Chiropractic care can be relaxing and relieving during pregnancy.
Pregnancy is a normal and somewhat physiological condition that may invite various medical issues in some susceptible women. Lower back pain is one of the normal symptoms of pregnancy that is usually first reported in second trimester of pregnancy and gradually increases in intensity and severity to peak at childbirth.
Are you aware that (1):
- Prevalence of low back pain during pregnancy in adult females is 68.5%
- 50 – 75% of all pregnant women experience moderate to severe low back pain during or after labor
- Data suggests that approximately 25% continue to report lower back pain even after childbirth
- 58% females report moderate sleep disturbances due to lower back pain during pregnancy
- 57% report alterations in the quality of life
A lot of people are really concerned about the efficacy and safety of medical treatments during high risk conditions such as pregnancy for the management of lower back pain. Several research studies suggested that chiropractic care is extremely helpful for the fetal and maternal well-being in addition to the management of lower back symptoms. Stuber (4) reported chiropractic case studies during the period of 1982 and 2007 and concluded “chiropractic care is associated with improved outcomes in pregnancy-related LBP”.
What causes low back pain in pregnancy?
Knowing what causes low back in pregnancy helps a great deal in prevention and early management.
- The pregnancy hormones cause loosening of pelvic ligaments in an attempt to widen the birth canal (or pelvic opening) for the delivery of the fetus.
- Sudden and disproportional central weight gain (due to expanding uterus) directly puts pressure on the lower spinal segment and leads to pain and lower back discomfort.
- Due to changes in the uterus and weight gain, the posture also changes that further affect the normal curvature of spine.
Chiropractic care for low back pain during pregnancy
Low back pain is usually managed by pain killers in most healthy subjects, but are you aware that painkiller use during pregnancy is generally not recommended?
Painkillers induce pain relief by blocking the production of pain chemicals; yet the same pathway also produces the chemicals that maintain the caliber of blood vessels. Unnecessary or unsupervised intake of painkillers during pregnancy can lead to narrowing of placental blood vessels that can directly compromise the blood circulation to the baby.
There is another reason why pregnant mothers should seek chiropractic care. Lower back pain in the pregnancy is also suggestive of curvature changes in lower pelvis. Any significant change in the angles or shapes of pelvis can directly affect fetal well-being by reducing the room for the baby. Moreover, pelvic changes also interfere with normal labor and may culminate in complications such as arrest of labor, protracted labor and even cesarean section due to non-progress.
Research report by Fallon (5) suggested that primigravida mothers (first time pregnant) who seek chiropractic care during pregnancy have 25% shorter labor duration than other primigravidas. Likewise, multigravida mothers (multiple times pregnant) report 31% short labor span than other multigravidas.
What are other benefits of chiropractic care during pregnancy?
- Chiropractic care promotes pelvic balance and stability to provide room for the fetal development and mobility within the maternal uterine cavity.
- The risk of malposition, post-date delivery, cesarean section and other pre and post labor complications decreases significantly.
- Interventions such as Webster Technique help in fetal re-positioning to cephalic for uneventful labor and delivery. According to the statistics reported by the Journal of Manipulative and Physiological Therapeutics (4) the success rate is 82%.
- Pregnant mothers who utilize chiropractic care during pregnancy have healthier pregnancy (with lesser risk of nausea, neck and back pain)
Is chiropractor care safe during pregnancy?
A study reported in Journal of Manipulative and Physiologic Therapeutics (5) suggested that 84% of all the study participants who received spinal manipulation during pregnancy reported absolute relief from lower back pain during pregnancy. The risk of any side effect or complication is also minimal after chirocare.
It is a common misconception that chiropractic care is only about spinal mobilization and manipulation that may endanger the pregnancy. Detailed Research analysis conducted by Cara (1) suggested that chiropractic care can be effectively used in pregnancy without threatening the fetal well-being.
Chiropractors use height and weight adjusted gravity tables for pregnant mothers and utilize interventions that does not drastically alter the pressure on the abdomen/ uterus.
