Manage Pregnancy Back Pain with Chiropractic
Pregnancy is a transformative time for women, but it can also bring about physical discomforts, with back pain being a common complaint. According to a 2018 study surveying women from the US, UK, Norway, and Sweden, as many as 70-86% of pregnant women at 30-38 gestational weeks reported experiencing low back and/or pelvic girdle pain. Concerns about medication safety for the developing child often lead both mothers and physicians to hesitate in utilizing medications for pain relief during pregnancy. Consequently, many adopt a “wait and see” approach, assuming the pain will resolve after delivery. However, this approach can significantly impact the mother’s quality of life, with some experiencing debilitating pain. Furthermore, back pain during pregnancy is often associated with back pain later in life.
The Motherisk Team at the Hospital for Sick Children in Toronto, one of the world’s leading pediatric health-care institutions, explains the biological reasons behind back pain during pregnancy. As the pregnancy progresses into the 2nd and 3rd trimesters, the mother’s center of gravity shifts forward, placing additional stress on the spine due to altered natural curvature and strained lower back muscles. Research also reports that hormonal changes affect ligaments further altering joint mechanisms. The Motherrisk Team note that educating women about these changes can reduce stress and anxiety associated with the pain. Conservative manual care such as chiropractic and massage are “highly safe and effective” options for these patients.
A 2014 study titled “Outcomes of pregnant patients with low back pain (LBP) undergoing chiropractic treatment” followed pregnant patients experiencing low back or pelvic pain who had not received manual therapy in the previous 3 months. The study found that over half of the patients reported clinically relevant improvement at 1 week, with the majority improving at all subsequent data collection points up to 1 year later.
While this study was not randomized, the findings align with a 2013 randomized trial which compared routine obstetrical care to routine obstetrical care PLUS chiropractic treatment that included manual therapy, stabilization exercises and patient education for pregnant patients with back pain. The trial demonstrated significant reductions in pain scores and disability questionnaire scores from baseline to follow-up, indicating that a multimodal approach to low back and pelvic pain in mid-pregnancy benefits patients more than standard obstetric care.
Chiropractic care and massage therapy are both safe and highly effective treatments for mechanical low back and pelvic pain. The Motherisk Team state: “Very few adverse effects have been reported in the literature, and those that were identified did not affect the lumbar spine, pelvis, or, most important, the developing child.” Chiropractors are trained to identify and diagnose these mechanical issues, as well as to understand when the symptoms indicate nonmechanical issues and can refer the patient to another appropriate health care provider as needed. Just knowing this can often alleviate anxiety and stress and reassure the patient.
In addition to spinal manipulation, chiropractors can assist patients with choosing appropriate pillows and shoes to support the changing body and reduce strain. While most pregnant women are advised to exercise within safe limits, less than half actually do. Chiropractors can provide guidance on exercises that are both safe for mom and baby, and also beneficial to combat the postural issues that can lead to back pain. With follow-up visits, these exercise recommendations can be confirmed or altered based on the specific needs of the individual patient.
In conclusion, back pain during pregnancy is a common and sometimes debilitating issue, but chiropractic care and massage therapy are safe and effective treatments that can significantly improve quality of life for pregnant women. Understanding the biological reasons behind the pain and the safety of these treatments can help alleviate anxiety and stress associated with pregnancy discomforts. If you are pregnant and experiencing back pain, consider consulting with a chiropractor to explore safe and effective treatment options.
RESOURCES:
Peterson CK, Mühlemann D, Humphreys BK. Outcomes of pregnant patients with low back pain undergoing chiropractic treatment: a prospective cohort study with short term, medium term and 1 year follow-up. Chiropr Man Therap. 2014 Apr 1;22(1):15. doi: 10.1186/2045-709X-22-15. PMID: 24690125; PMCID: PMC3994225.
George JW, Skaggs CD, Thompson PA, Nelson DM, Gavard JA, Gross GA. A randomized controlled trial comparing a multimodal intervention and standard obstetrics care for low back and pelvic pain in pregnancy. Am J Obstet Gynecol. 2013 Apr;208(4):295.e1-7. doi: 10.1016/j.ajog.2012.10.869. Epub 2012 Oct 23. Erratum in: Am J Obstet Gynecol. 2014 Jun;210(6):574-5. PMID: 23123166.
Gutke A, Boissonnault J, Brook G, Stuge B. The Severity and Impact of Pelvic Girdle Pain and Low-Back Pain in Pregnancy: A Multinational Study. J Womens Health (Larchmt). 2018 Apr;27(4):510-517. doi: 10.1089/jwh.2017.6342. Epub 2017 Aug 23. PMID: 28832267.
Oswald C, Higgins CC, Assimakopoulos D. Optimizing pain relief during pregnancy using manual therapy. Can Fam Physician. 2013 Aug;59(8):841-2. PMID: 23946024; PMCID: PMC3743693.