If you’re pregnant and looking for options to help you deal with back or pelvic pain, you may wish to consider chiropractic care. Let’s take a look at the subject.
Around two-thirds of pregnant women experience lower back and/or pelvic pain during their pregnancy, tending to occur more often later in the pregnancy and if the mother has a history of pain before or during previous pregnancies.1 And about half of these women don’t receive help or advice for the problem, which often interferes with daily activities, work, and sleep.1 Women may feel limited in their options while pregnant, wishing to avoid drugs or other therapies that they’re unsure about.
There are thought to be a number of possible causes for lower back and pelvic pain during pregnancy, though it is a complex topic that we don’t understand very well at present. Changes to your centre of gravity (from your growing tummy!) and weight gain leads to extra loads passing through the small spinal joints and shock absorbing discs of the lower part of the spine, as well as to the joints and ligaments around the pelvis.2 Muscles around your spine, pelvis, and abdomen might not function effectively because of the changes to your posture.1 On top of this, the pregnancy hormone Relaxin is thought to cause joints and ligaments to become lax or loose, in preparation for child birth.3 It is likely a combination of these factors, among others, that lead to pregnancy-related low back and pelvic pain, making it a complex issue.
So can chiropractic help?
There’s evidence that chiropractic may be helpful for lower back and pelvic pain in pregnancy. One recent study found that pregnant women who had chiropractic care once a week added to their regular medical care had significantly improved back and pelvic pain.4 There are also several other studies that found some positive results with chiropractic care.5-7
Alongside potentially helping with lower back and pelvic pain, it is suggested that chiropractic care can help women have an easier birth process. It may do this by helping to align the joints of your pelvis and reducing pelvic ‘torsion’ (twisting), allowing the baby to move about in the womb and through the pelvis easier. Many chiropractors also report that chiropractic can assist in ensuring your baby is in the right position for birth (head down). There is a lack of research on this topic though so these thoughts are based on the experience of chiropractors and their patients.
What does chiropractic treatment involve?
Chiropractors will work around your growing belly, and have a variety of gentle techniques at their disposal to manipulate or mobilise your joints to ensure they are balanced and moving correctly. Working on spine and pelvic muscles can also be an important part of supporting your body. You will usually be given advice and exercises to help you manage your symptoms proactively too.
What are the risks?
You might wonder, is chiropractic safe for me and my baby while I’m pregnant? Generally, the answer appears to be yes. There are no reports of risks specific to a healthy pregnant mother or growing foetus. Of course, you must consider the normal risks associated with chiropractic that apply to any person. These are mostly minor.8 You can get more information about the risks by speaking to a chiropractor, which can depend on your specific situation and the types of treatment used. And remember, you always have a say in what types of treatment you do or don’t receive and can opt out of anything you are concerned about.
What else can I do?
Regular moderate exercise in a normal pregnancy is highly recommended. It may relieve lower back and pelvic pain1 as well as help prevent excessive weight gain, among a variety of other health benefits for the mother.9 See the Sports Medicine Australia brochure “Pregnancy and Exercise” for further information about recommended exercise levels here. You can also consider physiotherapy, massage or acupuncture for pregnancy-related lower back or pelvic pain. Each of these options also have some limited evidence to support their use,1 so are viable alternatives to chiropractic care. Pelvic or sacroiliac belts can potentially be helpful short term, if you suffer from pelvic instability. You can speak to your health care provider about whether these might be right for you. You may also wonder which pain killers are safe – talk to your doctor or pharmacist who can best advise you.
The final message…
Chiropractic is a good option to consider if you are dealing with pregnancy-related lower back or pelvic pain, and could help you get through your pregnancy in greater comfort. We haven’t yet found one ‘best’ treatment, but you definitely have choices. You don’t have to suffer through, thinking there is nothing to be done. I encourage you to take control and support your body through this journey!
Dr Sasha Aspinall
Pennick, V. and S.D. Liddle, Interventions for preventing and treating pelvic and back pain in pregnancy. Cochrane Database Syst Rev, 2013. 8.
Aldabe, D., S. Milosavljevic, and M.D. Bussey, Is pregnancy related pelvic girdle pain associated with altered kinematic, kinetic and motor control of the pelvis? A systematic review. Eur Spine J, 2012. 21(9): p. 1777-87.
Aldabe, D., et al., Pregnancy-related pelvic girdle pain and its relationship with relaxin levels during pregnancy: a systematic review. Eur Spine J, 2012. 21(9): p. 1769-76.
George, J.W., et al., A randomized controlled trial comparing a multimodal intervention and standard obstetrics care for low back and pelvic pain in pregnancy. Am J Obstet Gynecol, 2013. 208(4): p. 295.e1-e7.
Khorsan, R., et al., Manipulative Therapy for Pregnancy and Related Conditions: A Systematic Review. Obstet Gynecol Surv, 2009. 64(6): p. 416-27
Peterson, C.D., M. Haas, and W.T. Gregory, A pilot randomized controlled trial comparing the efficacy of exercise, spinal manipulation, and neuro emotional technique for the treatment of pregnancy-related low back pain. Chiropr Man Therap, 2012. 20(1): p. 18.
Peterson, C.K., D. Mühlemann, and B.K. Humphreys, Outcomes of pregnant patients with low back pain undergoing chiropractic treatment: a prospective cohort study with short term, medium term and 1 year follow-up. Chiropr Man Therap, 2014. 22(1): p. 15.
Walker, B.F., et al., Outcomes of usual chiropractic. The OUCH randomized controlled trial of adverse events. Spine (Phila Pa 1976), 2013. 38(20): p. 1723-9.Lewis, E., Exercise in pregnancy. Aus Family Physician, 2014. 43(8): p. 42-3.