The Treatment Experience of Patients With Low Back Pain During Pregnancy

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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:


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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