Pregnancy-related Back Pain

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“…multimodal chiropractic care directed specifically at low back and pelvic pain during pregnancy was significantly more effective than standard obstetric care for reducing pain.”

Summary:

During pregnancy, many women experience low back pain and/or pelvic pain. Though these conditions are not typically hazardous to the health of the mother or fetus and are generally assumed to be temporary, they still contribute substantially to health care costs, maternal anxiety, difficulty sleeping, and workplace absenteeism. George et al. (2013) compared the effects of standard obstetrics care (STOB) and a multimodal musculoskeletal and obstetric management (MOM) intervention on low back and pelvic pain in pregnant women. Pregnant mothers between 24-28 weeks’ gestation were randomly assigned to one of the two treatments. Those women assigned to the STOB group received care only from their self-chosen obstetrician. This care could include rest, aerobic exercise, heating pad application, use of over-the-counter pain medications, or prescription narcotics for severe pain. Women assigned to the MOM group also continued to see their self-chosen obstetricians and received comparable pain intervention. However, women in the MOM group also had weekly sessions with a chiropractor who provided education (e.g., assuring mothers that exercise would not harm the fetus), manual therapy to restore joint mobility and decrease muscle tension, and stabilization exercises to strengthen muscles in the lower back and pelvis. Each mother’s pain level was evaluated using both objective and subjective methods prior to receiving treatment. At 33 weeks’ gestation, each woman’s pain indicators were reevaluated. Following 4-6 weeks of treatment, women in the MOM group showed a significant decrease in low back and pelvic pain on 7 measures, while women in the STOB group only showed a significant decrease on 1 measure. Furthermore, women in the STOB group showed a significant increase on 5 pain measures. Women in the MOM group also reported improvement in their sleep, while women in the STOB group reported no significant change. In general, George et al. (2013) found that multimodal chiropractic care directed specifically at low back and pelvic pain during pregnancy was significantly more effective than standard obstetric care for reducing pain. Women receiving chiropractic care experienced a subjective decrease in pain and disability as well as an objective increase in range of motion, stability, joint comfort, and quality sleep. No negative side effects were found.

George J. W., Skaggs, C. D., Thompson, P. A., Nelson, D. M., Gavard, J. A., & Gross, G. A. (2013). A randomized controlled trial comparing a multimodal intervention and standard obstetrics care for low back and pelvic pain in pregnancy. American Journal of Obstetrics Gynecology, 208(4), 295.e1-7. doi: 10.1016/j.ajog.2012.10.869.