Chiropractic Care For Pregnant Women With Low Back Pain
This is a most rewarding application of chiropractic spinal manipulation for two reasons: first, it is a joyous occasion for the mother and her family, and second, great relief is attainable for the back pain of pregnancy under Cox Technic Flexion Distraction and Decompression adjusting.
Let's look at some interesting facts about back pain in pregnancy.
Incidence of Low Back Pain and Leg Pain during Pregnancy
50 to 70% of Women Suffer with Back Pain During Pregnancy
Fifty six percent of pregnant women suffer with low back pain during pregnancy. They are more commonly Caucasian women while Hispanic women have a lower incidence of back pain during their pregnancies. Among the variables that were compared in both groups were the age, the weight gained by the mothers during pregnancy, the baby's weight, the number of previous pregnancies, number of prior children.
- The pain group complained of pain the low-back area, which radiated into the lower extremities in 45.5% of cases.
- In about 1/3 of the patients, the pain increased as the day wore on.
- In another 1/3, the pain increased during the night and disturbed sleep.
- Most of the patients started suffering from back pain between the fifth and seventh months of pregnancy. (1)
Another study reported that 76% of women reported back pain at some time during pregnancy. 61% reported onset during the present pregnancy. The prevalence rate increased to 48% until the 24th week and then remained stable and declined to 9.4% after delivery. (2)
Another study showed that pregnancy-related back pain disappears within a month after delivery in 62.5% of women and 8.6% still have pelvic joint pain 2 years after delivery. (3)
Young Women With A History Of Low Back Pain And Previous Pregnancy Have High A Incidence Of Low Back Pain During Their Pregnancy
Pregnancy-related back pain incidence is seen twice as often in women with a past history of low back pain. Women who had been pregnant previously tended to have an increased risk of back pain. There was a statistically significant correlation between multiparity and longer periods of back pain. Young age increased the risk of back pain and the pain intensity was higher in the younger women during the first part of their pregnancies but not later on. (4)
In a study of 855 pregnant women who were followed from the 12th week of pregnancy to the end of the pregnancy, 49% reported low back pain during pregnancy. True sciatica occurred in only 10 women (1%). Back problems before pregnancy increased the risk of back pain, as did young age, multiparity, and several physical and psychological work factors. (5)
The sacroiliac joint has been reported as the most common reason for severe low back pain with 50% of women experiencing it during pregnancy. Risk factors for low back pain during pregnancy were physically strenuous work and prior low back pain. (6)
Another study reported 69% of pregnant women reporting low back pain. The pain was described as causing sleep disturbance and impairing daily living. Risk factors for the pain were younger age and a history of pre-pregnancy back pain either while pregnant or not. Low back pain during the current pregnancy was predicted by age (Younger women were more likely to develop low back pain during pregnancy.) and history of LBP without pregnancy, during menstruation, and during a previous pregnancy. Nearly 30% of respondents stopped performing at least one daily activity because of pain and reported that pain also impaired the performance of other routine tasks. (8)
- Only 32% of the respondents with low back pain during pregnancy informed their prenatal care providers of this problem. (9)
- Only 25% of prenatal care providers recommended a treatment. (9)
- offered no help: 85% of pregnant women surveyed perceived that they had not been offered treatment of their musculoskeletal disorders during pregnancy. (10)
- 62% of surveyed pregnant women with low back pain would try complementary and alternative medicine for their back pain during pregnancy. (11)
Chiropractic for Pregnancy-Related Back Pain
Chiropractic care appears to be a safe and viable option for pregnant women with back pain. Stuber stated that spinal manipulative therapy was considered a safe therapy for use on pregnant patients, and nearly all of the respondents indicated that spinal manipulative therapy was an appropriate treatment for those conditions during pregnancy. (12)
Chiropractors sometimes manage low back pain in pregnant women. A group of 17 pregnant women with low back pain who underwent chiropractic treatment including spinal manipulation showed 16 of 17 (94.1%) cases demonstrated clinically important improvement.
- The average time to initial clinically important pain relief was 4.5 days (range 0-13 days) after initial presentation.
- The average number of visits undergone up to that point was 1.8 visits (range 1-5 visits).
No adverse effects were reported in any of the 17 cases. Although such pregnancy-related back pain can result in significant disability, it has been shown that as few as 32% of women report symptoms to their prenatal provider, and only 25% of providers recommend treatment for relief. The results in this study suggest that chiropractic treatment was safe in these cases and support the hypothesis that chiropractic may be effective for reducing pain intensity. (7)
A Case of Pregnancy-Related Back Pain Relieved with Chiropractic Cox Technic Flexion Distraction and Decompression
Here is an example of chiropractic treatment of a pregnant woman with leg pain is a 26-year-old woman in her second trimester of pregnancy who had severe pain in her lower back that radiated to her hips bilaterally and to her right leg. She reported tingling down her right lower leg to the dorsum of her foot. Although no diagnostic imaging was performed, her differential diagnoses included lumbalgia with associated radiculopathy (pain that radiated down the leg). Her treatment consisted of manual traction in the side-lying position using a specialized chiropractic table and treatment technique (Cox flexion-distraction decompression) modified for pregnancy. Relief was noted after the first treatment, and complete resolution of her subjective and objective findings occurred after >8 visits. (13)
Ironically, muscle strength and endurance building were not found to be beneficial in relieving pregnancy-related back pain. Fatigability of back extensor muscles was not found to be a predictor of back pain during pregnancy. (14)
Chiropractic for pregnancy-related back pain is a viable option that is being documented in the research literature. Chiropractic's non-invasive, non-drug, non-radiologically required examination, gentle treatment of the pregnant woman just may be a welcome option to women whose pregnancy joy is marred by pregnancy-related back pain.
Contact Aaron Chiropractic Clinic to discuss chiropractic care for your pregnancy-related back pain relief.