 | 0.621 | -0.05–1.29 | 0.070 | 0.351 | -0.59–1.29 | 0.454 | 0.209 | -0.85–1.26 | 0.689 | 0.204 | -0.67–1.08 | 0.633 | -0.666 | -2.28–0.95 | 0.402 | -1.299 | -3.64–1.04 | 0.257 | 0.861 | -1.29–3.01 | 0.714 | -1.66–3.09 | 0.500 | 0 | 0 | 0 | |
| Changing diapers on floor | 0.530 | -0.02–1.08 | 0.060 | 0.265 | -0.34–0.87 | 0.389 | 0.289 | -0.61–1.19 | 0.516 | 0.594 | -0.58–1.77 | 0.310 | 1.86 | -0.13–3.85 | 0.065 | 0.271 | -1.15–1.69 | 0.696 | -0.298 | -2.02–1.42 | 0.718 | -0.931 | -2.72–0.86 | 0.264 | 0 | 0 | 0 | NaN | NaN | NaN |
| Changing diapers in bed | 0.19 | -0.65–1.03 | 0.659 | 0.764 | 0.07–1.46 | 0.031 | 0.608 | -0.35–1.56 | 0.204 | 1.698 | -0.27–3.64 | 0.085 | 1.86 | -0.13–3.85 | 0.065 | 1.108 | -0.15–2.36 | 0.081 | 0.263 | -1.24–1.76 | 0.715 | -0.127 | -2.29–2.04 | 0.896 | 0 | 0 | 0 | NaN | NaN | NaN |
| Breast milking | 0 | 0 | 0 | 0.362 | -0.57–1.30 | 0.443 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Cutting with knife | -0.153 | -0.55–0.85 | 0.665 | 0.224 | -0.27–0.72 | 0.371 | 0.200 | -1.00–1.40 | 0.736 | -0.147 | -0.83–0.54 | 0.664 | 0.848 | -0.39–2.09 | 0.171 | 0.073 | -0.96–1.10 | 0.884 | 0.462 | -0.65–1.57 | 0.446 | 0.087 | -1.61–1.78 | 0.909 | -1.200 | -3.57–1.17 | 0.271 | NaN | NaN | NaN |
| Mixing with whipers | -0.215 | -1.39–0.96 | 0.717 | 0.395 | -0.24–1.03 | 0.218 | -0.343 | -2.51–1.83 | 0.750 | -0.264 | -1.31–0.78 | 0.608 | 0.68 | -0.38–1.74 | 0.197 | 0.204 | -0.896–1.3 | 0.705 | 0.812 | -0.46–2.08 | 0.194 | 0.163 | -1.63–1.95 | 0.839 | -0.431 | -2.78–1.92 | 0.677 | NaN | NaN | NaN |
| Manipulating a pan or pot | 0.470 | -0.05–0.10 | 0.074 | 0.193 | -0.26–0.65 | 0.400 | 0.982 | 0.07–1.89 | 0.035 | 0.188 | -0.48–0.85 | 0.568 | 0.558 | -0.23–1.35 | 0.158 | 0.648 | -0.18–1.47 | 0.118 | 0.099 | -0.96–1.16 | 0.845 | 0.194 | -1.63–2.02 | 0.812 | -0.314 | -1.81–1.18 | 0.635 | NaN | NaN | NaN |
| Washing dishes | 0.470 | -0.11–1.05 | 0.113 | 0.820 | 0.17–1.47 | 0.014 | 0.270 | -0.70–1.24 | 0.574 | 0.526 | -0.15–1.20 | 0.121 | 0.848 | -0.39–2.09 | 0.171 | -0.079 | -1.50–1.34 | 0.909 | -0.160 | -1.46–1.14 | 0.798 | 0.080 | -1.52–1.68 | 0.910 | 0.588 | -1.96–3.14 | 0.603 | 0 | 0 | 0 |
| Drying/undrying clothes | 0.249 | -0.19–0.69 | 0.262 | 1.226 | 0.56–1.90 | <0.01 | 0.209 | -0.57–0.99 | 0.589 | 0.575 | -0.35–1.50 | 0.212 | 0.482 | -0.37–1.33 | 0.254 | 0.431 | -0.99–1.85 | 0.537 | 0.266 | -2.13–2.66 | 0.817 | 0.256 | -1.56–2.08 | 0.754 | 0.588 | -1.96–3.14 | 0.603 | NaN | NaN | NaN |
