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Uterine myoma is a benign smooth muscle tumor of the uterus commonly found in women of reproductive age and may cause symptoms related to mass effect and hematologic disturbances. We report the case of a 41-year-old woman presenting with progressive vaginal pain for 3 months, accompanied by low back pain and impaired daily activities, without vaginal bleeding, vaginal discharge, fever, or urinary or defecatory symptoms. Laboratory examination revealed severe microcytic hypochromic anemia with a hemoglobin level of 4.7 g/dL, while ultrasonography demonstrated a 9.93 × 10.32 cm mass described as symmetric, well circumscribed, and hyperechoic, leading to a working diagnosis of uterine myoma with anemia. The patient was managed with general condition monitoring, intravenous fluids, analgesics, transfusion of four units of packed red cells, and laparotomy as definitive intervention. Following transfusion and surgery, the hemoglobin level increased to 9.4 g/dL and subsequently to 11.0 g/dL, accompanied by improvement in postoperative symptoms and clinical condition. This case demonstrates that a large uterine myoma may present predominantly with pelvic pain and functional impairment in the absence of vaginal bleeding. A comprehensive approach involving systematic evaluation, preoperative correction of anemia, appropriate surgical intervention, and postoperative monitoring is essential to improve safety and clinical outcomes in patients with symptomatic pelvic masses.

This case report examines the effectiveness of a combined pulmonary rehabilitation and musculoskeletal physiotherapy program for a 26-year-old male post-pulmonary tuberculosis patient with lumbar tuberculous spondylitis. The patient, who had completed anti-tuberculosis treatment, presented with low back pain, shortness of breath, fatigue, and limited mobility. Spirometry indicated severe restrictive ventilatory impairment (FVC 1.28 L, 32% of predicted), and lower extremity muscle strength was reduced (MMT 2-3/5). The patient used a TLSO brace and walking aid. Over a three-week physiotherapy program, the patient participated in breathing exercises, spinal mobilization, muscle strengthening, functional exercises, and education on brace use. Evaluation occurred at the first, second, and third weeks. After treatment, pain intensity decreased from VAS 6 to VAS 3, FVC improved to 1.72 L, chest expansion increased, muscle strength improved to MMT 4/5, and performance on the Five-Times Sit-to-Stand Test showed progress. The Functional Independence Measure (FIM) score increased from 98 to 115, reflecting improved functional independence. These findings suggest that the combination of pulmonary and musculoskeletal physiotherapy effectively improved respiratory function, muscle strength, and the patient’s overall functional capacity.

Background: Discomfort in third trimester pregnant women often arises due to physiological changes, with back pain being the most common complaint, occurring in 70% to 90% of cases. If left untreated, this pain can interfere with daily activities, cause insomnia, and even affect the childbirth process. Objective: This study aimed to determine the effect of back massage on reducing the intensity of back pain in third trimester pregnant women at Adow Community Health Center. Methods: The research design used a pre experimental approach with a one group pretest posttest design. The sample consisted of 40 third trimester pregnant women experiencing back pain at Adow Community Health Center. Data were analyzed using the paired t test statistical method. Results: Before receiving back massage, the majority of respondents (57.5%) experienced moderate scale pain. After the intervention, the majority of respondents (70%) reported a reduction in pain to a mild scale. The statistical test results showed a p value of 0.000 (p < 0.05) with an average pain reduction of 1.125. Conclusion: Back massage has a significant effect on reducing the intensity of back pain in third trimester pregnant women at Adow Community Health Center.

Background: Comprehensive midwifery care is essential for early detection of complications and reducing maternal and infant mortality rates. In Sleman Regency, despite high access to health services, continuous monitoring remains crucial for ensuring maternal and fetal safety. Objective: To provide comprehensive midwifery care for Mrs. M at Klinik Pratama Shaqi, Sleman, from the third trimester of pregnancy through the postpartum and neonatal periods. Methods: This is a descriptive qualitative study using a case study approach based on Varney's seven-step midwifery management and SOAP documentation. Findings: During pregnancy (37 weeks 6 days), the mother experienced physiological complaints of back pain and shortness of breath, managed through posture education and pregnancy exercises. Labor proceeded normally and spontaneously on October 6, 2024, utilizing "gentle birth" practices such as endorphin massage to reduce pain. A second-degree perineal tear occurred and was treated according to procedure. The baby was born healthy, weighing 3100 grams, with successful Early Initiation of Breastfeeding (EIB). During the postpartum and neonatal periods, uterine involution was normal, breast milk production was adequate, and the infant's growth met standards with no danger signs. Implications: Continuous assistance improves the mother's physical and psychological readiness and ensures a healthy neonatal transition.

