Pregnancy

Manipulative Therapy for Pregnancy and Related Conditions: A Systematic Review

By Frank M. Painter|December 22, 2021|Chiropractic Management, Pregnancy|

Manipulative Therapy for Pregnancy and Related Conditions: A Systematic Review

SOURCE: Obstet Gynecol Surv 2009 (Jun); 64 (6): 416–427

Raheleh Khorsan, MA, Cheryl Hawk, DC, PhD, Anthony J. Lisi, DC, and Anupama Kizhakkeveettil, BAMS, MAOM

Military Medical Research and Integrative Medicine,
Samueli Institute,
Corona del Mar,
California 92625, USA

Objective: The objective of this review is to evaluate the evidence on the effects of Spinal Manipulative Therapy (SMT) on back pain and other related symptoms during pregnancy.

Data sources: A literature search was conducted using Pubmed, Manual, Alternative and Natural Therapy Index System, Cumulated Index to Nursing and Allied Health, Index to Chiropractic Literature, the Cochrane Library, and Google Scholar. In addition hand searches and reference tracking were also performed, and the citation list was assessed for comprehensiveness by content experts.

Methods of study selection : This review was limited to peer-reviewed manuscripts published in English from 1966 until September 2008. The initial search strategy yielded 140 citations of which 12 studies were reviewed for quality.

Tabulation, integration, and results: The methodological quality of the included studies was assessed independently using quality checklists of the Scottish Intercollegiate Guidelines Network and Council on Chiropractic Guidelines and Practice Parameters. The review indicates that the use of SMT during pregnancy to reduce back pain and other related symptoms is supported by limited evidence.

Conclusion: Overall, this body of evidence is best described as emergent. However, since effective treatments for pregnancy-related back pain are limited, clinicians may want to consider SMT as a treatment option, if no contraindications are present.

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Best-Practice Recommendations for Chiropractic Care for Pregnant and Postpartum Patients: Results of a Consensus Process

By Frank M. Painter|December 16, 2021|Chiropractic Management, Pregnancy|

Best-Practice Recommendations for Chiropractic Care for Pregnant and Postpartum Patients: Results of a Consensus Process

The Chiro.Org Blog

SOURCE: J Manipulative Physiol Ther 2021 (Nov 23)

Carol Ann Weis, MSc, DC, Katherine Pohlman, DC, PhD, Jon Barrett, MBBch, MD, Maeve O’Beirne, MD, PhD, Kent Stuber, DC, MSc, Cheryl Hawk, DC, PhD

Department of Research,
Canadian Memorial Chiropractic College,
Toronto, ON, Canada.

Objective: The purpose of this project was to develop a best-practices document on chiropractic care for pregnant and postpartum patients with low back pain (LBP), pelvic girdle pain (PGP), or a combination.

Methods: A modified Delphi consensus process was conducted. A multidisciplinary steering committee of 11 health care professionals developed 71 seed statements based on their clinical experience and relevant literature. A total of 78 panelists from 7 countries were asked to rate the recommendations (70 chiropractors and representatives from 4 other health professions). Consensus was reached when at least 80% of the panelists deemed the statement to be appropriate along with a median response of at least 7 on a 9-point scale.

Results: Consensus was reached on 71 statements after 3 rounds of distribution. Statements included informed consent and risks, multidisciplinary care, key components regarding LBP during pregnancy, PGP during pregnancy and combined pain during pregnancy, as well as key components regarding postpartum LBP, PGP, and combined pain. Examination, diagnostic imaging, interventions, and lifestyle factors statements are included.

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Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy

By Frank M. Painter|July 31, 2018|Low Back Pain, Pregnancy|

Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy: A Retrospective Case Series

The Chiro.Org Blog

SOURCE: J Midwifery Womens Health 2006 (Jan); 51 (1): e7-10

Anthony J. Lisi

University of Bridgeport College of Chiropractic.

Low back pain is a common complaint in pregnancy, with a reported prevalence of 57% to 69% and incidence of 61%. Although such pain can result in significant disability, it has been shown that as few as 32% of women report symptoms to their prenatal provider, and only 25% of providers recommend treatment. Chiropractors sometimes manage low back pain in pregnant women; however, scarce data exist regarding such treatment. This retrospective case series was undertaken to describe the results of a group of pregnant women with low back pain who underwent chiropractic treatment including spinal manipulation. Seventeen cases met all inclusion criteria.

The overall group average Numerical Rating Scale pain score decreased from 5.9 (range 2-10) at initial presentation to 1.5 (range 0-5) at termination of care. Sixteen of 17 (94.1%) cases demonstrated clinically important improvement. The average time to initial clinically important pain relief was 4.5 (range 0-13) days after initial presentation, and the average number of visits undergone up to that point was 1.8 (range 1-5). No adverse effects were reported in any of the 17 cases. The results suggest that chiropractic treatment was safe in these cases and support the hypothesis that it may be effective for reducing pain intensity.

From the FULL TEXT Article:

INTRODUCTION

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Can a Bothersome Course of Pelvic Pain From Mid-pregnancy

By Frank M. Painter|July 29, 2018|Low Back Pain, Pregnancy|

Can a Bothersome Course of Pelvic Pain From Mid-pregnancy to Birth be Predicted? A Norwegian Prospective Longitudinal SMS-Track Study

The Chiro.Org Blog

SOURCE: BMJ Open. 2018 (Jul 25); 8 (7): e021378

Stefan Malmqvist, Inger Kjaermann, Knut Andersen, Anne Marie Gausel, Inger Økland, Jan Petter Larsen, Kolbjorn S Bronnick

The Norwegian Centre for Movement Disorders,
Stavanger University Hospital,
Stavanger, Norway.

