The Treatment Experience of Patients With Low Back Pain During Pregnancy
SOURCE: Chiropractic & Manual Therapies 2012 (Oct 9)
Shabnam Sadr, Neda Pourkiani-Allah-Abad and Kent Jason Stuber
Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario M2H 3 J1, Canada
Background Chiropractors regularly treat pregnant patients for low back pain during their pregnancy. An increasing amount of literature on this topic supports this form of treatment; however the experience of the pregnant patient with low back pain and their chiropractor has not yet been explored. The objective of this study is to explore the experience of chiropractic treatment for pregnant women with low back pain, and their chiropractors.
Methods This qualitative study employed semi-structured interviews of pregnant patients in their second or third trimester, with low back pain during their pregnancy, and their treating chiropractors in separate interviews. Participants consisted of 11 patients and 12 chiropractors. The interviews consisted of 10 open-ended questions for patients, and eight open-ended questions for chiropractors, asking about their treatment experience or impressions of treating pregnant patients with LBP, respectively. All interviews were audio-recorded, transcribed verbatim, and reviewed independently by the investigators to develop codes, super-codes and themes. Thematic saturation was reached after the eleventh chiropractor and ninth patient interviews. All interviews were analyzed using the qualitative analysis software N-Vivo 9.
Results Five themes emerged out of the chiropractor and patient interviews. The themes consisted of Treatment and Effectiveness; Chiropractor-Patient Communication; Pregnant Patient Presentation and the Chiropractic Approach to Pregnancy Care; Safety Considerations; and Self-Care.
Conclusions Chiropractors approach pregnant patients with low back pain from a patient-centered standpoint, and the pregnant patients interviewed in this study who sought chiropractic care appeared to find this approach helpful for managing their back pain symptoms.
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From the Full-Text Article:
Background:
Low back pain (LBP) during pregnancy is reported by approximately 50% to 80% of pregnant women [1-3]. The structural, postural, or hormonal changes that occur during pregnancy, or any combination thereof, may lead to LBP during pregnancy [3]. Treatment options include a range of therapies, such as exercise programs, massage therapy, acupuncture, and chiropractic [4, 5]. Chiropractic care may include spinal manipulative therapy (SMT), mobilizations and soft tissue therapy, as well as exercise prescription. [3] Previous studies and systematic reviews of the literature have indicated the relative safety and effectiveness of chiropractic treatment for LBP during pregnancy. [3, 5, 7]
To date, no study has explored the treatment experience of the pregnant population seeking care for their back pain, whether that treatment is from a chiropractor or any other health care provider, nor has any study assessed the experience of chiropractors providing treatment for their pregnant patients with LBP. The qualities of the care provided by the treating chiropractor and that received by the pregnant patient may impact the outcomes of chiropractic care for women with LBP during pregnancy. As such, the objective of this study was to explore the experience of chiropractic treatment for pregnant women who have LBP, as well as their chiropractors in providing care for such patients.
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Having treated my wife and delivering 4 children at home I can attest to the value of chiropractic care that not only helped my wife with back pain, but made her home deliveries much easier. A report in the Journal of Manipulative and Physiological Therapeutics also reported that 84% of the women that experienced back pain during pregnancy received relief with chiropractic manipulation. Conway reported many of the women with low back pain during pregnancy also had longer labors. Melzack and Schaffelberg suggested that there may be a relationship between back pain during pregnancy and during delivery. Chiropractic care should be a given for pregnancy.
We have a number of patients that come to our office complaining of lower back pain during pregnancy. The best part of my day is informing patients about the safety and effectiveness of chiropractic care during pregnancy. Thank you for giving this very informative article that I can now share with our patients!
Pregnant women absolutely get a great benefit with chiropractic care. In our office we have had a lot of women who were in labor for 20+ hours for their first child without chiropractic care, and once they go through chiropractic care for their second delivery they see a dramatic drop in labor. Most will go down to 3-5 hours of labor. Also the strain placed on the low back from the extra weight is also greatly relieved with chiropractic care.
Chiropractic care is just so important while pregnant. Not just to treat low back pain, but to help remove nerve interference and improve function. There was just so much incredible information in this article and it was very well written. It will be a great resource for chiropractors and their patients alike. I appreciate you publishing this article.
Thanks Dr. Trevens!
It takes a lot of effort to format these materials to make the visually appealing, and it’s really worth it when the material is so relevant.
My Oby/Gyn teacher at Palmer (Maxine McMullen, D.C.) had a waiting list practice in Davenport, and her patients regularly noted a halving of delivery time, because all 3 layers of the uterine muscles work in concert when you remove nerve interferance.
Best to increase our knowledge about back pain treatment and we will incorporate your ideas into our therapy classes.
Chiropractic care has been very effective for pregnant women with back pain, and has been success for years. Muscles get tight as the woman gains weight during the pregnancy, which alters the biomechanical gait, and can lead to back pain as a result.