This article was provided by Dr. Christopher Curry, DC of Kapsner Chiropractic Centers of Austin in Cedar Park, TX. If you'd like to learn more, please visit https://www.kapsner.com/

Chiropractic Care And Pregnancy

My wife is currently pregnant with our first child and with that she has started to develop all of the aches and pains and common symptoms associated with being pregnant. Naturally, as a Chiropractor, I find this to be the perfect opportunity to address how Chiropractic Care can improve the pregnancy experience.

Over the years I have had the pleasure of treating many pregnant women. Pregnant women often wonder if chiropractic care is safe for them and their developing baby and the answer is a resounding yes! Pregnant women have been seeing chiropractors for decades as an alternative to dealing with medications and their ill side-effects. I actually once saw a patient the morning she was scheduled to be induced. So whether you have just become pregnant or are just days away from labor chiropractic treatment is safe and effective.

During pregnancy, there are physical and hormonal changes that occur in preparation for creating the environment for a developing baby. Physical changes include rapid changes in weight, posture, and gait all of which can lead to a misaligned spine and pelvis. These changes can lead to painful conditions that we will address here.

We will review some very common musculoskeletal problems that arise due to these changes in the body. These include low back pain, sacroiliac pain, and sciatic pain. The following will break down in more detail some of these common problems.

Common Symptoms During Pregnancy

Let’s start with the first which is pregnancy-related low back pain. Low back pain during pregnancy is quite common. In fact, according to an article in the Journal of Manipulative and Physiological Therapeutics between 50-75% of all pregnant women will experience low back pain at some point with upwards of 33% having severe lower back pain. It can be so bad that some women actually avoid future pregnancies due to fear of returning symptoms.

Pregnancy-related low back pain usually starts towards the end of the second trimester of pregnancy, although a significant portion of women may experience pain sooner. The average woman gains between 20-40 pounds throughout pregnancy. This weight gain moves your center of gravity forward, causing your pelvis to tilt and your lower back to sway – this places excessive stress on the ligaments, discs, and joints of your spine. Symptoms often start in the lumbar spine and may radiate into your glute or thigh. Pain is often exacerbated or increased by prolonged sitting, standing, coughing, or sneezing. Your symptoms may increase throughout the day, and some patients get nighttime pain that leads to tossing and turning and disturbs their sleep. Various activities seem to contribute to pregnancy-related low back pain – with increased risk for both sedentary and very active individuals. People who have suffered with back pain prior to being pregnant are more than twice as likely to re-develop back pain during pregnancy.

Second of the common pain conditions is Sacroiliac joint pain. The sacroiliac joint is formed by the junction of the sacrum which is the triangle shaped bone just below your lumbar spine and the ilium which is the large pelvic bone to either side of the sacrum. These bones when joined together effectively form the pelvis. Sacroiliac joint problems often begin as a discomfort in your back just below the waist line and slightly to one side of center. Your pain will often travel into your buttock or upper thigh. Symptoms are often made much worse by standing on the affected side. The pain may become more apparent when you go for a walk or change positions ( like coming up out of a chair, car, or bed, or during long car rides). The pain is often relieved by lying down and resting.

Thirdly there is sciatica. Sciatica is characterized by shooting or radiating pain, numbness, and/or weakness down one of the legs. Typically you will feel the pain from the low back to your buttock and the back of your thigh and calf sometimes to the heel. This often starts as lower back pain before radiating down. Pain can vary and either be dull and achy or can be stabbing and shooting pain down the leg all the way to the toes. The pain can last for days or weeks or it can come and go randomly. Sciatica has numerous causes, in the case of pregnancy it is usually caused from excessive weight putting pressure on the spine and discs. Sciatic pain can also be created by compression of the sciatic nerve from tight gluteal muscles. This leads to a condition called piriformis syndrome which closely mimics sciatica.

It is unfortunate that these conditions occur at a time when your medical treatment options are limited. Obviously when you are pregnant you do not want to take large doses of pain killers or anti-inflammatories. Most prenatal health care providers actually recommend drug-free treatment. This is where alternative treatments such as chiropractic have been shown to be very helpful. Studies have shown that chiropractic manipulation provides significant relief of pregnancy-related low back pain. According to research in the Journal of Manipulative and Physiological Therapeutics; almost 75% of women undergoing chiropractic treatment report significant pain reduction with improved ability to function.

Let’s say you decide to make the leap and go visit a chiropractic office. You might be wondering what kind of treatment you will receive. Typical treatment may include chiropractic adjustments, various therapy modalities, myofascial release, and exercise/stretching. Chiropractic adjustments will gently restore movement to your spine and correct pelvic imbalance. Therapeutic modalities will be used to decrease your muscle tightness, pain, and swelling. Myofascial release can be a variety of soft tissue techniques which remove muscle knots and adhesions. Stretching and exercise of course is used to restore flexibility, strength, and range of motion.

Additional Benefits

Receiving Chiropractic Care while pregnant has other benefits besides pain reduction as well. Some of these benefits are preventing a potential cesarean delivery and reducing the time of labor and delivery. The International Chiropractic Pediatric Association actually recommends women receive chiropractic care throughout pregnancy to correct pelvic balance and optimize the room a baby needs for development throughout pregnancy. With a balanced pelvis babies have a better chance of moving into the correct position during birth. If a baby does not assume the correct downward facing direction this is known as a breech presentation. This in turn can lead not only to shorter labor time and a more comfortable delivery for the mother but actually reduce the chance of the baby needing a cesarean.

In practice I tend to see a lot of women who have recently had babies. These women usually experience some of the common symptoms that we talked about previously like low back pain, sacroiliac pain, or sciatica . The pain can still be there due to the physiological changes as the body begins to return to prepregnancy status. In addition, it is common to develop pain to the upper or middle back. This is due to the increased weight of milk in the breasts and also the act of hunching over to feed the baby. Any breastfeeding mothers know this pain all too well. Continued chiropractic care and core strengthening is beneficial in assisting proper restoration of normal biomechanics in the thoracic and lumbar spine.

If you or a loved one is pregnant or plan to become pregnant consider consulting a chiropractic practitioner. Chiropractic evaluation and treatment during pregnancy may be warranted and considered a safe and effective means of treating painful musculoskeletal conditions.

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References and sources:

1. Diakow P.R.P., Gadsby T.A., Gadsby J.B., Gleddie J.G., Leprich D.J., Scales A.M. Back pain during pregnancy and labor. J Manipulative Physiol Ther. 1991;14(2):116–118.
2. Hall J, Cleland J, Palmer J. The Effects of Manual Physical Therapy and Therapeutic Exercise on Peripartum Posterior Pelvic Pain: Two Case Reports. Journal of Manual and Manipulative Therapy. 2005;13(2): 94-102
3. Sabino J, Grauer JN. Pregnancy and low back pain. Curr Rev Musculoskelet Med. 2008 Jun; 1(2): 137–141.