| Folding the laundry | -0.214 | -0.10–0.57 | 0.589 | 0.608 | -0.42–1.63 | 0.242 | 0.039 | -0.93–1.11 | 0.940 | -0.494 | -1.98–0.99 | 0.501 | 0.848 | -0.39–2.09 | 0.171 | 0 | 0 | 0 | -0.515 | -2.22–1.19 | 0.532 | -0.953 | -3.87–1.97 | 0.473 | 0 | 0 | 0 | 0 | 0 | 0 |
| Vaccuming | -0.30 | -1.16–0.56 | 0.490 | 0.394 | -0.41–1.20 | 0.330 | 0.354 | -0.84–1.55 | 0.550 | 0.047 | -1.41–1.50 | 0.948 | 0.467 | -0.64–1.58 | 0.395 | -0.525 | -2.77–1.72 | 0.633 | -0.050 | -1.63–1.53 | 0.947 | 0.26 | -1.56–2.08 | 0.754 | 0 | 0 | 0 | 0 | 0 | 0 |
| Wiping tables and floor | 0.82 | -0.09–1.74 | 0.076 | 0.167 | -0.47–0.80 | 0.603 | -0.100 | -1.39–1.20 | 0.877 | -0.826 | -1.73–0.08 | 0.073 | 0.936 | -0.22–2.10 | 0.109 | 0.603 | -1.05–2.25 | 0.458 | -0.082 | -1.81–1.65 | 0.921 | -0.983 | -3.87–1.97 | 0.473 | 0 | 0 | 0 | 0 | 0 | 0 |
| Carrying heavy objects when shopping | -0.04 | -0.43–0.35 | 0.839 | 0.568 | 0.11–1.03 | 0.016 | 0.919 | 0.18–1.66 | 0.016 | 0.334 | -0.33–1.00 | 0.314 | 0.12 | -0.68–0.92 | 0.755 | 0.787 | -0.01–1.58 | 0.051 | -0.229 | -1.57–1.11 | 0.721 | 0.622 | -1.00–2.24 | 0.402 | 0.632 | -1.05–2.31 | 0.403 | NaN | NaN | NaN |
| Driving a car | 0.054 | -0.51–0.62 | 0.850 | 0.180 | -0.30–0.66 | 0.705 | 0.032 | -1.19–1.12 | 0.955 | -0.108 | -1.33–1.12 | 0.163 | 0.82 | -1.28–2.91 | 0.431 | -1.529 | -3.73–0.67 | 0.161 | 0.496 | -0.66–1.65 | 0.672 | -1.173 | -3.23–0.88 | 0.224 | -1.200 | -3.57–1.17 | 0.271 | 0 | 0 | 0 |
| Riding a bicycle | 0.745 | -1.27–2.76 | 0.465 | 0 | 0 | 0 | 0.511 | -1.07–2.09 | 0.514 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0.266 | -2.13–2.66 | 0.817 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Operating a laptop | 0.089 | -0.41–0.59 | 0.724 | 0.453 | -0.47–1.38 | 0.333 | 1.178 | -0.96–3.31 | 0.269 | 0 | 0 | 0 | 1.297 | -0.09–2.67 | 0.066 | -0.235 | -2.31–1.84 | 0.814 | -0.082 | -1.81–1.65 | 0.921 | 0 | 0 | o | 0 | 0 | 0 | 0 | 0 | 0 |
| Operating a smartphone | 0.47 | 0.06–0.88 | 0.025 | -0.069 | -0.55–0.42 | 0.779 | 0.739 | -0.17–1.65 | 0.109 | -0.78 | -0.75–0.59 | 0.813 | 0.74 | -0.08–1.56 | 0.078 | -0.09 | -1.47–1.30 | 0.896 | 0.618 | -0.46–1.69 | 0.240 | -1.303 | -2.64–0.04 | 0.055 | -0.588 | -2.48–1.30 | 0.486 | NaN | NaN | NaN |
