Back Pain during Pregnancy

Does Chiropractic Help Back Pain Associated with Pregnancy?

If you are pregnant and suffering from low back pain, a neighbor or a friend has probably suggested you visit a chiropractor because a chiropractor was able to help them during their pregnancy.

The discussion probably left you curious, is that good advice or just a single success story?

Additionally, you may be wondering whether chiropractic is safe during pregnancy and how much low back pain improvement the average pregnant woman can expect to get.

After looking at several scientific publications on these exact topics, the appropriate conclusion seems to be that “chiropractic evaluation and treatment during pregnancy may be considered a safe and effective means of treating common musculoskeletal symptoms that affect pregnant patients. The scarcity of published literature warrants further research.” (Borggren, 2007)

So basically the answers are:

• Yes, chiropractic is safe during pregnancy.
• Yes, chiropractic helps common musculoskelatal probelms during pregnancy  (including back pain).
• Your friends experience isn’t just one woman’s story. Many women are finding relief and the results are being sporadically published in medical journals too.
• More research under more controlled conditions is needed for the purposes of educating primary care physicians and obstetricians about chiropractic care during pregnancy.

Here are a few additional details about the prevalence of low back pain during pregnancy and the number of women being referred for treatment.

• 57 – 69% of women complain of low back pain during pregnancy
• Only about 32% of women report these symptoms to their primary doctor
• Only about 25% of primary doctors recommend seeking treatment for the pain.

Clearly this is a big problem with 2 in 3 having pregnancy-related back pain. Also a big problem is that they are generally not talking to their obstetricians and primary care physicians about it and that these professionals are not referring them to effective treatment options.

Chiropractic treatments can be quite effective for pregnancy-related back pain with just a few visits for the majority of women seeking help. In a small study of 17 women:

• Sixteen of 17 (94%) saw clinically important improvements in low back pain with chiropractic care.
• The average pain rating went down from 5.9 to 1.5 (on a scale of 0 to 10).
• It took an average of 1.8 visits and 4.5 days to get clinically important pain relief.

We hope this article gave you hope that many pregnant women do get significant, rapid relief from low back pain.

If you are currently pregnant with low back pain, you probably have many questions not answered by this article. Perhaps you’ve never had chiropractic care before or you want to know how we adjust our techniques to work with pregnant patients.

The best way to get answers to your questions is with an initial consultation. The only way for us to know whether you are a good candidate is for you to come see us, so call Dr. Wintermute at (949) 559-7999 for an initial appointment today.

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Bibliography
 
Borggren, C. L. (2007, Spring). Pregnancy and chiropractic: a narrative review of the literature. J Chiropr Med, 6(2), 70-74.

Khorsan, R., Hawk, C., Lisi, A., & Kizhakkeveettil, A. (2009, Jun). Manipulative therapy for pregnancy and related conditions: a systematic review. Obstet Gynecol Surv, 64(6), 416-27.

Lisi, A. (2006, Jan-Feb). Chiropractic spinal manipulation for low back pain of pregnancy: a retrospective case series. J Midwifery Womens Health, 51(1), 7-10.

Stuber, K., & Smith, D. (2008, ul-Aug). Chiropractic treatment of pregnancy-related low back pain: a systematic review of the evidence. J Manipulative Physiol Ther., 31(6), 447-54.

Common Causes of Back Pain

Understanding the cause of your back pain is the key to proper treatment.

There are many different underlying conditions that cause back pain. The more common causes of back pain are described below. Don’t try to make your own diagnosis. A trained chiropractor that deals with back pain complaints on a daily basis will know what to look for and what questions to ask you to determine the underlying cause.

1.    Muscle strains and muscle spasms are the most common cause of low back pain.  Patients may or may not remember the initial event that triggered their muscle spasm. Back pain from muscle spasms can be incredibly painful and feel like nerve pain when the muscle tighten and twitch around a key nerve such as the sciatic nerve.

2.    A ruptured intervertebral disc, also called a herniated disc, is another common cause of back pain. The terms ruptured, herniated, slipped and bulging disc don’t really have precise definitions to distinguish one from another and are often used somewhat interchangeably to describe protruding disc material. It is important to note that a large percent of the population is walking around with bulging discs that cause no symptoms, so not every herniated disc warrants treatment or intervention.

3.    Discogenic back pain is the result of damage to the intervertabral disc, but without disc herniation. Diagnosis of discogenic back pain may require the use of a discogram.

4.    Spinal stenosis causes a lot of back pain in the elderly. As we age, the spinal canal can become constricted from arthritis and other conditions.  If the spinal canal becomes too tight, back pain can be the result.

5.    Arthritis most commonly affects joints such as the knees and fingers. However, arthritis can affect any joint in the body, including the small joints of the spine. Arthritis of the spine can cause back pain with movement.

6.    Spondylolisthesis causes back pain because adjacent vertebra become unstable and begin to "slip."  The most common cause of spondylolisthesis are degenerative changes causing loss of the normal stabilizing structures of the spinal column. 

As stated earlier, backaches are hard to self-diagnose. The causes listed above are just a few of more common possibilities. If you suffer from acute or chronic backaches, consult a qualified chiropractor for a complete exam.

Surgery or Chiropractic for Chronic Sciatica Sufferers?

Pain coming from compression or irritation of the sciatic nerve is called sciatica. Sciatica — which can include pain, tingling, numbness and muscle weakness — is really a symptom indicating an underlying problem, not a diagnosis in and of itself. This article will explore in detail the findings of a recent controlled study comparing spinal manipulation (chiropractic) and surgery for people whose sciatica did not respond to traditional medical treatment approaches.

The study discussed here was conducted by the National Spine Center in Alberta Canada and published in October of 2010 in the Journal of Manipulative and Physiological Therapeutics. The 40 study participants all had sciatica lasting over 3 months which had not responded to treatment with pain medications, lifestyle modifications, physical therapy, massage therapy or acupuncture. They had all been referred by their primary care physicians to spinal surgeons who had deemed them appropriate surgery candidates.

Instead of having all the patient proceed with surgery, they were split into two groups — one group to undergo a surgical microdiscectomy and the other group to be treated with standardized chiropractic spinal manipulation by a single chiropractor. (If not satisfied with the results they obtained from their assigned method, the patients were allowed to switch to the other treatment plan after 3 months.)

So what happened? Both groups made significant improvements over baseline scores — meaning that they saw noticeable improvements whereas previous approaches had failed. A full 60% of the study participants benefitted from chiropractic spinal manipulation to the SAME degree as if they underwent surgery. And, after 1 year there was no difference in outcome success based on the treatment method. That means that a full 60% of people referred for surgery by their primary care physicians and accepted as surgical candidates by the neurosurgeon could actually get similar results with chiropractic. That is a lot of potentially unnecessary cutting, anesthesia and ER time.
 
There is one paragraph in the results section of this study that is easy to overlook, but incredibly important. There were originally 120 candidates of which 60 met the study criteria and were asked to participate. Of these 60, 20 refused. Why? Because they had never been offered spinal manipulation as an alternative to surgery! They didnít want to participate in the study and be randomly placed in the surgery group without first trying the spinal manipulation! This is incredibly telling. Not only does it demonstrate that there is still a lot of education about chiropractic that needs to happen among the public and among primary care providers, it also demonstrates that people understand the risks and costs of surgery and want to exhaust other possibilities first.

This was the first study to ever look at people who had failed traditional medical management of sciatica. Currently most patients that fail "conservative care" are referred for a surgical evaluation. Now we know that 60% of these folks could avoid surgery and get similar long-term outcomes with chiropractic.
Please share this article with anyone considering surgery for sciatica.