Pregnancy and Chiropractic
Pregnancy: Top problems that we see in office and how we can help.
Pregnancy is a monumental and exciting time in a woman’s life. The ability to create and support life in the human body is truly an amazing thing. As everyone is aware, the body undergoes quite a bit of changes over the course of 40 weeks. These changes are mostly physical, and a good bit of that is due to a shift in hormone levels within the body. Often during these changes, it is common for your body to experience discomfort, especially from a musculoskeletal standpoint. A recent study published by the Journal of Obstetrics and Gynecology Canada estimates that about 75% of woman experience pregnancy-related back pain1. We wanted to share some of the most common problems that we encounter in our office regarding the pregnant population, and offer some insight on how we can help.
Low Back Pain
As mentioned above, low back pain is probably the most common reason this particular population comes into our office. There are a couple reasons why a patient experiences low back pain during pregnancy. First of all, as the baby grows, there is an anterior (front-facing) shift in the center of gravity in your body. As the center of gravity shifts, it creates more stress on the lumbar spine. Normally, your lumbar spine has a natural “backwards C” shaped curve when observing your body from the side view. As the center of gravity shifts forward, it creates more of a bend in the curve. An increase in this bend creates more compression and force on the vertebrae in the lumbar spine, which causes irritation and discomfort.
Another reason you might experience discomfort in the low back involves hormone production in your body. When you are pregnant, your body produces a hormone known as Relaxin. This is a very important hormone because it allows ligaments to relax in the pelvis, creating more space to accommodate the baby during growth. While this hormone is very beneficial, it can often create problems from a biomechanical standpoint. Many times, patients will have pain in the sacroiliac joints of the pelvis. These are joints that reside where your tailbone meets your hip bones on each side in the lower back/gluteal area. These joints are not extremely mobile like some other joints in your body, however they do move slightly during movements such as walking, sitting down/squatting, sitting to standing, and bending forward. These joints are encased in dense ligaments, which stretch when Relaxin is produced. This can cause some instability during these particular movements, which can cause irritation in these joints. Patients will often report symptoms ranging from dull/achy pain to sharp pain with movement.
Round Ligament Pain
The round ligaments are fibers that help suspend the uterus in the abdomen. They connect to the front wall of the abdomen on each side. As the baby starts to grow, tension increases on these ligaments. Patients will often report discomfort or pain in the lower abdomen near the attachment sites of these ligaments.
Sciatica
Your sciatic nerves are created from some of the lower exiting nerve roots of the lumbar spine and sacrum. They span into the gluteal area and travel down each of your legs, before branching into other nerves at the knee. Some studies suggest that the growing baby can increase pressure in the placenta, which places direct pressure on these nerves. We find that pregnant patients often present with tight muscles, which sometimes can be due to a decrease in activity while pregnant. Some of these muscles, such as the gluteal muscles and hip external rotators, can actually cause pressure on the sciatic nerve. Many patients will report symptoms of pain, numbness, or tingling in the low back, gluteal area, or the legs when this occurs.
Pubic Symphysis Pain
Some patients will also experience pain in the groin area, more commonly in the region just above the genitals. Pain can range from dull/achy, to sharp with certain leg movements. The pubic symphysis is a joint that is not typically mobile. Like the sacroiliac joints, this joint can also widens when Relaxin is produced. While less common than sacroiliac joints, the laxity in ligaments surrounding this joint can also create discomfort during your pregnancy.
How We Can Help?
The good news is that many of these are fixable issues! During your initial consultation and examination, we will administer many different tests that will scan for biomechanical issues related to these issues. After we learn more about you and some of the issues you are having, we will devise a treatment plan tailored to your individual needs as a patient. A typical treatment plan can involve a variety of different things.
Typically, we start by manually stretching any tight muscles that we find during your exam. This can help especially if you’re experiencing any sciatic issues above, or if these particular muscles are causing dysfunctional movement and contributing to your pain. We will also address any myofascial issues using techniques such as soft tissue mobilization, cupping, release techniques, as well as instrument-assisted massage. During your exam, we also assess for dysfunction in joints. In this case, common issues are usually found in the thoracic and lumbar spine, and even into the pelvis. We will perform gentle adjustments which will restore proper movements in these joints and reduce irritation and discomfort. Lastly, along with your traditional prenatal care team, it is our job to further educate you about what is going on with your body. This may involve modifications of your activities of daily living, stretches that will alleviate tension in muscles, proper biomechanics with certain activities, and strengthening exercises to help promote stability in your joints.
Chiropractic care is a safe and effective means of alleviating some of these common conditions related to pregnancy. Like any condition that we treat, our office is committed to providing high quality, patient-focused care to ensure that your pregnancy goes as smoothly as possible. If you are experiencing any of the symptoms above or have any questions, feel free to reach out to our office at (919) 342-0900.
References:
*This blog was originally from an excerpt that we elaborated on from the American Chiropractic Association. Link: https://www.acatoday.org/News-Publications/Publications/ACA-Blogs/ArtMID/6925/ArticleID/394/5-Conditions-Chiropractic-Care-Can-Improve-During-Pregnancy