| Bathing | 0.130 | -0.33–0.59 | 0.577 | 0.463 | -0.02–0.95 | 0.060 | 0.812 | 0.04–1.59 | 0.040 | 0.483 | -0.24–1.21 | 0.183 | 0.065 | -0.82–0.95 | 0.881 | 1.118 | -0.15–2.38 | 0.800 | -0.046 | -1.12–1.02 | 0.928 | -0.931 | -2.72–0.86 | 0.264 | -0.431 | -2.78–1.92 | 0.677 | NaN | NaN | NaN |
| Making up | 0.501 | -0.42–1.42 | 0.283 | 0.414 | -0.21–1.04 | 0.191 | 0.997 | -0.23–2.22 | 0.108 | 0.20 | -0.99–1.39 | 0.166 | 0.848 | -0.39–2.09 | 0.171 | -0.033 | -1.38–1.31 | 0.960 | -0.111 | -1.38–1.15 | 0.854 | 0 | 0 | 0 | 0 | 0 | 0 | NaN | NaN | NaN |
| Changing clothes | 0.482 | 0.00~0.97 | 0.052 | 0.776 | 0.22–1.33 | 0.007 | 0.612 | -0.22–1.44 | 0.143 | 1.254 | 0.48–2.02 | 0.002 | 0.543 | -0.53–1.61 | 0.307 | -0.136 | -1.32–1.04 | 0.813 | 0.999 | -0.76–2.76 | 0.247 | 0.405 | -1.41–2.22 | 0.623 | 0 | 0 | 0 | NaN | NaN | NaN |
| Writing | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0.65 | -1.41–2.70 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | |
The data in bold is statisticaly significant
RC/Regression coefficient, CI/confidence interval, NaN/Not a Number
| Period | Number of women who had upper extremity pain | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Neck/scapula | Radial wrist | Shoulder | Thumb CM | Lateral elbow | Ulnar wrist | Finger PIP | Thumb MP | Medial elbow | Thumb IP | Total | ||||||||||||
| (N = 114) | (N = 79) | (N = 36) | (N = 35) | (N = 31) | (N = 27) | (N = 20) | (N = 12) | (N = 11) | (N = 4) | (N = 369) | ||||||||||||
| 0 m | 40 | (35.1) | 18 | (22.8) | 13 | (36.1) | 4 | (11.4) | 8 | (25.8) | 7 | (25.9) | 5 | (25.0) | 2 | (16.7) | 3 | (27.3) | 1 | (25.0) | 101 | (27.4) |
| 1 m | 23 | (20.2) | 24 | (30.4) | 5 | (13.9) | 7 | (20.0) | 8 | (25.8) | 9 | (33.3) | 6 | (30.0) | 0 | (0.0) | 1 | (9.1) | 2 | (50.0) | 85 | (23.0) |
| 2 m | 7 | (6.1) | 10 | (12.7) | 3 | (8.3) | 4 | (11.4) | 1 | (3.2) | 3 | (11.1) | 2 | (10.0) | 1 | (8.3) | 1 | (9.1) | 1 | (25.0) | 33 | (8.9) |
| 3 m | 16 | (14.0) | 8 | (10.1) | 5 | (13.9) | 6 | (17.1) | 3 | (9.7) | 1 | (3.7) | 4 | (20.0) | 2 | (16.7) | 2 | (18.2) | 0 | (0.0) | 47 | (12.7) |
| 4 m | 5 | (4.4) | 7 | (8.9) | 3 | (8.3) | 4 | (11.4) | 1 | (3.2) | 2 | (7.4) | 0 | (0.0) | 2 | (16.7) | 1 | (9.1) | 0 | (0.0) | 25 | (6.8) |
| 5 m | 2 | (1.8) | 4 | (5.1) | 0 | (0.0) | 3 | (8.6) | 1 | (3.2) | 2 | (7.4) | 1 | (5.0) | 1 | (8.3) | 0 | (0.0) | 0 | (0.0) | 14 | (3.8) |
