The good news during a normal pregnancy is that your baby is growing. The bad news is that you are likely to experience back pain. Your symptoms may occur in the pelvic area or the low back, or both; some women may also experience leg pain. Back pain during pregnancy is generally attributed to postural changes (increased low back curve to balance increasing belly weight) and ligament laxity caused by hormones.
Most pregnant women will experience some degree of back and/or pelvic pain during pregnancy. It usually begins in the third month of pregnancy and peaks in the third trimester before declining in severity. Many women report a return to pre-pregnancy levels of low back pain within six months of delivery, but some experience chronic low back or pelvic pain. The 12-month postpartum rate of back or pelvic pain is 37 percent and the six-year rate is 18 percent.
Pregnancy-related low back pain contributes substantially to health care costs. 94 percent of women who experienced low back pain during pregnancy have recurrent symptoms with subsequent pregnancies and two-thirds of these patients experience disability requiring sick leave. Notably, 19 percent of women with pain in an initial pregnancy report avoiding a future pregnancy out of fear of a recurrence of these symptoms.
Fortunately, several effective non-drug strategies can help reduce the severity and frequency of back and pelvic pain: practicing good posture when standing and sitting, sleeping on your side and wearing low-heeled shoes with good arch support. Exercise and spinal manipulation are also very effective.
Medical research teams have found that an individualized exercise program that includes stabilizing exercises and aerobic exercise is effective for pregnant patients with back or pelvic pain. Aerobic exercise during pregnancy is important to overall health, mood management and reduction of fatigue.
Stabilizing exercises can control pain, improve function and enhance overall quality of life. Both forms of exercise can be used not only to treat pain, but also to prevent it. You should consult with your medical doctor before beginning any exercise program.
Researchers have found that spinal manipulation can provide safe and effective relief of back and pelvic pain in pregnant women. Three scientific reviews found that chiropractic treatment during pregnancy is a safe and effective means of treating common spinal symptoms in pregnant patients. Altogether, the current literature suggests that chiropractic treatment is a safe intervention for pregnant women with back and pelvic pain.
Recently, a randomized clinical trial found that adding chiropractic care (four to six treatment sessions) to standard obstetric management provided important clinical benefits to pregnant women with back and pelvic pain. The study, published in American Journal of Obstetrics and Gynecology, was conducted with medical doctors and chiropractors.
The Mayo Clinic has also recommended spinal manipulation for pregnant patients. If you are considering chiropractic care, it is recommended that you consult with an evidence-based chiropractor.
Dr. Hari Dass Khalsa is a chiropractor specializing in the non-surgical treatment of spinal conditions with offices located in the Hawthorne District. Please call 503.238.1032 for more information.
Editor’s note: Wellness Word is an informational column which is not meant to replace a healthcare professional’s diagnosis, treatment or medication.