Pregnancy, Low Back Pain and Chiropractic
A report on the scientific literature
By: Mark Studin DC, FASBE(C), DAAPM, DAAMLP
It has been this authors personal experience that pregnant woman experiencing low back pain secondary to her pregnancy has been told to “wait and see” over time, with the hope that the back pain would go away. This is predominantly because the “drug option” is off the table with complications to the fetus and most doctors are not willing to take the chance to relieve mechanical (no tumors, fractures or infection) low back pain. My patients reported to me that their obstetricians told them their pain was a result of altered biomechanics and hormonal changes affecting the muscles and ligament of their spine. Current research has now verified through scientific evidence what practicing chiropractors and their patients have been claiming for decades, that chiropractic work to help relieve pain for pregnant woman with a safe, conservative treatment for both mother and the fetus. As a result of the effectiveness and safety, it now demands that chiropractic be the first referral option for pregnant woman experiencing low back pain.
According to Petersen, Muhlemann and Humphreys (2014) “Low back and pelvic pain in pregnant women is such a common phenomenon that it is often considered a normal part of the pregnancy [1-3]. However, the high prevalence of this problem (50-80% of women) and the impact that this may have on their quality of life, as well as the fact that back pain during pregnancy is commonly linked to low back pain persisting after pregnancy, mandates that it be taken seriously by health care practitioners. Many of these patients rate their back pain as moderate to severe with a small percentage claiming to be significantly disabled by the pain [6-8]. Pregnancy-related low back pain is most often divided into 3 categories based on location. These are: lumbar spine pain, posterior pelvic pain, or a combination of these two, with posterior pelvic pain reported to be the most common presentation and the location most specific for pregnant patients. Although the etiology of low back pain associated with pregnancy is not definitively known, the predominate theories include biomechanical changes due to the enlarging uterus resulting in an increasing lumbar lordosis and the influence of the hormone relaxin on stabilizing ligaments leading to hypermobility of joints.” [pg. 2]
Petersen went on to report “The results of this current study which showed that a high proportion of pregnant patients with LBP undergoing chiropractic treatment reported clinically relevant ‘improvement’ support those published in a recent cohort study as well as the recent randomized clinical trial (RCT) looking at chiropractic treatment for pregnant patients with low back or pelvic pain.” [pg. 5] Meaning, that chiropractic works for low back pain in pregnant woman and it has been proven in many scientific studies. The result showed that at various times during the pregnancy, upwards of 90% of pregnant woman reported positive results. The specific results reported:
52% improved at 1 week
70% improved at 1 month
85% improved at 3 months
90% improved at 6 months
All of these were with chiropractic care only and no drugs or any other type of intervention beyond patient education by the chiropractor.
Mullen ET. Al reported that when interviewing midwives, that 88.8% had an experience with chiropractors and 97% was positive. In addition, 94.5% of those had chiropractors treated their children and had a positive experience. The most revealing statistic is one of safety. 100% of midwives question answered that chiropractic was safe for their pregnant patients.
We also know that chiropractic is one of the safest treatments currently available in healthcare and when there is a treatment where the potential for benefits far outweighs any risk, it deserves serious consideration. Whedon, Mackenzie, Phillips, and Lurie (2015) based their study on 6,669,603 subjects after the unqualified subjects had been removed from the study and accounted for 24,068,808 office visits. They concluded, “No mechanism by which SM [spinal manipulation] induces injury into normal healthy tissues has been identified (Whedon et al., 2015, p. 5)
References:
Pregnancy and Chiropractic: Care and Safety
“A Report on Midwives & Chiropractic”
A report on the scientific literature
By: Mark Studin DC, FASBE(C), DAAPM, DAAMLP
Being a chiropractor for 34 years, I have treated hundreds of pregnant patients in my career for a host of “pregnancy related spinal conditions.” The impetus for conservative chiropractic care was in part because the pregnant patient could not utilize drugs as a result of contraindications with pregnancy and also in part because of the positive experiences both patients, midwives and obstetricians have observed through the years. It has been my persona observation that chiropractic is a safe alternative for pregnant patients and should always be the first option for anyone (pregnant or not) before the utilization of drugs, making them needless if a non-drug approach delivers positive outcomes.
According to Mullen, Alcantara, Barton and Dever (2011) “Chiropractors and midwives, with their conservative approach to patient care grounded in a holistic and vitalistic philosophy, share many common ideals in the care of patients. In the age of evidence based practice with an emphasis on an integrative approach to patient care, chiropractors and midwives have a unique opportunity to develop partnerships in this regard.” They found “that 57% of their nurse-midwife responders recommended chiropractic to their pregnant patients to address pregnancy-related neuromusculoskeletal (NMS) complaints, sciatica and fetal malposition. In a survey of both lay-midwives and nurse-midwives on their use of CAM (complementary and alternative medicine) therapies, found chiropractic was the most popular CAM therapy to address musculoskeletal back pain. There are also indicators that chiropractors advocate for a strong working relationship with midwivesparticularly in addressing fetal malposition during pregnancy.” Pg. 135
Mullen Et. Al went on to report that 98.9% of midwives were aware that chiropractors worked with “birthing professionals” and 92.5% were knowledgeable about chiropractic’s role in prenatal care. 88.8% had an experience with chiropractors and 97% was positive. In addition, 94.5% of those had chiropractors treated their children and had a positive experience. The most revealing statistic is one of safety as 100% of midwives questioned answered that chiropractic was safe for their pregnant patients.
We are now starting to get answers from disparate sects of healthcare that verify what was once considered “miracles” with maladies such as fetal repositioning during pregnancy. These research findings verify that the chiropractic adjustment does not deliver miracles, it only helps the body work better and we now know why.
We also know that chiropractic is one of the safest treatments currently available in healthcare and when there is a treatment where the potential for benefits far outweighs any risk, it deserves serious consideration. Whedon, Mackenzie, Phillips, and Lurie (2015) based their study on 6,669,603 subjects after the unqualified subjects had been removed from the study and accounted for 24,068,808 office visits. They concluded, “No mechanism by which SM [spinal manipulation] induces injury into normal healthy tissues has been identified (Whedon et al., 2015, p. 5)
References:
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