| 6 m | 6 | (5.3) | 3 | (3.8) | 4 | (11.1) | 3 | (8.6) | 2 | (6.5) | 1 | (3.7) | 1 | (5.0) | 2 | (16.7) | 1 | (9.1) | 0 | (0.0) | 23 | (6.2) |
| 7 m | 1 | (0.9) | 1 | (1.3) | 2 | (5.6) | 0 | (0.0) | 2 | (6.5) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 1 | (9.1) | 0 | (0.0) | 7 | (1.9) |
| 8 m | 3 | (2.6) | 1 | (1.3) | 0 | (0.0) | 1 | (2.9) | 0 | (0.0) | 1 | (3.7) | 0 | (0.0) | 1 | (8.3) | 0 | (0.0) | 0 | (0.0) | 7 | (1.9) |
| 9 m | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 1 | (3.2) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 1 | (0.3) |
| 10 m | 1 | (0.9) | 1 | (1.3) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 2 | (0.5) |
| 11 m | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | 0.0 |
| 12 m | 1 | (0.9) | 0 | (0.0) | 0 | (0.0) | 0 | 0.0 | 0 | (0.0) | 0 | 0.0 | 0 | (0.0) | 0 | (0.0) | 1 | (9.1) | 0 | (0.0) | 2 | (0.5) |
| 13–18 m | 6 | (5.3) | 1 | (1.3) | 0 | (0.0) | 0 | 0.0 | 3 | (9.7) | 1 | (3.7) | 0 | (0.0) | 1 | (8.3) | 0 | (0.0) | 0 | (0.0) | 12 | (3.3) |
| 19–24 m | 1 | (0.9) | 1 | (1.3) | 1 | (2.8) | 3 | (8.6) | 1 | (3.2) | 0 | (0.0) | 1 | (5.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 8 | (2.2) |
| 25–30 m | 2 | (1.8) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 2 | (0.5) |
| 31–36 m | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 0 | 0.0 |
m/month
We investigated the status, location, timing, and movements causing neck-upper extremity pain in the postpartum period. Approximately 80% of postpartum women experienced moderate neck-upper extremity pain by 3 months postpartum. Pain occurred in various parts of the neck-upper extremity due to daily activities such as feeding, carrying the child, handling heavy objects, cooking, bathing, dressing the child, operating strollers, and bottle-feeding. Various daily activities cause pain in different regions of the neck-upper extremity. Previous studies3,4) suggested that carrying a baby causes pain. Additionally, this study clarified that various daily activities cause neck-upper extremity pain.
1) Basic informationAccording to the 2022 Vital Statistics from the Japanese Ministry of Health, Labour, and Welfare, the average maternal age at birth is 30.9 years, and the total fertility rate is 1.2614). The participants in this study had an average age of 32.2 ± 4.4 years and an average of 1.8 ± 0.9 children, similar to the general population.