Some of the common chiropractic interventions used during pregnancy are:
Massage during pregnancy is soothing and helps in relaxation. You can also improve the quality of your sleep with massage. There are various varieties of therapeutic massage (3); such as:
- Trigger or pressure point massage
- Movement reeducation massage
- Deep tissue massage
- Swedish massage
- Cold or moist heat massage
Depending upon the severity of back pain, your chiropractor may advise different types of massaging techniques that also promote blood circulation along your spinal and pelvic region to enhance fetal well-being.
Chiropractic exercises:
Chiropractic exercises are performed generally to improve range of motion, flexibility and strength in muscles. Due to sudden weight gain of pregnancy and pressure of expanding uterus, the blood circulation decreases in the lower limbs (resulting in pedal swelling and venous stasis. Chiropractic exercises helps in reducing the spinal pressure and improving the circulation.
Borggren (6) reported that mothers who perform chiropractic exercises manifest following benefits:
- Higher energy levels
- 21% lower weight gain
- Better mood, lower stress and healthy sleep
- At least a reduction of 2 hours in the total duration of labor
- 14% lesser risk of instrumental delivery (forceps) and 24% lower risk of surgical intervention (cesarean section)
Besides intervention, chiropractors also provide nutritional support and guidelines for:
- Diet and nutrition: Intake of healthy diet and recommended weight gain decreases the pressure and stress on the joints and therefore decreases the
- intensity of lower back pain.
- Pelvic stabilization: As discussed previously, the central weight gain of pregnancy destabilize the spinal balance; however, certain postures and relaxing activities can help in dissipating this destabilization and reducing back pain
- Hydrotherapy: Hydrotherapy as the name implies utilizes water as a medium to alleviate and manage lower back pain of pregnancy. Hydrotherapy during pregnancy can be performed in a whirlpool or a simple pool. The temperature of the water is used to promote blood circulation in the spinal region and also to decrease the intensity of pain.
What are the other benefits of utilizing chiropractic care during pregnancy?
Besides healthy pregnancy, chiropractic care has other benefits in promoting reproductive health:
- Increasing the chances of fertility
- Promoting recovery and rehabilitation after childbirth
- Early restoration of spinal curvature
According to the recommendations of International Chiropractic Pediatric Association (ICPA), it is advised to all pregnant mothers to get chiropractic help throughout pregnancy not just for symptomatic management of lower back pain but also for the uneventful pregnancy, labor and postpartum period.
References:
- Wang, S. M., Dezinno, P., Maranets, I., Berman, M. R., Caldwell-Andrews, A. A., & Kain, Z. N. (2004). Low back pain during pregnancy: prevalence, risk factors, and outcomes. Obstetrics & Gynecology, 104(1), 65-70.
- J.M. Fallon. Textbook on chiropractic & pregnancy. Arlington, VA: International Chiropractic Association; 1994: 52, 109.
- Cherkin, D. C., Eisenberg, D., Sherman, K. J., Barlow, W., Kaptchuk, T. J., Street, J., & Deyo, R. A. (2001). Randomized trial comparing traditional Chinese medical acupuncture, therapeutic massage, and self-care education for chronic low back pain. Archives of Internal Medicine, 161(8), 1081-1088.
- Stuber, K. J., & Smith, D. L. (2008). Chiropractic treatment of pregnancy-related low back pain: a systematic review of the evidence. Journal of manipulative and physiological therapeutics, 31(6), 447-454.
- Diakow, P. R., Gadsby, T. A., Gadsby, J. B., Gleddie, J. G., Leprich, D. J., & Scales, A. M. (1991). Back pain during pregnancy and labor. Journal of manipulative and physiological therapeutics, 14(2), 116-118.
- Borggren, C. L. (2007). Pregnancy and chiropractic: a narrative review of the literature. Journal of chiropractic medicine, 6(2), 70-74.
- Chalker H.M. Spinal compensation of pregnancy. Am Chiropr. 1993;15(3):23–26.
