During pregnancy the body goes through many changes as the baby grows and develops. As your womb and stomach grow, the curve in your lower back increases and your pelvis changes its shape, changing your posture. An excessive curve in the lower back diminishes the spines capacity to absorb load, compressing the discs in your spine (1, 2, 3). These changes can cause back pain and discomfort.
Researchers estimate that 45-76% of pregnant people experience lower back pain at some point in pregnancy (4, 5, 6, 7, 8) and 33% of those people report the pain as severe in nature (9). If your back and pelvis was not properly aligned before pregnancy, this will increase the risk of back pain during pregnancy (10). The recurrence rate for lower back pain in pregnancy is 85-90% (11-13), with almost 1 in 5 people who had pregnancy related back pain avoiding future pregnancies due to fear of returning symptoms (14).
In addition, the hormone relaxin is released during pregnancy (13), this increases the risk of lumbopelvic hypermobility and potential weakening of your core stability (15). This leads to potential pain and disability increasing throughout pregnancy (16).
Chiropractic care during pregnancy not only helps to provide a more comfortable pregnancy; it also maintains and improves the balance of your spine and pelvis and reduces muscle tension (17, 18). Almost 75% of pregnant people under chiropractic care report significant pain reduction and clinically significant improvement in disability (19, 20). Additionally, 4 in 5 pregnant people receiving manual therapy report a reduction in other pregnancy related symptoms; such as heartburn, vomiting, nausea, dizziness, excess salivation, insomnia, neck pain and headaches (21, 22). This allows you to have a more comfortable pregnancy and support your babys needs during pregnancy and the birthing process.
The Webster technique is a specific chiropractic technique used during pregnancy. It reduces inference to the nervous system and balances the pelvis, muscles and ligaments (23). It is successful in relieving intra-uterine constraint. Intrauterine constraint is a reduction of the amount of room available in the womb, this can potentially affect the way your baby grows and may reduce your baby’s ability to get into an optimal birthing position (24).
Studies have shown that chiropractic care significantly reduces labour time. First time pregnancies had an average of a 24% shorter labour time and repeat pregnancies had an average of a 39% reduction in labour time. (25, 26) Studies also show that under chiropractic care there is a 50% decrease in the need for painkillers during delivery. Chiropractic care can also improve post partum lower back pain (27).
References:
- DiMarco D.B. The female patient: enhancing and broadening the chiropractic encounter with pregnant and postpartum patients. J Am Chiropr Assoc. 2003;40(11):18–24. Hart L.M. Obstetrical practice. J Am Osteopath Assoc. 1918:609–614.
- Jones M. The value of routine manipulation in pregnancy. J Am Osteopath Assoc. 1952;51:554–557.
- Wu WH, Meijer OG, Uegaki K, Mens JM, van Diee¨n JH, Wuisman PI, et al. Pregnancy related pelvic girdle pain (PPP), I: terminology, clinical presentation, and prevalence. Eur Spine J 2004;13:575–89.
- Pierce H, Homer C, Dahlen H, King J. Pregnancy related low back and/or pelvic girdle pain: listening to Australian women. Abstract presented at the XI International Forum for Low Back Pain Research in Primary Care, Melbourne, Australia, 15–18 March 2011.
- 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.
- Berg G., Hammer M., Moller-Nielsen J., Linden U., Thorblad J. Low back pain in pregnancy. Obstet Gynecol. 1988;71:71–75.
- Mogren IM, Pohjanen AI. Low back pain and pelvic pain during pregnancy: prevalence and risk factors. Spine . 2005 Apr 15;30(8);983-91.
- 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
- Ostgaard HC, Andersson GB. Previous back pain and risk of developing back pain in a future pregnancy. Spine (Phila Pa 1976). 1991 Apr;16(4):432-6.
- George JW, Skaggs CD, Thompson PA, Nelson DM, Gavard JA, Gross GA. A randomized controlled trial comparing a multimodal intervention and standard obstetrics for low back and pelvic pain in pregnancy. Am J Obstet Gynecol 2013 Apr; 208(4):295.e1-7
- Sabino J, Grauer JN. Pregnancy and low back pain. Curr Rev Musculoskelet Med. 2008 Jun; 1(2): 137–141.
- Mens JMA, Vleeming A, Stoeckart R, Stam HJ, Snijders CJ. Understanding peripartum pelvic pain. Implications of a patient survey. Spine. 1996;21(11):1363–70.
- Wang SM, DeZinno P, Fermo L, et al. Complementary and alternative medicine for low-back pain in pregnancy: a cross-sectional survey. J Altern Complement Med. 2005;11(3):459-464.
- DiMarco D.B. The female patient: enhancing and broadening the chiropractic encounter with pregnant and postpartum patients. J Am Chiropr Assoc. 2003;40(11):18–24.
- Filipec M et al. Incidence, pain, and mobility assessment of pregnant women with sacroiliac dysfunction. Int J Gynaecol Obstet. 2018 Sep;142(3):283-287. Epub 2018 Jun 25.
- George JW, Skaggs CD, Thompson PA, Nelson DM, Gavard JA, Gross GA. A randomized controlled trial comparing a multimodal intervention and standard obstetrics for low back and pelvic pain in pregnancy. Am J Obstet Gynecol 2013 Apr; 208(4):295.e1-7
- Haavik H, Murphy BA, Kruger J. Effect of Spinal Manipulation on Pelvic Floor Functional Changes in Pregnant and Nonpregnant Women: A Preliminary Study. J Manipulative Physiol Ther. 2016 Jun;39(5):339-347. doi: 10.1016/j.jmpt.2016.04.004. Epub 2016 May 6. PMID: 27157677.