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Health & Fit Chiropractic Care During Pregnancy: Is It Safe?

23:40  24 september  2019
23:40  24 september  2019 Source:   usnews.com

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For several months, a pregnant Portland, Oregon-based woman in her early 30s suffered from debilitating pain in her pubic bone area.

a person sitting in a chair: A chiropractor helps a young pregnant woman.© (Getty Images) A chiropractor helps a young pregnant woman.

She had trouble walking. Taking the stairs was agonizing. The woman even had a hard time standing on one leg long enough to pull on a pair of pants, recalls Jennifer Brocker, a board-certified pediatric chiropractor based in Portland.

A midwife thought chiropractic treatment might help the woman, who was about seven months pregnant. The cartilage that holds the pubic bones together (forming a joint) had softened during pregnancy. This allowed the joint to get stuck, which caused her pain. The midwife referred the woman to Brocker, who treated her three times over two weeks, providing simple adjustments as she would with most patients.

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It worked. "The pain was totally resolved," says Brocker, who's president of the American Chiropractic Association's pediatrics council.

Before getting chiropractic treatment, the woman believed that severe pain was simply part of being pregnant, Brocker says. "She was going on the assumption that pain is normal in pregnancy, and that's just the way it is," Brocker says. "It's not the way it is. There's a lot we (chiropractors) can do to help with discomfort during pregnancy and make pregnancy enjoyable and comfortable." Brocker says she often tells patients, "Just because it's common, doesn't mean it's normal. Pregnancy shouldn't be painful."

For the many pregnant women who experience back pain and other types of discomfort, chiropractic treatment is a safe and often effective option, says Dr. Carrie Ann Terrell, associate professor, Department of Obstetrics, Gynecology and Women's Health at the University of Minnesota Medical School in Minneapolis.

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There's no research to suggest chiropractic care presents health risks to a pregnant woman or her fetus. "We generally support the use of many complementary therapies, including chiropractic care," Terrell says. "We do not know of any demonstrated risks."

Terrell says she often recommends chiropractic treatment for pregnant women who struggle with musculoskeletal pain – like lower back discomfort – that they haven't been able to manage themselves by such approaches as stretching or wearing a pregnancy support belt.

Research suggests it's common for women to experience musculoskeletal pain during pregnancy. A study published in the journal Therapeutic Advances in Musculoskeletal Disease in December 2018 found that 70% of 184 women who gave birth in a hospital reported having low back pain during their pregnancy. Overall, 80% reported experiencing back pain, 33% had hand-wrist discomfort and 32% said they endured hip pain, researchers wrote.

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Chiropractic treatment as an option to treat pain is particularly important for pregnant women because there are many pain medications they shouldn't use because they could adversely affect their baby, says Dr. Heather L. Beall, an OB-GYN with Northwestern Medicine in Crystal Lake, Illinois.

"You don't want (pregnant women) to use chronic pain pills because they're addictive," Beall says. Such medications could cause the baby to go into withdrawal when he or she is born. Some non-steroidal pain medications could cause the fetus's heart valve to close prematurely, which could be life-threatening, she says.

Tens of millions of people in the U.S. see chiropractors for relief from an array of conditions, including back, shoulder, foot and neck pain, headaches, a loss of strength in their arms and hands and numbness and tingling.

What Is Chiropractic Treatment?

Chiropractors restore motion to restricted joints with an array of adjustments, Brocker says. During an initial visit, a chiropractor typically takes a thorough health history and does a physical exam, paying attention to anything that may be a contraindication to chiropractic care, like a fractured bone or joint dislocation. Chiropractors employ an array of adjustments. For example, a chiropractor can use his or her hands to apply controlled and rapid force to a restricted joint. This allows the joint to move in a normal manner and reduces inflammation and pain, Brocker says. Modifications to the applied force with special populations – like pregnant women – help ensure the adjustment is "comfortable, safe and effective," Brocker says.

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If you're pregnant and experiencing discomfort and are considering seeking chiropractic treatment, experts recommend these strategies:

  • Talk to your health care provider.
  • Look for a chiropractor experienced in treating pregnant women.
  • Develop an exercise and stretching routine.
  • Consider acupuncture and massage.

1. Talk to your health care provider. Your health care provider can help determine whether whatever pain you're experiencing is related to your joints and could therefore be helped with chiropractic treatment, or whether it's being caused by something else, Beall says. For example, pain in your gallbladder, which you'd typically feel in the front of your abdomen, is sometimes referred to your back. If you're considering chiropractic treatment, ask your OB-GYN, family medicine doctor or certified nurse-midwife for recommendations. Your OB provider may have specific chiropractors in mind who have experience working with pregnant women, Beall says.

2. Look for a chiropractor experienced in treating pregnant women. If you were seeing a chiropractor before you learned you were expecting, he or she is not necessarily the provider you'd want to go to during your pregnancy, Beall says. Ideally, you'd see a chiropractor who's experienced in treating pregnant women. Do an online search of chiropractors in your area, she suggests. Some chiropractors have lots of experience working with pregnant women and are likely to say so on their website, where they'll also note their educational background and training.

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3. Develop an exercise and stretching routine. While chiropractic treatment can be an effective option for pregnant women experiencing discomfort, it should be buttressed with stretching and exercise, says Andrew Bang, a chiropractor with Cleveland Clinic Wellness. "Manipulation can provide instant relief because the body releases pain-fighting chemicals," Bang says. Deep stretches and exercises you can do at home will provide a longer-lasting benefit, he says. Your chiropractor or a physical therapist can show you which stretches and exercises would be beneficial.

4. Consider acupuncture and massage. In addition to developing an exercise and stretching routine, pregnant women should consider acupuncture, acupressure and massage, Terrell says. Like chiropractic adjustments, these types of treatments cause the body to release analgesic chemicals. Acupuncture is a traditional Chinese medicinal practice in which a provider inserts small needles into different points on the body. Research suggests it can help blunt chronic pain. Acupressure is a "specific type of massage that relies primarily on using the thumbs, fingers and palms to apply pressure to various points on the body" without using needles, according to the Acupuncture Massage College in Miami. "Acupuncture and acupressure can be helpful with nausea and vomiting associated with early pregnancy as well as the various pains women experience in pregnancy," Terrell says.

The Mayo Clinic says that some types of acupuncture are "thought to stimulate labor, which could result in a premature delivery." However, acupuncture is safe for pregnant women, according to research published in 2015 in the journal Acupuncture Medicine. Two published systematic reviews found no "miscarriage, preterm deliveries or other obstetric complications" attributable to acupuncture, according to the study. Massage can also be helpful. Whichever approach you choose, look for a provider experienced with treating pregnant women.

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