There’s so much to look forward to when a woman becomes pregnant – hearing baby’s heartbeat for the first time, finding out if it is a boy or a girl, picking out baby gear and of course, the “pregnancy glow”! On the other hand, the physical changes expected to follow are not quite as fun: morning sickness, weight gain, swelling, and quite possibly the most commonly expected complaint – low back & pelvic girdle pain. While there are plenty of biological reasons that women experience low back and pelvic girdle pain during pregnancy, there are also ways to combat their effects to help ease pain and discomfort.
Studies show that as the uterus enlarges to accommodate the growing baby, the center of gravity shifts. This alters the mechanics of the musculoskeletal system. Shifts in hormones can also affect the joints, such as toward the end of pregnancy when pelvic bones soften and shift to facilitate delivery of the newborn. In some women, these changes occur prematurely, allowing bones to shift which can cause discomfort and pain. Similarly, the fluid retention that leads to swollen feet, can also compress soft tissues in other areas of the body.
One multi-national study looked at pregnant women from the US, the UK, Norway and Sweden. They found the rate of Pelvic girdle pain (PGP) and low-back pain (LBP) to be 70%-86% of all pregnant women. A 2018 Canadian study suggests that experiencing back pain prior to pregnancy increases the risk of pregnancy-related back pain. Additionally, the prevalence of pregnancy-related pain increases as the pregnancy progresses.
Pain management for a pregnant woman can be complicated. The multi-national study found that of those who received treatment for their pregnancy-related back pain, 68%-87% reported positive results. Yet, interestingly, only 24% of American women in that study sought treatment.
A comprehensive literature search, conducted to assess pregnancy safety data for pharmacological and nonpharmacological pain management methods, was recently published in Pain Practice, the official journal of the World Institute of Pain. It reported as association between some analgesics and a higher risk of fetal and pregnancy outcomes.
While some medications such as NSAIDs are considered “appropriate for mild to moderate pain,” they are not advised in the 3rd trimester due to established risks. Additionally, there are many medications that may or may not be safe, but there is insufficient data to make a determination. Due to these findings, the literature search review authors concluded: “Treatment should be tailored to the lowest therapeutic dose and shortest possible duration, and management should involve a discussion of risks and benefits and monitoring for response.”
With growing knowledge about those risks, women may mistakenly think they simply have to suffer through it. However, not treating pain can also lead to depression and hypertension – both of which can lead to complications in both the pregnancy and the baby. Thankfully, there are other options.
Dr. Carrie Ann Terrell, Associate Professor in the Department of Obstetrics, Gynecology and Women’s Health at the University of Minnesota Medical School in Minneapolis, reports that for many pregnant women, chiropractic care is both safe, and often effective at relieving the mother’s back pain and discomfort. She says there is no research suggesting there is health risk to either the pregnant mother or her baby.
“We generally support the use of many complementary therapies, including chiropractic care,” Terrell says. “We do not know of any demonstrated risks.” She goes on to say she often recommends chiropractic care for pregnant women with musculoskeletal pain.
During an initial visit, a chiropractor will take a complete health history and perform a physical exam. Based on these and what is learned in communicating with the patient about their health goals, a treatment plan will be developed.
Not only are chiropractors trained in a variety of treatment techniques to use for various conditions and situations, they are also trained to modify those techniques for special situations such as pregnancy.
This allows the chiropractor to treat the patient while keeping the adjustment “comfortable, safe and effective,” says Jennifer Brocker, a board-certified pediatric chiropractor based in Portland, Oregon and president of the American Chiropractic Association’s pediatrics council. “There’s a lot we (chiropractors) can do to help with discomfort during pregnancy and make pregnancy enjoyable and comfortable,” she says.
If you are pregnant and experiencing musculoskeletal discomfort or pain, you have treatment options to help you maintain your favorite activities while still being safe for your baby. Brocker says she often tells patients, “Just because it’s common, doesn’t mean it’s normal. Pregnancy shouldn’t be painful.”
Talk to your chiropractor about how you can benefit from this safe, non-pharmaceutical method of pain management. If you don’t have a chiropractor, you can find one near you here.
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Black E, Khor KE, Kennedy D, Chutatape A, Sharma S, Vancaillie T, Demirkol A. “Medication Use and Pain Management in Pregnancy: A Critical Review.“ Pain Pract. 2019 Jun 26. doi: 10.1111/papr.12814. https://www.ncbi.nlm.nih.gov/pubmed/31242344.
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