2) Occurrence and location of postpartum neck-upper extremity painNagami3) reported pain sites in postpartum women: shoulder (56.5%), neck (38.3%), wrist (31.3%), and fingers (7.8%). In this study, 50.9% had pain in the neck and scapula, 15.6% in the shoulder joint, 35.2% in the radial wrist joint, 7.7% in the finger PIP joint, 5.5% in the thumb MP joint, and 1.8% in the thumb IP joint. The trend of wrist pain was similar, with about 30% experiencing wrist pain and a few percent having finger pain. However, there was less shoulder pain in this study. Satoh et al.4) reported 30% to 50% of women had pain in the thumb CM and MP joints, higher than in this study. There was a difference in shoulder joint pain compared to Nagami3). This study defined shoulder pain as the upper trapezius fibers from the neck to the shoulder girdle and the deltoid muscle. It is unclear if Nagami3) used body shaders for pain location. Some women who reported “shoulder” pain might have included upper trapezius fibers. The difference likely arises from the pain site selection method, but neck and shoulder pain trends align with previous studies. Some women who reported “shoulder” pain might have included upper trapezius fibers. The difference likely arises from the pain site selection method, but neck and shoulder pain trends align with previous studies. The difference from the study by Satoh et al.4) may be due to the number of subjects, and the number of women with mother’s finger pain in this study may have been small. However, the Baby Wrist is also known as Mummy Thumb15), and it is necessary to consider the possibility that many women have pain in the thumb.
3) Timing of postpartum pain and movementsPostpartum pain sites occurred until 3 or 6 months, consistent with previous studies, with no site-specific differences. Movements requiring heavy upper extremity loads, such as carrying a baby, baby bathing, manipulating pots and pans, and shopping, caused pain in various body parts. Postural changes, such as breastfeeding and changing clothes, and finger pinch movements, like washing dishes, were associated with pain. Previous studies did not examine daily activities beyond child-rearing. Pain occurred in the neck, scapula, radial wrist, shoulder joint, thumb CM joint, lateral elbow joints during weight-bearing activities like carrying and bathing the child, shopping, and cooking.
Neck/scapular and radial wrist pain with carrying is consistent with a previous study5). Neck-upper extremity pain from carrying may relate to the baby’s motor development. The infant’s head and trunk stabilize by 3 months, and they sit unaided by 6 months16). Until 6 months postpartum, supporting the infant’s head to trunk while carrying may cause upper extremity pain due to continuous muscle contraction and poor circulation3). Manipulating heavy items such as cooking pans, and shopping bags may cause pain due to some factors. The factors are movement with wrist ulnar deviation, continuous muscle contraction of wrist extensor muscles, elbow and shoulder muscles. When grasping the handle of a pot or frying pan, the wrist joint is in the ulnar flexion position, and a load is applied to the wrist joint in the ulnar flexion direction when the pot or frying pan is moved. The pain on the radial side of the wrist joint is thought to be caused by the stretching of the extensor digitorum brevis and abductor pollicis longus and the mechanical stress on the tendon sheath caused by muscle contraction to resist the load from the pot or frying pan. In the elbow joint, a relationship between manipulation of heavy objects and lateral epicondylitis has been reported17), and lifting heavy objects causes dorsiflexion of the wrist joint, which places stress on the extensor carpi radialis brevis muscle and is thought to cause pain in the lateral side of the elbow joint. In the shoulder joint, flexion and abduction of the shoulder during heavy lifting may cause contraction of the upper trapezius and deltoid muscles18) , resulting in pain. Postural changes caused wrist and neck/scapular especially during diaper changes, clothes changes, and smartphone use. because the distance to the child on the bed is closer than on the floor, ulnar flexion of the wrist joint tends to occur during diaper changing, and as mentioned, mechanical stress is applied to the extensor pollicis brevis and abductor pollicis longus tendons and tendon sheaths, which may cause pain.
Many postpartum mothers report stiff shoulders and back pain due to a hunched posture from carrying and feeding babies19). In Japan, childcare on the floor may cause head forward posture during tasks like reaching and changing clothes. Head forward posture due to childcare may cause neck pain20). Also using smartphones may cause neck pain. Women tend to get a posture during using a smartphone at a 42°neck tilt21). This posture increases trapezius tension and pain, especially with hunched posture22). Additionally, postpartum women have joint laxity23). The previous study suggests that joint laxity bring hyper muscle tone24). The joint laxity might be influence these results.
