Pelvic girdle pain (PGP) is a common condition affecting the joints of the pelvis during pregnancy. This discomfort, which can manifest as pain in the pubic joint or the sacroiliac joints in the lower back, affects up to half of all pregnant women. Seeking relief for this musculoskeletal pain is common, and many women look for non-pharmacological options. Chiropractic care, which focuses on the alignment of the spine and pelvis, offers a recognized, drug-free approach to managing this pregnancy-related discomfort.
Understanding Pregnancy-Related Pelvic Discomfort
The physical changes during pregnancy create an environment that can lead to pelvic pain. Hormones like relaxin and progesterone surge, causing increased ligamentous laxity throughout the body, particularly in the pelvic joints. This softening is necessary to prepare the pelvis for childbirth but can also result in instability, especially in the pubic symphysis and the two sacroiliac (SI) joints.
The increasing weight of the growing fetus and uterus shifts the mother’s center of gravity forward. To compensate for this anterior load, the body often increases the curve in the lower back, known as increased lumbar lordosis. This postural adaptation places excessive mechanical stress and strain on the already lax SI joints and surrounding ligaments. When these structures become overworked and misaligned, the resulting inflammation and movement dysfunction cause the characteristic deep, aching pain of PGP.
Safety and Specialized Chiropractic Care
A primary concern for any expectant mother is the safety of any treatment she receives. Chiropractic care is considered safe throughout pregnancy, provided the practitioner uses modified techniques and specialized equipment. Patients should seek out chiropractors with advanced training in prenatal care, often signified by certifications from organizations like the International Chiropractic Pediatric Association (ICPA).
This specialized training ensures the chiropractor is proficient in techniques that are safe for the pregnant body. Adjustments are never performed with the patient lying face down on a standard table. Instead, the practitioner utilizes specialized tables with abdominal cut-outs or supportive pregnancy pillows to ensure the mother is comfortable and no pressure is placed on the growing abdomen.
A specific protocol frequently employed is the Webster Technique, which is a specialized analysis and adjustment method. This technique is used to balance the pelvic muscles and ligaments, helping to restore proper pelvic function. By addressing the soft tissue and joint imbalances of the mother’s pelvis, this method promotes an optimal environment for fetal positioning.
The Chiropractic Approach to Pelvic Alignment
The core of chiropractic care for PGP is the restoration of proper pelvic biomechanics to reduce strain on the affected joints and ligaments. Adjustments focus on improving mobility in the sacroiliac joints, which often become restricted or hypermobile due to hormonal changes and postural shifts. By gently restoring motion to these joints, the chiropractor reduces the source of inflammation and pain.
The Webster Technique involves a specific adjustment to the sacrum, the triangular bone at the base of the spine, and gentle work on the surrounding soft tissues. This includes balancing the tension in the round ligaments, which attach the uterus to the groin and can become painfully stretched as the uterus expands. When the pelvis is misaligned, these ligaments can pull unevenly on the uterus, contributing to pain and discomfort.
By balancing the sacrum and releasing tension in the attached soft tissues, the treatment reduces the physical constraint placed on the uterus. The improved alignment decreases the potential for nerve impingement, such as sciatica, which often accompanies pelvic instability during pregnancy.
Coordinating Care and Timing Consultations
For optimal results, women should initiate chiropractic care early, ideally as soon as pain begins or in the second trimester as the body begins to change more rapidly. Starting early allows the practitioner to help the body adapt to the shifting center of gravity before significant pain develops. Patients often find that monthly visits early on, increasing to weekly care in the final month, help maintain comfort and alignment.
It is advisable to discuss the inclusion of chiropractic treatment with the patient’s primary care provider, such as an obstetrician or midwife, to ensure a coordinated approach. While chiropractic care is effective for musculoskeletal pain, certain symptoms require immediate medical attention from the OB/GYN. These warning signs include vaginal bleeding, fever, sudden and severe abdominal pain, or a significant decrease in fetal movement.