Nillumbik Osteopathic Health Centre

Pregnancy

Pregnancy can be a happy time for an expecting mother, however some women may suffer illness, pain and discomfort. During pregnancy a woman’s body may experience both hormonal changes (promoting the softening of muscles and ligaments) and weight gains (shifting the body’s centre of gravity). These vast changes in the body may lead to problems such as back pain, sciatica, pubic symphysis discomfort, joint pain from instability and accentuation of the normal back curves.

Osteopathic treatment aims to support the natural process of pregnancy and birth – guiding the body’s own natural ability to compensate and adjust to these changes as efficiently as possible (with minimal pain or discomfort). Using manual techniques our osteopaths may assist with improving pelvic movement and stability. Treatment techniques used by our osteopaths are tailored to each pregnancy and are comfortable for both the mother and her growing baby. Techniques are carefully selected, minimizing any associated risk for the mother and her unborn child, although like with all forms of health care, some patients may experience adverse reactions or outcomes.

Our osteopaths complete a thorough case history for all patients to determine any underlying conditions and any risk factors that may be involved. They not only work in connection with the patient’s pre-natal team (obstetrician or midwife) to provide the utmost care, but also work in connection with other local allied health practitioners and services, such as pre-natal yoga and calm birthing classes.

Some common musculoskeletal pregnancy-related complaints that our osteopaths may assist with are:

  • Lower back pain (105, 108, 109, 110)
  • Sciatica (leg pain) (105, 108, 109, 110, 112, 123)
  • Neck, shoulder or middle back pain (109)
  • Pelvic instability (108, 109, 110)
  • Groin or sacroiliac joint pain (108, 109, 110)
  • Pubic symphysis pain (108, 109, 110)

We encourage all our pregnant patients to return for a post-partum check-up, as both the pregnancy and the birthing process may be stressful on the mother’s body – particularly the pelvic girdle.

Even after birth, weakened ligaments and reduced muscle strength can leave some women with constant back pain and other musculoskeletal dysfunction. It is also common for new mothers to experience postural strain through the neck, shoulders and middle back from compromised postures involved with both holding and caring for their new baby and breast-feeding. Treatment may help to ease this pain, aid the recovery of the back and the pelvis and promote improved blood flow (153). It may also help to prevent ongoing musculoskeletal issues associated with pregnancy once the hormonal influence on the musculoskeletal system ceases (in particular the ligaments) (105, 106, 107, 108, 109, 110, 112). Our osteopaths will also give instruction on posture, breast-feeding position (66), nutrition and exercises to strengthen the pelvic floor and abdominal muscles.

And our osteopaths will also work in connection with local practitioners for specific post-partum issues such as abdominal separation and incontinence (154, 155) and will refer on when necessary.

 

66. Douglas P. & Keogh R. (2017). “Gestalt Breastfeeding: Helping Mothers and Infants Optimize Positional Stability and Intraoral Breast Tissue Volume for Effective, Pain-Free Milk Transfer.” Journal of Human Lactation, Vol 33(3): 509-18. https://www.ncbi.nlm.nih.gov/pubmed/28614671
105. Franke H., Franke J.D., Belz S. & Fryer G. (2017). “Osteopathic manipulative treatment for low back and pelvic girdle pain during and after pregnancy: A systematic review and meta-analysis.” Journal of Bodywork & Movement Therapies. Article in Press. https://www.ncbi.nlm.nih.gov/pubmed/29037623
106. Smallwood C.R., Borgerding C.J., Cox M.S.and Berkowitz M.R. (2013). “Osteopathic manipulative treatment (OMT) during labor facilitates a natural, drug-free childbirth for a primigravida patient: A case report.” International Journal of Osteopathic Medicine, Vol 16(3), 170-177. https://www.sciencedirect.com/science/article/pii/S1746068912001010
107. Sheraton A., Streckfuss J. and Grace S. (2017). “Experiences of pregnant women receiving osteopathic care.” Article in Press: Accepted Manuscript Journal of Bodywork & Movement Therapies. http://www.sciencedirect.com/science/article/pii/S1360859217302310
108. Pennick V & Liddle S.D. (2015). “Interventions for preventing and treating low-back and pelvic pain during pregnancy.” Cochrane Database Syst Rev, Sept 30(9). https://www.ncbi.nlm.nih.gov/pubmed/26422811
109. Borg-Stein J. & Dugan S.A. (2007). “Musculoskeletal Disorders of Pregnancy, Delivery and Postpartum”. Physical Medicine and Rehabilitation Clinics of North America, Vol 18 (3), 459-476.
https://www.ncbi.nlm.nih.gov/pubmed/17678762
110. Hall H1, Cramer H, Sundberg T, Ward L, Adams J, Moore C, Sibbritt D. Lauche R. (2016). “The effectiveness of complementary manual therapies for pregnancy-related back and pelvic pain: A systematic review with meta-analysis.” Medicine (Baltimore), Vol 95(38), e4723. https://www.ncbi.nlm.nih.gov/pubmed/27661020
112. Nistler G., Deutschmann U., Lenz D. & Schwerla F. (2010). “Osteopathy as a therapy during pregnancy: A randomised controlled trial.” International Journal of Osteopathic Medicine, Vol 13(3), 128-128. http://www.journalofosteopathicmedicine.com/article/S1746-0689(10)00082-9/fulltext
123. Bell J. (2008). “Massage therapy helps to increase range of motion, decrease pain and assist in healing a client with low back pain and sciatica symptoms.” Journal of Bodywork & Movement Therapies, Vol 12(3): 281-289.  https://www.ncbi.nlm.nih.gov/pubmed/19083683
153. Hensel K.L, Pacchia C.F. & Smith M.L. (2013). “Acute improvement in hemodynamic control after osteopathic manipulative treatment in the third trimester of pregnancy.”  Complementary Therapies in Medicine, Vol 21(6): 618-626. http://www.ncbi.nlm.nih.gov/pubmed/24280470
154. Ringkamp C., Rodriguez B., Alberts K., Rutz M. (2010). “Osteopathic treatment of women with voiding dysfunction: A randomized controlled trial.” International Journal of Osteopathic Medicine,Volume 13(3):107-107. http://www.journalofosteopathicmedicine.com/article/S1746- 0689(10)00061-1/fulltext
155. Gerhardt K., Montag G., Ruetz M.& Schwerla F. (2008). “Osteopathic treatment of women suffering from urinary incontinence following an injury to the perineum during delivery: A randomized controlled trial.” International Journal of Osteopathic Medicine,Volume 11(4):158-158. http://www.journalofosteopathicmedicine.com/article/S1746-0689(08)00105-3/pdf