Radial wrist, thumb CM and MP joints, and finger PIP joint pain related to changing clothes, cooking, and washing dishes. Pinching and grasping may cause this pain. Pinching occurs when washing dishes or dressing. Cooking and changing clothes require significant pinching25). Repeated contractions of thumb stabilizing muscles such as extensor pollicis brevis and abductor pollicis longus26) may cause pain. Additionally, Increased plasma and edema during pregnancy and lactation may increase the force needed for flexor tendon excursion27,28). This may cause thumb and PIP joint pain. Lateral elbow pain related to stroller operation, possibly due to stroller design. For example, strollers of Aprica that stroller’s provider almost have flat horizontal bars29), causing forearm pronation and wrist dorsiflexion. The continuous dorsiflexion of the wrist causes degeneration of the extensor tendon of the lateral epicondyle to which the extensor carpi radialis brevis muscle is connected30), and there is a risk that this may lead to lateral epicondylitis of the elbow joint.
As we describe, postpartum women experience many neck-upper extremity pain symptoms. Fernandes31) states occupational therapists can prevent pain, improve function, and promote meaningful occupational tasks during pregnancy and postpartum. This study clearly shows the circumstances of postpartum women’s neck-upper extremity pain. This result highlighted the need for occupational therapists to prevent neck-upper extremity pain in postpartum women. Occupational therapists can use these findings to guide and prevent pain in postpartum women. Future research should focus on intervention for postpartum women to prevent pain and also get comfortable doing meaningful occupational tasks.
This study surveyed the timing and activities including not only baby care but also various ADL tasks related to neck-upper extremity pain in postpartum women. About 80% experienced moderate upper extremity pain, mostly within 3 months postpartum. Common pain sites included the neck/scapula, shoulder and radial wrist joint. Pain was often related to weight-bearing activities like carrying, feeding, bathing, shopping, and cooking. Postural changes and pinch movements, such as diaper changing and smartphone use, also contributed. Elbow pain from continuous wrist dorsiflexion, like when using a stroller, was noted. We suggest that mechanical stress on joints and muscles, and poor posture, mainly cause these pains.
This study has several limitations. First, the variation in participant numbers by body part requires caution in interpreting the results. Second, this study did not investigate the postpartum physical changes, such as breastfeeding-related edema, and joint instability. Furthermore, the cross-sectional design precludes the examination of causal relationships between these factors. Additionally, the absence of a control group limits the ability to compare findings with a postpartum group. Although the online survey was designed with reference to previous studies to minimize discrepancies in the timing of pain occurrence, the possibility of recall bias cannot be completely ruled out. Moreover, the study did not assess the impact of postural changes in the postpartum period, which may have influenced the results.
Future studies should address these limitations by including control groups, investigating the role of postpartum physical changes in more detail, and incorporating observational assessments of posture to better understand the causes of pain.
We didn’t have any grants. We thank Ms.Beth Weiss, Occupational Therapist, Certified Hand Therapist of Sutter Health and Ms. Liana Mukha, Occupational Therapist of Sutter Health who gave us many suggestions in planning this study. Ms. Saori Morino physical therapist, Osaka Metropolitan University for her guidance in planning the study. We appreciate Dr. Tokumitsu Mase, Director of Kudo Clinic, Ms. Emiko Oikawa, Nurse Manager, and their staff for their cooperation. We are grateful to the mothers who participated in the survey and the colleagues who cooperated in distributing the questionnaires.
Mizuki Miyamoto, Marie Saruta, and Yuki Miyake contributed to making the study concept, design, survey, manuscript, and analysis. Kenta Kiyomoto and Ryota Hayasaki contributed making study concept, design also critical revision of the manuscript.
We don’t have Conflict of Interest.
