Pregnancy

Pregnancy Back Pain

Pregnant woman

Chiropractic Care during Pregnancy

–        Are you aware that more than 50-75% females experience moderately severe backache during pregnancy that may require medical/ pharmacological intervention?(1)

–        Other popular musculoskeletal issues during pregnancy are pelvic pain (35 to 60%), leg cramps (about 30%), carpal tunnel syndrome, De Quervain tenosynovitis and transient osteoporosis of pregnancy (2).

–        Unfortunately only 21% females seek medical help.

–        Untreated or poorly managed musculoskeletal issues can directly affect maternal health, fetal health, pregnancy outcome and post-pregnancy recovery; for example severe pelvic pain can affect labor progression and childbirth.

–        Risk of depression, post-partum blues/ psychosis, long term pain, disturbances in metabolism and digestion and other complications are higher in females who do not seek appropriate help while pregnant.

According to latest data, about 48.1% females seek chiropractic care during pregnancy and about 52.0% females use herbal/ non-pharmacological products while pregnant (3). It is expected that the popularity of chiropractic care is expected to increase in the coming few years.

Pathophysiological changes during pregnancy:

Pregnancy marks the beginning of several physiological changes in your body; such as biochemical alterations (due to hormonal changes), physiological alterations (due to pregnancy related sudden weight gain) and circulatory changes (due to feto-placental circulation.

Chiropractors believe that most of the pregnancy related symptoms and resulting complications are the result of misalignment of joints or spine (also referred to as sacroiliac joint asymmetry). The pathophysiological factors are:

–        A shift in the center of gravity due to sudden and more centralized weight gain

–        Expansion of uterus and ascent into abdominal cavity that directly presses upon the spine from behind and abdominal contents from anterior aspect.

–        Loosening of pelvic ligaments to provide support to expanding uterus.

–        Under the influence of hormones, your pelvic cavity and joints undergo several changes to support pregnancy and allow childbirth at the term

What are the indications of seeking chiropractic care during pregnancy?

Virtually any female in reproductive age group who is pregnant or looking to get pregnant should seek chiropractic care. Primary indications for which most non- pregnant females seek chiropractic help are:

–        Nutritional counseling for metabolic/ weight related issues

–  Low back pain associated with menses.

Primary indications for which pregnant females seek chiropractic care are:

–        Antenatal follow-up visits to ensure a healthy pregnancy

–        In order to address minor or moderate pregnancy related issues; such as backache, nausea, tingling/ numbness in extremities, sciatica, round ligament pain and sacroiliac pain (and other musculoskeletal issues listed above).

–        To facilitate uncomplicated labor and childbirth by strengthening pelvic architecture and supporting tissues,

–        To hasten the recovery and healing after delivery

Why choose chiropractic care while pregnant?

–        During pregnancy, chiropractic care can re-establish pelvic balance and alignment. Misaligned pelvis reduces the available amount of space required for developing baby and this restriction (also known as intrauterine constraint) can significantly affect fetal outcomes if not addressed early.

–        Severe pelvic or back pain during pregnancy and other musculoskeletal ailments can affect the chances of uneventful childbirth and delivery.

–        Posterior and breech positions may interfere with natural labor and may directly increase the risk of interventions like C -sections.

–        Other available options of treatment are exceptionally hazardous for fetal as well as maternal health; for example, consumption of non-steroidal anti-inflammatory drugs (or over the counter pain killers) can compromise blood circulation to the placenta (also referred to as placental insufficiency in scientific terms). Likewise, consumption of opioids or narcotic pain-killers can lead to addiction or physical dependence (both in mother and the baby).

Research published in peer reviewed journal Pediatrics (4) suggested that mother who consume narcotic or addictive pain killers during pregnancy are more likely to give birth to low-birth weight babies. In addition, babies may develop neonatal narcotics abstinence syndrome marked by symptoms like irritability, tremors, high-pitched crying spells, diarrhea or other gastrointestinal issues, inability in maintaining core body temperature and other symptoms.

What are some benefits of obtaining chiropractic care during pregnancy?

Breech position in babies is normal until third trimester. Mostly birth practitioners are not concerned about the positioning until pregnant mother approaches terminal weeks of pregnancy. However, chiropractors on the other hand take active measures from the beginning of pregnancy to enhance feto-maternal well-being.

According to recent estimates, the prevalence of breech presentation at the term is 4% in general population. Chiropractors can address breech deliveries (in which the presenting part of the baby is not head) by introducing well-calculated and measured chiropractic adjustments in order to restore natural balance and alignment of pelvic cavity. Chiropractic manipulation in pregnancy has several other benefits; such as:

–        Reducing stress and pressure from the supporting ligaments of back and uterus to optimize a healthy pregnancy and an uneventful delivery.

–        The Webster Technique, a specialized chiropractic adjustment is helpful in optimizing fetal well-being by promoting natural balance and connectivity.

–        According to a report published in peer-reviewed Journal of Manipulative and Physiological Therapeutics (3), with chiropractic manipulation (or Webster Technique), more than 82% breech presentations can be switched to vertex presentation without adding any risk to the pregnancy.

According to recommendations of ICPA (International Chiropractic Pediatric Association) pregnant women should consider chiropractic care during pregnancy in order to improve feto-maternal health during pregnancy, at the time of active labor and even after childbirth.

How chiropractors help during pregnancy?

Chiropractors utilize multi-modal approach to address physiological, hormonal, biochemical and emotional needs of pregnant women. Most popular interventions are:

–        Exercise and therapeutic exercises to improve muscular strength, joint mobility and range of motion, especially core musculature.

–        Nutritional counseling to enhance physical health and more importantly health of your baby. During pregnancy, most women gain unnecessary weight that can complicate the pregnancy and greatly affect outcome. Chiropractors advise healthy exercises, nutritional tips and healthy ways to enhance metabolism for better pregnancy.

–        Therapeutic massage to reduce backache, pedal edema, pain in pelvis, legs and other parts of the body. Massage also helps in inducing relaxation and promoting circulation across major tissues.

After childbirth, chiropractors help in rehabilitation (via exercises and diet) to restore natural rhythm of the body (in terms of hormones, musculoskeletal symmetry and alignment and overall metabolism) and restore core strength.

It is seen that most women are interested in seeking the chiropractic care benefits during pregnancy. Chiropractors who address medical and physical needs of pregnant females undergo extensive training to identify, manage and treat prenatal, antenatal and postnatal issues. Dr. Rockers has treated numerous pregnant women throughout the pregnancy. 

References:

  1. Khorsan, R., Hawk, C., Lisi, A. J., & Kizhakkeveettil, A. (2009). Manipulative therapy for pregnancy and related conditions: a systematic review. Obstetrical & gynecological survey, 64(6), 416-427.
  2. Borg-Stein, J., & Dugan, S. A. (2007). Musculoskeletal disorders of pregnancy, delivery and postpartum. Physical medicine and rehabilitation clinics of North America, 18(3), 459-476.
  3. Borggren, C. L. (2007). Pregnancy and chiropractic: a narrative review of the literature. Journal of chiropractic medicine, 6(2), 70-74.
  4. Hudak, M. L., Tan, R. C., Frattarelli, D. A., Galinkin, J. L., Green, T. P., Neville, K. A., … & Watterberg, K. L. (2012). Neonatal drug withdrawal. Pediatrics, 129(2), e540-e560.
  5. Sadr, S., Pourkiani-Allah-Abad, N., & Stuber, K. J. (2012). The treatment experience of patients with low back pain during pregnancy and their chiropractors: a qualitative study. Chiropr Man Therap, 20(1), 32.

 

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