Low back pain (LBP) and pelvic girdle pain (PGP) are common complaints during pregnancy. Some studies suggest these conditions affect up to half of expecting mothers. During the postpartum period, it’s estimated that one-in-five women will continue to experience forms of musculoskeletal pain. This can last up to three years following the birth of their child.
Typically, there isn’t one reason why an expectant mother develops LBP/PGP. There can be a number of contributing factors such as maternal weight gain, spinal biomechanical pregnancy-related changes, and abdominal muscle changes to accommodate the growing fetus. During pregnancy, the body also begins circulating a hormone called relaxin. Relaxin helps relax the joints and ligaments in preparation for labor and delivery. This may be associated with an elevated risk for LBP/PGP.
While pregnancy and pregnancy-related LBP/PGP are very common, there is not a lot of published information on effective treatment options. With respect to the use of chiropractic care, there are a few randomized controlled trials. Most of the published literature involves small trials and case studies.
A 2016 systematic review and meta-analysis looked at ten studies with a total of 1,198 pregnant women. It reported that chiropractic care can be effective in reducing pain intensity in women with LBP/PGP. The authors recommended additional studies with larger patient populations.
Pregnancy Conclusion
Typically, chiropractors utilize a multimodal approach when managing expecting moms that can include a combination of manual therapies like spinal manipulation, mobilization (non-thrust), massage, and stretch/muscle release techniques, along with exercise training, patient education (such as ergonomic and activity modifications), diet and nutritional counseling, and the use of stabilizing belts. To accommodate for the growing fetus, the doctor may modify the patient’s positioning during treatment or adjust the table so that the patient can lay comfortably in a prone position. The chiropractor may also opt for low-force adjusting techniques instead of the high-velocity, low-amplitude adjustment most commonly associated with chiropractic care.
