Pregnancy & Chiropractic Care

Chiropractic care is based on the theory of alterations to the biomechanics of the spinal and extraspinal structures such as the cranial or extremities bones, can lead to the altered neural signal being sent to the spine or vice- versa. This altered state of the spine can interfere with the neurological function, affecting homeostatic balance which may symptomatically and adversely affect the individual’s health. Adjusting the spine or correcting the biomechanics helps to restore and improve the overall function. Chiropractic care is not limited to any individual with any age and condition present. It is becoming quite popular in pregnant women in terms of their specific pregnancy related health concerns, such as back or neck pain. In this blog, I will talk about the physiological and hormonal changes that occur during pregnancy, benefits of Chiropractic care and what to expect during your appointment.

Physiological changes

During pregnancy, these are the common changes that happen which include changes in the spinal curve, increase in cervical lordosis and thoracic kyphosis, increase in ligament laxity, tightness in back extensor muscles, reduction in skeletal muscle tone, tight hamstring stretching, additional weight in breast may cause downward traction, stretching of uterus ligament, abdominal muscles may stretch and separate, weight of the baby constantly increase which can change the centre of gravity, Pelvis misalignment leading to hip joints to rotate internally, lumbricals weakening, tight tender Achilles and foot arch dropping. Ribs increase in diameter by up to 10cm and rib attachment angles flatten. Joints of the body can become unstable as they widen. In terms of Cardiovascular system, during pregnancy cardiac output increased about 30-50%, stroke volume increased about 10-15%, pulse increases about 15-20 bpm and systolic ejection murmur and S3 heart sound is common in 90% of population. There is normally a fall in blood pressure during the second trimester (5-10mmHg systolic and 10-15 mmHg diastolic) and then returns to normal during the third trimester. In terms of hematologic system. Plasma volume increases by about 50% and platelet count decreases. Respiratory system increases the inspiratory capacity by 5% and tidal volume by about 30-40%. It is common to experience the symptoms of bladder irritability, frequency and nocturia, urinary tract infection due to changes in progesterone hormone which slows down the smooth muscle contraction and the urine get retained. During pregnancy, there is also increase in kidney size and weight as well as bladder becomes an intra-abdominal organ.

In terms of gastrointestinal system, pregnancy hormones also affect the smooth muscles which slows down the digestive process. Stomach is usually displaced and squashed by the uterus as it rises which can cause reflux, nausea and/or constipation. In terms of reproductive changes, the uterus weight increases from 70gram to 1100 gram and blood flow increases by about10-15%. There is an increase in water content, vascularity and cervical mucous secretion in the cervix. It is common to have chloasma (dark, blotchy brown patches of skin) due to the oestrogen stimulating melanin production. Having the spine checked by a chiropractor helps ensure that your pelvis is sitting correctly and allows for optimum room for your baby to grow and move. It Maintains and improves the function of your spine with chiropractic adjustments throughout your pregnancy helps to clear your nerve system of interference. This allows you to be as healthy as possible enabling your body to more easily combat many of the physical hurdles of pregnancy. The reason of joint misalignment or altered neural signal may include weight gain, hormonal changes and alterations of the supporting structure of the joint, previous physical trauma may have altered the biomechanics of the spine and become more pronounced during pregnancy, Lifestyle factors and level of exercise, Number of previous pregnancies and status of pelvic musculature, Changing posture – increased lumbar lordosis, anterior head carriage compensating for lumbar changes and Rib cage – + 10cm diameter.

Common health complaints during pregnancy

The common complaints that are experienced during pregnancy include Nausea and vomiting, Constipation, Heartburn/reflux, Varicose veins and haemorrhoids, Headaches, Edema/swollen ankles, Back Pain, Faintness and light-headedness, Breast tenderness, Carpal tunnel syndrome, Urinary Tract Infections, Anaemia, Hip pain especially when sleeping and Pelvic instability – most common 22-26 weeks

Physical examination

Chiropractor will review your health history by asking questions around current presentation, previous pregnancies, lifestyle choices, health history, previous chiropractic care and screening for red/yellow flags including any contraindications. After a thorough health history examination will be performed which may include range of motion, posture, orthopaedic test, abdominal physical exam and any other regional system if required.
Modifications to the treatment will be made if required. These modifications include using pregnancy pillows, table with drop pieces, pillows to support tender breast, place under leg or between knees when side lying. There are several Chiropractic techniques that may help to address the joint misalignment in the spine. Activator method, drop-assist, Thompson, diversified are few to list. Your Chiropractor will moderate the force and depth accordingly to the patient’s presentation.

Recommendations of spinal care during pregnancy

These are the following recommendations which should be utilized to minimize the risk of joint dysfunction. Do not Don’t try and sit up from lying using your abdominal muscles – roll on to your side and push up with your arm. Relax your knees when standing. Let others lift heavy items for you. Try to minimize carrying toddlers. Avoid twisting – i.e. when getting out of the car turn your whole body and place both feet on the ground. Avoid remaining in one position too long. Set up your workstation to accommodate for each stage. Keep your pelvic floor strong by doing Kegel exercises. Regularly moving, stretching and eating healthy. Smiley belt can also be utilized to stabilize the spine while doing any lifting e.g. picking up laundry or toddlers.

If you or anybody you know who may get benefits from chiropractic care while they are pregnant, get in touch with your nearest Chiropractor and start the journey towards the healthy living.