Pregnancy & Chiropractic

The female body experiences structural stresses in pregnancy, commonly including : increased lumbar lordosis and sacral base angle, increased segmental mobility (particularly of the sacroiliac and pubic articulations), a weight-bearing shift to one’s heels, and gait alterations. While multiple factors may cause pubic symphysis dysfunction, it has been suggested that instability of the pelvic girdle is the most common cause of pelvic joint pain in pregnancy, including pain in the pubic symphysis.

Maternal hormones contribute to joint-laxity by producing connective-tissue changes that cause ligaments to lengthen and weaken, allowing changes in posture to accommodate the pregnancy. This change puts more stress and increases the work-load of muscles, which usually provides the stability to the pelvic ring. A combination of muscle weakening and joint laxity brings the chance of joint instability and corresponding pain syndromes.

Postpartum studies demonstrate mechanical damage in all women who deliver vaginally if a baby weighs over 2.3 kg (5 lbs). Multiple births create a repetitive strain to the articular surfaces of the pubic symphysis from repeated distraction, disturbance of the symphyseal disk, and damage to the hyaline cartilage.

Restricted motion of one or both sacroiliac joints may contribute to increased motion at the pubic symphysis. This coupled with ligament laxity resulting from maternal hormones may cause repetitive stress to the pubic symphysis.

Many pregnancies (pre-, ongoing-, and post-partum) respond favorably to chiropractic care.

Through interventions including chriropractic adjustments, maternity belts, and exercise advice, a chiropractor is a suitable option for women experiencing structural compensation difficulty in pregnancy (and after).

References:

Borggren, C. L. (2007). Pregnancy and chiropractic: a narrative review of the literature. Journal of chiropractic medicine, 6(2), 70-74.

Robert Fano, D. C., & Linda Mullin, D. C. Chronic Post Partum Osteitis Pubis Managed with Chiropractic.