What happens to your body during pregnancy?
At least 50% of pregnant women will experience back pain (1-4), with many suffering from severe discomfort that impacts their activities of daily living. Pregnancy-related back pain can be multi-factorial and rarely only has one cause. Back pain, wrist pain and leg cramps are the most common complaints reported.
The average healthy weight gain is approximately 30 lbs, most of which is around the abdomen adding a significant frontal load. The added weight puts stress on the back, hips, knees and feet/ankles. Additional weight can lead to altered posture and biomechanics as we change the way we sleep, stand, and move during pregnancy. As the baby grows and the uterus expands, the abdominal muscles also stretch and lose their ability to support as they did. The change in posture, shifting forward, may cause pain and discomfort specifically in the lower back.
During the third trimester, levels of the hormone “relaxin” increase and contribute to the loosening of joints in order for the pelvis to accommodate for enlarged uterus, the baby and later birth. However, the loosening of joints can decrease joint stability and further alter posture. Other structures including musculature may be taxed, resulting in a predisposition to pain and injury. This may result in back pain.
What are the most common symptoms during pregnancy?
- Neck pain
- Low back pain
- Mid-back pain
- Pelvic pain and pressure
- Aching legs and buttocks
- Peripheral swelling
- Sciatica or shooting pain down the leg/foot
- Fatigue and low energy
- Night-time muscle spasms
- Carpal tunnel syndrome
- de Quervain tenosynovitis
- Sleep disturbances
Studies (5-10) have shown that manual therapy, including chiropractic, can help decrease pain in pregnancy and labour. Chiropractors can provide safe, effective and drug-free conservative care to relieve pain and improve function during pregnancy and after birth.
How can chiropractic care help during pregnancy?
Reduce back and pelvic pain: Conservative care including spinal manipulation and mobilization of joints and soft tissue therapy can help reduce pain and improve function.
Relieve fatigued, aching muscles: Chiropractic treatment plans can include soft tissue therapy and various modalities including TENS, IFC, and acupuncture among others. Chiropractors can also recommend exercises to help rehabilitate postural changes.
Help prepare for childbirth: A chiropractor can recommend safe, effective exercises and stretches to help prepare your body for the baby’s delivery.
Ensure a faster recovery: As part of a comprehensive plan of management, chiropractic treatment can help manage quicker recovery and address post-natal biomechanical complaints and rehabilitation.
Is chiropractic care safe during pregnancy? What’s the evidence?
” … According to many studies, there are no contraindication to chiropractic therapy throughout pregnancy. Although the research is limited, there have been no shown cases of adverse effects with chiropractic manipulation during pregnancy. In fact, many studies suggest that chiropractic therapy can provide a safe, effective, and drug-free conservative care to relieve pain during pregnancy. More research is needed, however, to increase awareness and understanding of this topic…”
What are some tips to help minimize back pain during pregnancy?
- Exercise can help increase muscle support for your aching back. Always consult a healthcare practitioner before participating in a new exercise regimen. Low-impact cardiovascular activities, such as swimming, walking, or stationary cycling can help relieve pain and maintain fitness.
- Sleep on your left side to reduce the pressure of the uterus on the large blood vessels in the abdomen, and optimize blood flow to both mother and baby.
- Place a pillow between your knees to take pressure off your lower back when sleeping on your side. Place the pillow under your knees if you sleep on your back.
- Take frequent, short breaks with your feet elevated.
- Remember, adequate rest restores your energy and gives your back a chance to relax.
- Wear flat, supportive shoes and use a lumbar support pillow in your chair at home or work. If you sit at a computer or desk, take frequent breaks and walk around for a few minutes each hour.
- Don’t be afraid to ask for help, especially when lifting heavy objects, including other toddlers and children.
Dr. Khoshroo’s blogs on chiropractic & pregnancy
- CHIROPRACTIC & PREGNANCY (Part III): Exercises, stretches, and proper pregnancy postures/techniques
- CHIROPRACTIC & PREGNANCY (Part II): “Help my sore back, I’m pregnant!” – Does evidence-based chiropractic therapy help with pregnancy pain?
- CHIROPRACTIC & PREGNANCY (Part I): Post-Pregnancy Issues – “What a pain in the neck!”
Dr. Khoshroo provides chiropractic care for pregnancy and pregnancy related pain in North Vancouver at QubeCore Sports & Rehab.
Information courtesy of Canadian Chiropractic Association.
1. Wang, S., Dezinno, P., Maranets, I., Berman, M., Caldwell-Andrews, A., Kain, Z. (2004). Low back pain during pregnancy: prevalence, risk factors, and outcomes. Obstet Gynecol. 104(1): 65-70.
2. Depledge J, McNair PJ, Keal-Smith C, Williams M. (2005). Management of symphysis pubis dysfunction during pregnancy using exercise and pelvic support belts. Physical Therapy. 85(12):1290–1300.
3. Leadbetter RE, Mawer D, Lindow SW. (2004) Symphysis pubis dysfunction: a review of the literature. J Maternal-Fetal Neonatal Medicine. 16:349–354.
4. Borg-Stein J, Dugan SA. (2007). Musculoskeletal disorders of pregnancy, delivery and postpartum. Phys Med Rehabil Clin N Am. 18(3):459–476.
6. Berg G, Hammer M et al. (1988). Lower Back Pain During Pregnancy. Obstetrics and Gynecology. 71: 701-775.
7. Diakow P, Gladsby T et al. (1991). Back Pain During Pregnancy and Labour. Journal of Manipulative and Physiological Therapeutics. Vol 14: 116-118.
8. Fallon J. (1991). The Effect of Chiropractic Treatment on Pregnancy and Labour: A Comprehensive Study. Proceedings of the World Federation of Chiropractic. 24-31.
9. Zerdecki, L., Passmore, S. (2008). Chiropractic evaluation and management of the pregnant patient: an update from recent literature. Midwifery Today Int Midwife. 28(9): 67-68.
10. Shaw G. (2003). When to adjust: chiropractic and pregnancy. J Am Chiropr Assoc. 40(11):8–16.