Low back pain is one of the most common complaints experienced by pregnant women, particularly in the third trimester, as a result of various physiological, hormonal, and biomechanical changes that occur during pregnancy. Changes in posture, weight gain, and shifts in the center of gravity contribute to the development of this condition. This study aims to examine various non-pharmacological interventions that can be used to reduce low back pain in pregnant women and to analyze the role of midwives in implementing these interventions in midwifery practice. The method employed is a narrative literature review synthesizing ten verified and relevant studies, particularly those discussing prenatal yoga and pregnancy exercise as forms of non-pharmacological intervention. The results indicate that the implementation of prenatal yoga and pregnancy exercise is effective in reducing the intensity of low back pain, improving muscle flexibility and strength, and providing physical and psychological relaxation for pregnant women. In addition, these interventions contribute to increased comfort and improved quality of life during pregnancy. The findings of this study support the importance of evidence-based midwifery practice and highlight the active role of midwives in providing education, assistance, and empowerment for pregnant women through the application of safe and effective non-pharmacological interventions.

The goal of continuous midwifery care is to use the SOAP documentation technique to provide comprehensive care to pregnant women up to birth control according to care standards. From May 2 - July 14, 2025, Mrs.C, G2P1A0, 32 years old received continuous midwifery care from pregnancy until get contraception methods, starting at 34 weeks of gestation. The mother complained of back pain during prenatal check-ups. The labor process went smoothly. With the assistance of a midwife, the baby was born on June 10, 2025. Birth weight: 3000 grams; length: 50 cm; head circumference: 34 cm; chest circumference: 33 cm; received Hb0 vaccine two hours after birth, eye ointment, and vitamin K shortly thereafter. The baby did not experience any problems or complaints during the first visit. Mrs. C received four visits during the postpartum period. The mother did not feel anything during the first visit up to the following visits. She continued to breastfeed exclusively, and her vital signs and fundal height returned to normal. The mother used a three-month injectable contraceptive so as not to interfere with the exclusive breastfeeding program. Mrs.C has received continuous midwifery care during pregnancy and contraceptive use, and her health is normal. It is expected that the midwife will be able to provide continuous midwifery care so that in the event of an emergency, it can be immediately identified and promptly handled.

Low back pain (LBP) is one of the most common musculoskeletal complaints globally and is the main cause of decreased work productivity. One of the risk factors that has been widely studied in the literature is prolonged sitting duration. Prolonged sitting activities cause increased static pressure on the lumbar spine, fatigue of the supporting muscles, as well as a decrease in local blood flow that can trigger chronic pain. This study is a literature review with a meta-analytical approach that aims to analyze the relationship between long-term sitting and the incidence of LBP. The review process was carried out following PRISMA guidelines through searches on PubMed, Scopus, ScienceDirect, and Google Scholar databases for publication in 2020–2025. Of the 20 previous studies analyzed, most showed a positive association between sitting time and an increased risk of LBP, both in adults, adolescents, and children. Sitting for more than 6 hours per day increases the risk of LBP by 33%, especially in individuals with low physical activity. In addition, longer sitting durations with poor posture and minimal active rest were found in the group of office workers and professional drivers who had a high prevalence of LBP. Physical activity has been shown to play a protective role against the risk of LBP, while ergonomic interventions such as lumbar support can reduce pain complaints. Although most studies were observational, the consistency of results supports the importance of prevention through reduced sitting time, increased physical activity, and ergonomic work environment settings. These findings provide a scientific basis for multidimensional interventions to effectively reduce the incidence of LBP.  

During gravidity, back pain is a significant issue, especially due to changes in posture along with increasing physical load in the third trimester. Muscle relaxation and stretching exercises for pregnant women can help reduce back pain, one of which is the butterfly exercise. That study aims until determine the impact to the butterfly activity on gravidity in their third trimester at TPMB Amilia Intarti Klampisrejo, Pasuruan Regency. A quantitative method was used with a quasi-experimental approach employing a one-group pre-test also post-test design. The study involved 32 third-trimester gravidity as respondents. Data were collected using purposive sampling, before-and-after measurements, and assessed with the Numeric Rating Scale (NRS). The intervention be carried out over a period of four weeks. The findings show that the butterfly pregnancy exercise effectively reduces back pain in third-trimester gravid. Therefore, the butterfly exercise can serve as an alternative method to help alleviate back pain and enhance comfort during pregnancy.  