OBJECTIVE: To explore if pregnant women with pelvic girdle pain (PGP), subgrouped following the results from two clinical tests with high validity and reliability, differ in demographic characteristics and weekly amount of days with bothersome symptoms through the second half of pregnancy.

DESIGN: A prospective longitudinal cohort study.

PARTICIPANTS: Pregnant women with pelvic and lumbopelvic pain due for their second-trimester routine ultrasound examination.

SETTING: Obstetric outpatient clinic at Stavanger University Hospital, Norway.

METHODS: Women reporting pelvic and lumbopelvic pain completed a questionnaire on demographic and clinical features. They were clinically examined following a test procedure recommended in the European guidelines for the diagnosis and treatment of PGP. Women without pain symptoms completed a questionnaire on demographic data. All women were followed weekly through an SMS-Track survey until delivery.

PRIMARY AND SECONDARY OUTCOME MEASURES: The outcome measures were the results from clinical diagnostic tests for PGP and the number of days per week with bothersome pelvic pain.

RESULTS: 503 women participated. 42% (212/503) reported pain in the lumbopelvic region and 39% (196/503) fulfilled the criteria for a probable PGP diagnosis. 27% (137/503) reported both the posterior pelvic pain provocation (P4) and the active straight leg raise (ASLR) tests positive at baseline in week 18, revealing 7.55 (95% CI 5.54 to 10.29) times higher mean number of days with bothersome pelvic pain compared with women with both tests negative. They presented the highest scores for workload, depressed mood, pain level, body mass index, Oswestry Disability Index and the number of previous pregnancies. Exercising regularly before and during pregnancy was more common in women with negative tests.

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Chiropractic Management of Pregnancy-Related Lumbopelvic Pain

By Frank M. Painter|August 7, 2016|Low Back Pain, Pregnancy|

Chiropractic Management of Pregnancy-Related Lumbopelvic Pain: A Case Study

The Chiro.Org Blog

SOURCE: J Chiropractic Medicine 2016 (Jun); 15 (2): 129–133

Maria Bernard, BSc, GradDipChiro, GradCertChiroPaediatrics,
Peter Tuchin, BSc, GredDipChiro, OHS, PhD

Private Practice,
Sydney, Australia.

Associate Professor,
Department of Chiropractic Faculty Science,
Macquarie University,
Sydney, NSW, Australia.

OBJECTIVE: The purpose of this case report is to describe chiropractic management of a patient with pregnancy-related lumbopelvic pain.

CLINICAL FEATURES: A pregnant 35-year-old woman experienced insidious moderate to severe pregnancy-related lumbopelvic pain and leg pain at 32 weeks’ gestation. Pain limited her endurance capacity for walking and sitting. Clinical testing revealed a left sacroiliac joint functional disturbance and myofascial trigger points reproducing back and leg pain.

INTERVENTION AND OUTCOME: A diagnosis of pregnancy-related low back pain and pregnancy-related pelvic girdle pain was made. The patient was treated with chiropractic spinal manipulation, soft tissue therapy, exercises, and ergonomic advice in 13 visits over 6 weeks. She consulted her obstetrician for her weekly obstetric visits. At the end of treatment, her low back pain reduced from 7 to 2 on a 0-10 numeric pain scale rating. Functional activities reported such as walking, sitting, and traveling comfortably in a car had improved.

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Back and Pelvic Pain in an Underserved United States Pregnant Population

By Frank M. Painter|January 19, 2016|Low Back Pain, Pregnancy|

Back and Pelvic Pain in an Underserved United States Pregnant Population: A Preliminary Descriptive Survey

The Chiro.Org Blog

SOURCE: J Manipulative Physiol Ther. 2007 (Feb); 30 (2): 130–134

Clayton D. Skaggs, DC, Heidi Prather, DO,
Gilad Gross, MD, James W. George, DC,
Paul A. Thompson, PhD, D. Michael Nelson, MD, PhD

Department of Obstetrics and Gynecology,
Washington University School of Medicine,
St Louis, MO, USA.
skaggsdc@swbell.net

OBJECTIVE: The objective of this study was to identify the prevalence of back pain and treatment satisfaction in a population of low-socioeconomic pregnant women.

METHODS: This study used a cross-sectional design to determine the prevalence of self-reported musculoskeletal pain in pregnancy for 599 women. Women completed an author-generated musculoskeletal survey in the second trimester of their pregnancy that addressed pain history, duration, location, and intensity, as well as activities of daily living, treatment frequency, and satisfaction with treatment.

RESULTS: Sixty-seven percent of the total population reported musculoskeletal pain, and nearly half presented with a multi-focal pattern of pain that involved 2 or more sites. Twenty-one percent reported severe pain intensity rated on a numerical rating scale. Eighty percent of women experiencing pain slept less than 4 hours per night and 75% of these women took pain medications. Importantly, 85% of the women surveyed perceived that they had not been offered treatment for their musculoskeletal disorders.

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