Assistant Clinical Professor Hanover College Dayton, Ohio, United States
Objectives: Abdominal pain during pregnancy presents diagnostic challenges due to varied etiologies. This case study aimed to assess and manage persistent abdominal pain in a pregnant patient, utilizing a manual therapy approach.
Methods: A 23-year-old G2P1 pregnant female with unexplained abdominal pain underwent a comprehensive physical therapy evaluation. Differential diagnosis encompassed neuromuscular, visceral, and obstetric conditions. Examination included a review of systems, physical assessment, and outcome measures such as Numeric Pain Rating Scale (NPRS) and Global Rating of Change Scale (GRC). Treatment involved manual therapy, patient education, therapeutic exercise, and activities of daily living (ADL) training.
Results: The patient demonstrated tenderness and hyperalgesia around a scar from a prior appendectomy, along with decreased scar mobility and left-sided pelvic translation. Carnett’s test indicated abdominal muscle-related pathology, supporting a clinical hypothesis of a cutaneous nerve entrapment. After three physical therapy visits with intervention focusing on releasing scar tissue and myofascial restrictions, the patient reported complete resolution of symptoms, with NPRS decreasing from 5/10 to 0/10 and meeting all treatment goals.
Conclusions: This case highlights the importance of a systematic approach in evaluating abdominal pain during pregnancy. Differential diagnosis and targeted interventions, including manual therapy, led to successful symptom resolution. Effective communication and collaboration between healthcare providers and patients are essential for managing complex clinical presentations in pregnancy.