Low back pain is a common complaint among pregnant women in the second and third trimesters due to biomechanical and hormonal changes. Non-pharmacological interventions like prenatal exercise are believed to be effective, though evidence from controlled trials is limited. This study aimed to evaluate the effectiveness of prenatal exercise in reducing low back pain intensity. A quasi-experimental pretest–posttest control group design was used with 30 pregnant women (15 in the intervention group, 15 in the control group), selected by purposive sampling. The inclusion criteria were gestational age of 20–36 weeks, no medical contraindications, and willingness to participate. The intervention group performed prenatal exercises twice a week for 8 weeks (45 minutes per session), while the control group received health education without physical exercise. Pain intensity was measured using the Visual Analogue Scale (VAS). Data analysis was conducted using paired t-test, independent t-test/Mann–Whitney, and ANCOVA to control for age, parity, and BMI. Both groups had homogeneous baseline characteristics (p > 0.05). The intervention group’s pain score decreased from 6.9 ± 1.1 to 3.6 ± 1.0 (Δ = -3.3; p < 0.001), while the control group’s pain score decreased from 6.8 ± 1.2 to 6.3 ± 1.1 (Δ = -0.5; p = 0.09). The difference in pain reduction between groups was significant (p < 0.001). ANCOVA confirmed that prenatal exercise was significantly effective after adjusting for confounders (β = -2.8; p < 0.001). Prenatal exercise is an effective, safe, and affordable intervention for reducing low back pain in pregnant women.

The rapid development of the digital era has led to a major shift in the modern workplace, with over 1.5 billion people spending more than six hours daily in front of computer screens. This working condition poses significant occupational health risks, including Musculoskeletal Disorders (MSDs) such as Low Back Pain (LBP) and neck strain, with a global prevalence of 60-80%. Furthermore, prolonged screen exposure and high workload contribute to mental health issues like chronic stress and digital fatigue. This community service aimed to increase awareness among PT. XYZ employees regarding the importance of integrated ergonomics to achieve optimal productivity. The method used was an informative sharing session through a presentation and discussion. The material emphasized a three-pronged intervention approach: physical ergonomics (workstation adjustment), technology-based interventions (wearable devices, break reminder apps, and electromagnetic radiation prevention), and mental well-being integration (mindfulness and relaxation techniques). The results showed a significant increase in participant understanding of the health risks and the practical steps to implement integrated ergonomic solutions. It was found that combining technology-based reminders and mindfulness exercises can reduce health complaints by up to 40% better than physical interventions alone. The implication of this service is the recommendation for PT. XYZ to adopt an integrated ergonomic policy that addresses physical, technological, and mental aspects to create a healthier, safer, and more productive work environment for its employees.

Overview: Back pain during pregnancy is a common problem experienced by approximately 50–70% of pregnant women. Back pain during pregnancy is caused by an imbalance between the muscle activity in the lumbar region. Several maternal factors are known to play a role in the onset of back pain during pregnancy, including maternal age, body mass index (BMI), number of pregnancies (gravida), and physical activity. Research Method: This is a quantitative analytical study with a cross-sectional approach. The sample size was 33 pregnant women in their third trimester. The sampling technique used purposive sampling, and data analysis used the Chi-square test. Research Results: There was a relationship between BMI and back pain (p-value: 0.015), and there was no relationship between maternal age (p-value: 0.715), gravida (p-value: 0.442), and physical activity (p-value: 0.156) and back pain in pregnant women in their third trimester. Conclusion: There was a significant relationship between BMI and back pain in pregnant women in their third trimester, and there was no significant relationship between maternal age, gravida, and physical activity and back pain in pregnant women in their third trimester.

Low back pain is a discomforting condition that can cause various disorders and potentially disrupt a person's quality of life, such as causing decreased work productivity. Therefore, it is important for the community, especially farmers in Bulakrejo Hamlet, Ngawi Regency. To improve understanding of low back pain, efforts are needed to expand farmers' knowledge regarding this condition, including its definition, prevention, and treatment in Bulakrejo Hamlet. The method applied was providing physiotherapy education through health promotion about low back pain using leaflets as a medium for information delivery. A question and answer session was also conducted to measure the level of understanding of farmers in Bulakrejo Hamlet and provide exercises that can address problems of weakness, stiffness, limitations and pain in the back muscles. The activity ran smoothly and the material was easily understood by farmers in Bulakrejo Hamlet. Evaluation results showed an increase in farmers' knowledge, from 40% to 90%. The extension activity proved effective in increasing farmers' understanding of low back pain cases.

