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Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy

By |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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Chiropractic Pediatrics Section and the:

Female Issues and Chiropractic Page and the:

Pregnancy-related Pain and Chiropractic Page

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Can a Bothersome Course of Pelvic Pain From Mid-pregnancy to Birth be Predicted?

By |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 |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 |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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Chiropractic Pediatrics Page and the:

Low Back Pain and Chiropractic Page

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A Randomized Controlled Trial Comparing a Multimodal Intervention and Standard Obstetrics Care for Low Back and Pelvic Pain in Pregnancy

By |February 1, 2015|Low Back Pain, Pregnancy|

A Randomized Controlled Trial Comparing a Multimodal Intervention and Standard Obstetrics Care for Low Back and Pelvic Pain in Pregnancy

The Chiro.Org Blog


SOURCE:   Am J Obstet Gynecol. 2013 (Apr);   208 (4):   295.e1-7 ~ FULL TEXT

James W. George, DC, Clayton D. Skaggs, DC,
Paul A. Thompson, PhD, D. Michael Nelson, MD, PhD,
Jeffrey A. Gavard, PhD, Gilad A. Gross, MD

Chiropractic Science Division,
College of Chiropractic,
Logan University,
Chesterfield, MO, USA.


OBJECTIVE:   Women commonly experience low back pain during pregnancy. We examined whether a multimodal approach of musculoskeletal and obstetric management (MOM) was superior to standard obstetric care to reduce pain, impairment, and disability in the antepartum period.

STUDY DESIGN:   A prospective, randomized trial of 169 women was conducted. Baseline evaluation occurred at 24-28 weeks’ gestation, with follow-up at 33 weeks’ gestation. Primary outcomes were the Numerical Rating Scale (NRS) for pain and the Quebec Disability Questionnaire (QDQ). Both groups received routine obstetric care. Chiropractic specialists provided manual therapy, stabilization exercises, and patient education to MOM participants.

RESULTS:   The MOM group demonstrated significant mean reductions in Numerical Rating Scale scores (5.8 ± 2.2 vs 2.9 ± 2.5; P < .001) and Quebec Disability Questionnaire scores (4.9 ± 2.2 vs 3.9 ± 2.4; P < .001) from baseline to follow-up evaluation. The group that received standard obstetric care demonstrated no significant improvements.

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Pre-Eclampsia and the Impact on Chiropractic Management of the Pregnant Patient

By |August 3, 2014|Chiropractic Management, Pre-Eclampsia, Pregnancy|

Pre-Eclampsia and the Impact
on Chiropractic Management
of the Pregnant Patient

The Chiro.Org Blog


SOURCE:   J Clinical Chiropractic Pediatrics 2012 (Dec)

Sharon Gordon, BAppSc(Chiro), DICCP and Sherryn Silverthorne, M Clinical Chiro, RN, RM

Sharon Gordon, BAppSc(Chiro), DICCP
Private Practice, Gippsland, Victoria, Australia

Sherryn Silverthorne, M Clinical Chiro, RN, RM
Private Practice, Melbourne, Victoria, Australia


Up to 10% of women develop pre-eclampsia during pregnancy. It is a significant cause of mortality, responsible for 10-15% of maternal deaths. Its diagnosis is based on the presence of hypertension, with or without proteinuria and edema. As primary contact health care providers, chiropractors must be aware of the risk factors, clinical signs of pre-eclampsia, and the need to modify their management appropriately. An open internet search was conducted for current guidelines in scientific journal databases, in the diagnosis and management of pre-eclampsia. Although there is little literature outlining the role of the chiropractor in patient management, it is clear that specific history and examination procedures must be performed for appropriate co-management and referral.

Key Words:   pre-eclampsia, eclampsia, toxemia, hypertension, pregnancy, chiropractic


From the Full-Text Article:

Introduction

Pre-eclampsia (also known as toxemia of pregnancy) is one of the major causes of maternal mortality and morbidity. 10%-15% of maternal deaths are directly associated with pre-eclampsia and eclampsia. [1] Up to 10% of pregnant women develop pre-eclampsia. [2] The incidence of pre-eclampsia in the nulliparous woman is cited as being between 3%-7% and for the multiparous woman 1%-3%. [1, 3] This diagnosis is based on the presence of hypertension, proteinuria, with or without edema. As primary contact health care providers, chiropractors must be aware of the risk factors, clinical signs of pre-eclampsia, and the need to modify their management appropriately.


Objective

To review the diagnostic criteria, risk factors and complications of pre-eclampsia, and discuss how this may affect chiropractic management of the pregnant patient.


Methods

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