I would like to touch on the topic of chiropractic and pregnancy because I currently have a lot of pregnant patients. Although I learned all about the changes in the body associated with pregnancy while in graduate school, I never realized the effort it takes to be pregnant. I think that most men take this for granted! There are so many chemical changes in the body that most people seem to forget about the accompanying physical changes that take place too. As the fetus grows, the amount of stress placed on the joints, muscles, and ligaments is quite impressive. It’s no wonder that it’s difficult for women to stay comfortable during pregnancy! In fact, pregnant women tend to complain of many aches and pains. Most of these discomforts are felt in the low back, mid-back, and feet.
Low back pain is by far the most common complaint experienced by pregnant women but mid-back and foot discomfort is also fairly common. The source of low back pain is most often the pelvis (sacroiliac joints) or the junction where the spine meets the pelvis (lumbosacral area). The pelvis is often affected due to the combination if increased body weight and relaxation of the pelvic ligaments associated with pregnancy. In effect, the pelvic girdle expands and this leads to all types of mechanical imbalances. The lumbosacral area is affected by increased stress on the low back. A characteristic feature of normal pregnancy is a progressive increase in the curve of the low back. The increased forward weight of the enlarging uterus and its contents shifts the center of gravity considerably forward from the normal. The result is a rearward lean that increases the low back curve, thus, placing an increased amount of stress on the low back…this leads to a lot of low back pain.
The mid-back discomfort is usually described as an annoying ache. This area is stressed due to the enlargement and increased weight of the breasts, as well as the result of the forward shift of the center of gravity. In order to help maintain balance, a pregnant woman will tend to hold the shoulders back and move the head forward. This altered position places greater stress on the mid-back joints and muscles and tends to worsen already existent postural faults. The result is that mid-back joints become locked and muscles tighten, causing a deep aching sensation.
There isn’t much that needs to be said about the feet. Simply put, the increase in body weight and shift in center of gravity places additional stress on the feet. A foot has 28 bones and 55 joints. It becomes readily apparent that joint dysfunction in the feet can cause serious discomfort. To confirm this, just ask any pregnant woman!
I am always asked if pregnant women can be treated with chiropractic manipulation. The answer is clearly YES. During the first trimester, chiropractic care can be utilized as with any patient. There are only two precautions — the use of x-ray analysis and the use of therapies such as electrical muscle stimulation and ultrasound over the low back and abdomen. X-rays, of course, should not be utilized due to the potential damaging effect on the rapidly dividing cells of the fetus. Therapies are contraindicated because they may induce premature uterine contractions. Most other forms of treatment are fine and exercise is regarded as safe during the first trimester.
During the second and third trimesters, some additional alterations may need to be made. One of the more obvious changes is the inability for the patient to lie face down. We have a solution for that, though! Luckily, many chiropractic tables have a mid-section that drops down so that it can accommodate the enlarged abdomen. (During late stage pregnancy, this becomes the only time a woman can lay face down…most of my pregnant patients welcome this opportunity to lay face down as it’s the only place they can do so!) In addition, spinal manipulation can be performed with lighter pressure due to the relaxing effects that estrogen and other hormones have on the ligaments of the body. The only times when manipulation should be avoided during pregnancy are when the patient presents with conditions such as excessive bleeding, premature labor, placenta previa, placenta abruptio, ectopic pregnancy, and the incidence of ruptured amniotic membranes without labor.
For many pregnant women, chiropractic care is probably the best option for pain. The use of pain medication is not recommended due to its potential side effects that may endanger both mother and child. As a result, many women find themselves destined to suffer for nine months. Unless they have experience with chiropractic care, most women do not know where to turn for relief. This is unfortunate because chiropractic care can really help! There are added benefits as well. In addition to helping control aches and pains during pregnancy, chiropractic care has been demonstrated in studies to reduce the mean labor time and reduce the likelihood of back pain during labor.
Next time we’ll discuss the effect your newborn has on the health of your back!