In order to guarantee the best possible maternal health and fetal growth throughout pregnancy, complementary services for expectant mothers are required. These services include nutrition, mental health, and supplementary medical treatment. According to data, 70% of pregnant women have low back discomfort. According to a different poll, eight out of ten third-trimester pregnant women report having back pain. Doing Childpose (Balasana) exercises is one more way to lessen this problem. This study sought to ascertain if Childpose (Balasana) exercises were beneficial in lowering low back pain complaints among pregnant women in their third trimester at the South Bolango City Health Center. This study employed a quasi-experimental pretest-posttest approach with a sample of 34 pregnant women in the third trimester. There were twenty participants in the study's sample. Childpose or balasana exercises are beneficial in relieving back discomfort in third trimester pregnant women at the South Bolango Health Center, according to the data, which indicated a P-value of 0.000 <0.05.

Work activities in workshops often require static and repetitive body positions, such as bending over, lifting heavy loads, or reaching into narrow areas of vehicles. These habits can gradually cause muscle tension and lead to neck and lower back pain. Given the high risk, physiotherapy counseling on occupational safety and health (OSH) and ergonomics was conducted to provide practical understanding to B-Garage, Batu City workshop workers. The counseling was delivered interactively through material presentations, direct discussions, and demonstrations of stretching exercises that can be easily applied in daily activities. The results of the activity showed a very significant increase in knowledge; participants who initially did not understand the principles of ergonomics and musculoskeletal pain prevention were able to identify work risks and practice stretching exercises correctly after the education session. This change was clearly evident from the post-test results, which showed a significant overall improvement compared to the pre-test. These findings indicate that physical therapy education not only enhances knowledge but also promotes behavioral changes toward safer, more comfortable, and more productive work patterns.

A safe and healthy environment is crucial to minimizing accidents and occupational diseases, and this is where Occupational Health and Safety (OHS) comes in. Workers in the informal sector, such as online drivers, are more likely to experience musculoskeletal problems, especially low back pain (LBP), because they frequently lack proper occupational protection and health services. LBP is a complaint of lower back pain that can be brought on by extended periods of static sitting, bad posture, and personal characteristics like body mass index, smoking, and length of service. The purpose of this program is to educate online drivers in Malang City, East Java, and help them avoid LBP. The risk of LBP can be decreased in part by promoting physical activity and education. One recommended intervention is the William Flexion Exercise (WFE), an exercise aimed at improving posture, increasing muscle strength and flexibility, and reducing lower back pain. Implementing WFE education and training for online car drivers is anticipated to strengthen OHS awareness and reduce the incidence of LBP among informal sector workers.

Prenatal exercise plays a vital role in maintaining the physical and mental well-being of pregnant women. This activity helps reduce common discomforts such as back pain, enhances stamina, and strengthens pelvic muscles in preparation for childbirth. However, knowledge among pregnant women regarding safe and effective exercises remains limited. The lack of structured information often leads to uncertainty and discourages participation in physical activities during pregnancy. This condition highlights the need for well-directed and comprehensive physiotherapy education. This community service program was conducted in Building B of the Kedungkandang Community Health Center and involved 15 participants. A holistic approach was employed, combining interactive counseling to convey the theoretical benefits and safety of exercise, group discussions to share experiences, and practical demonstrations. The exercises demonstrated were carefully selected to be simple, safe, and easy to perform independently at home, ensuring continuity beyond the educational sessions. The results indicated a significant improvement in participants’ knowledge, as evidenced by the comparison between pre-test and post-test scores. This improvement reflects the growing awareness among pregnant women of the importance of maintaining fitness through structured and safe physical activity. Continuous education through a community physiotherapy approach is necessary to ensure consistent implementation of prenatal exercise and to support long-term behavioral changes toward better maternal health.

Introduction: Pregnancy is a natural process that every woman experiences. During pregnancy, pregnant women experience many changes, both physiological and psychological. These changes can cause various symptoms in each pregnant woman. Some common complaints during pregnancy include nausea and vomiting, back pain, edema, and shortness of breath. Method: This activity was conducted through counseling aimed at explaining the condition and understanding it to pregnant women. This activity used leaflets and live demonstrations so that participants could perform exercises correctly. Conclusion: After conducting counseling on the role of physiotherapy in pregnancy problems at the integrated health posts (Posyandu) for pregnant women in Sempulang Village, Janju Village, and Keluang Lolo Village, it can be concluded that education is important regarding understanding good exercises to do during pregnancy, such as child pose, cat and camel exercise or yoga for pregnant women, and breathing exercises. This is useful for reducing and preventing symptoms during pregnancy by always paying attention to signs of when to stop the exercise.

Low Back Pain (LBP) is often caused by spondylolisthesis, which causes pain, limited mobility, and disability. Conservative physiotherapy is the primary option to reduce symptoms and improve function. This study aims to evaluate the effectiveness of multimodal physiotherapy interventions in patients with LBP and spondylolisthesis. A case report study was conducted on a 59-year-old female patient diagnosed with LBP and spondylolisthesis. The patient underwent three physiotherapy intervention sessions: Infrared (IR), Short-Wave Diathermy (SWD), Transcutaneous Electrical Nerve Stimulation (TENS), William Flexion Exercise, Core Stability, and Strengthening. Evaluation was performed using the Numeric Rating Scale (NRS) for pain, a goniometer for joint range of motion (LGS), Manual Muscle Testing (MMT) for muscle strength, and the Oswestry Disability Index (ODI) for function. The results of the therapy showed a significant reduction in pain, namely silent pain from a score of 5 to 1 and pain on movement from a score of 6 to 3. Lumbar ROM increased with flexion from 70 degrees to 85 degrees. Lumbar muscle strength also improved, flexors from a score of 4 to 5 and extensors from a score of 3 to 5. ODI decreased from 55.5% (severe disability category) to 12% (minimal disability category). Multimodal physiotherapy interventions have been proven effective in reducing pain, improving LGS, muscle strength, and function in patients with LBP et causa spondylolisthesis.

Back discomfort is a common musculoskeletal complaint among pregnant women, particularly in the third trimester, caused by biomechanical and physiological changes during pregnancy. This condition can interfere with daily activities, reduce sleep quality, and decrease overall comfort. Pharmacological treatments during pregnancy are limited due to safety concerns, making non-pharmacological therapies essential in primary healthcare. One alternative is the use of warm ginger compresses, which combine the benefits of heat therapy with the anti-inflammatory properties of ginger. This study aimed to examine the effect of warm ginger compresses on reducing back pain intensity in third-trimester pregnant women at the Jailolo Community Health Centre. The research used a pre-experimental one-group pretest–posttest design. The sample consisted of 16 pregnant women selected through purposive sampling. Pain intensity was measured using the Numeric Rating Scale (NRS) before and after the intervention. The treatment involved applying warm ginger compresses to the lower back following a standardized procedure. Data analysis was conducted using univariate and bivariate methods with the Wilcoxon signed-rank test. The results showed a significant reduction in back pain intensity after the intervention (p < 0.05). These findings indicate that warm ginger compresses are an effective, safe, and simple non-pharmacological method for reducing back pain in third-trimester pregnant women.

Introduction: Back pain during pregnancy is a problem that is often experienced by pregnant women and is complex because it involves not only physical changes, but also psychological aspects. Changes in body biomechanics, weight gain, and shifting of the center of gravity due to uterine enlargement are the main factors that trigger pain complaints, especially in the lower back area. This condition can have a negative impact on the quality of life of pregnant women, interfere with daily activities, and even worsen emotional states due to the emergence of anxiety, fear, and stress if not managed properly. Treatment of back pain in pregnant women can be done through safe non-pharmacological methods, one of which is prenatal yoga. Yoga practice for pregnant women has been proven to provide benefits in the form of relaxation, posture improvement, and increased muscle elasticity. One of the effective movements is the Angry Cat Pose because it is able to stretch the back muscles, improve blood circulation, and reduce pressure on the lower spine. Objective: This study aims to analyze the effect  of Angry Cat Pose  exercise on the intensity of back pain in pregnant women in the third trimester. Methods: This study used a quasi-experimental design with a one group pretest-posttest design. The study sample consisted of 31 pregnant women in the third trimester with complaints of back pain who visited the Gunungpati Health Center. The research instrument was in the form of a questionnaire, while the data analysis was carried out using the Wilcoxon test with a significance level of <0.05. Results: The results showed a significant effect of the Angry Cat Pose  exercise on the reduction of back pain in pregnant women in the third trimester with p=0.000. After the intervention, the majority of respondents experienced a decrease in pain to the mild category on a scale of 1–3. Conclusion: The Angry Cat Pose  exercise has been shown to be effective in reducing back pain in third trimester pregnant women, so it can be recommended as a safe, simple, and routine nonpharmacological intervention under the supervision of health workers.