Physiotherapy management of back pain during pregnancy

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Does Acupuncture Help Lower Back Pain During Pregnancy?

Physiotherapy management of back pain during pregnancy

Answer Guide

In this guide you will discover:

Due to the weight gain, the center of gravity changes, and hormones relaxing the ligaments in the pelvis, lower back pain is a common complaint among pregnant women. In fact, seventy-two percent of women complain of lower back and pelvic pain during pregnancy. [1]

Effectiveness of Traditional Treatments Lower Back Pain in Pregnancy

Though traditional therapies include physiotherapies such as massage and exercise, no strong evidence exists confirming the effectiveness of these treatments for the prevention or treatment of back and pelvic pain related to pregnancy. [2]

Effectiveness of Acupuncture for Lower Back Pain in Pregnancy

Because lower back pain is the leading cause of sick leave during pregnancy in Sweden, researchers from the Department of Obstetrics and Gynecology, Vrinnevi Hospital, Norrköping, Sweden conducted a prospective randomized study comparing acupuncture with physiotherapy for low-back and pelvic pain in pregnancy. The trial included sixty pregnant women already suffering from lower back pain (LBP). Half received physiotherapy treatments including water gymnastics and massage while the other half received acupuncture treatments only. The study concluded that acupuncture relieved pain and diminished disability in low-back pain during pregnancy better than physiotherapy. [3]

In an interesting turn, 66% of the participants in the physiotherapy group dropped out before the study was complete while no acupuncture participants dropped out indicating that acupuncture may also serve the benefit of being a treatment that patients may actually accept and complete. (4)

National Institutes of Health Not Yet Sold

The US Department of Health and Human Services’ National Center for Complementary and Alternative Medicine (NCCAM) is the Federal government’s leading agency for scientific research on complementary and alternative medicine. Their mission is to “define, through rigorous scientific investigation, the usefulness and safety of complementary and alternative medicine interventions and their roles in improving health and health care”. It merits pointing out that though this agency acknowledges preliminary promising results, it has yet to recognize acupuncture as an effective treatment for pregnancy-related pelvic and back pain citing the lack of research. [5]

[1] Mogren IM, Pohjanen AI. Low back pain and pelvic pain during pregnancy: prevalence and risk factors. Spine (Phila Pa 1976) 2005;30:983–991. [PubMed]

Along with the prevalence cited in this research, this study was designed to find the risk factors for low back and pelvic pain (LBPP) during pregnancy. The researchers found that women who suffered from LBPP during pregnancy had significantly higher pregnancy weight, end-pregnancy weight, and higher BMI.

[2] Stuge B; Acta Obstet Gynecol Scan

Physical therapy for pregnancy-related low back a pelvic pain: a systematic review

2003; Volume: 82; No: 11; Pages: 983-990 [PubMed]

In this meta-analysis, the researchers only found nine studies to analyze of which they only considered three to be high-quality. Two of the three studies considered in the analysis showed no difference between the pain experienced by the exercise groups versus the control group.

[3] Wedenberg, KAJ; Acta Obstet Gynecol Scand

A prospective randomized study comparing acupuncture with physiotherapy for low-back and pelvic pain in pregnancy

2000; Volume: 79 Pages: 331–335

The study authors do not definitively pinpoint why acupuncture may be effective in treating pain but suggest that the somatic and autonomic nervous systems as well as the neuroendocrine system are most likely involved.

[4] Wedenberg, KAJ; Acta Obstet Gynecol Scand

A prospective randomized study comparing acupuncture with physiotherapy for low-back and pelvic pain in pregnancy

2000; Volume: 79 Pages: 331–335

The study authors speculate several reasons for the dropout rate of the pregnant women in the physiotherapy group. They hypothesize that the women may have perceived that the physiotherapy was more difficult than acupuncture, the acupuncture was considered new and alternative, and/or the women perceived that the acupuncture was more effective. They also suggested that because the physiotherapy group received treatment as a group, the acupuncture patients may have received the benefit of a closer relationship to their caregivers.

[5] National Center for Complementary and Alternative Medicine (NCCAM)

Interestingly, though the NCCAM describes the evidence on the effectiveness of acupuncture for lower back pain as insufficient, the clinical practice guidelines issued by the American Pain Society and American College of Physicians 2007 list acupuncture as one of several CAM therapies physicians should consider for patients with lower back pain who do not respond to traditional therapies.

Management of Back Pain in Pregnancy

Physiotherapy management of back pain during pregnancy

Fig. 1: Proper posture.

Physiotherapy management of back pain during pregnancy

Fig. 2: Sleep on your left side.

Conservative (non-surgical) treatment of back pain in pregnancy generally includes performance of appropriate exercise and use of proper body mechanics. These efforts promote and support proper posture, which is essential to avoiding unnecessary stress to supporting structures.

Often just one or two visits to a physical therapist experienced in pre/post partum treatment can be very helpful to help minimize or alleviate unwanted pregnancy pain in the lower back. If more extensive back pain treatment is required, a physical therapist should perform an individual evaluation and recommend a treatment program for you.

Back Pain Treatments during Pregnancy

Maintaining an optimal level of function throughout your pregnancy and having the least amount of discomfort are the main goals of treatment for back pain during pregnancy.

Your healthcare professional may utilize different treatments for pregnancy back pain, including instructions on:

Pregnancy Pain Treatments:

  • Proper posture while pregnant (See Figure 1)
  • Specific body mechanics for routine activities, such as housework, job, sleeping (See Figure 2)
  • A home exercise program appropriate for your stage of pregnancy
  • Self-help techniques for pain management and mobilization during pregnancy
  • Hands-on treatment (such as soft tissue work, gentle mobilization, and stabilization exercises) as determined by evaluation by a health care professional.
  • In This Article:

    • Back Pain in Pregnancy
    • Types of Back Pain in Pregnancy
    • Common Causes of Back Pain in Pregnancy
    • Management of Back Pain in Pregnancy
    • Causes of Pregnancy Back Pain Video

    Remember, while back pain is fairly common during pregnancy, it should definitely not be accepted as just part of the process.

    To help make your pregnancy as pleasant as possible and facilitate an easier delivery, back pain symptoms should always be addressed as quickly as possible and managed throughout your pregnancy.

    Welcome to Stretch Physio

    Our Approach to Physiotherapy

    Physiotherapy management of back pain during pregnancy

    Whatever your story, we’d love to hear it. We understand that most of what we need to know about the problems you are experiencing will come from what you tell us. We will then look at what is going on, by conducting a thorough examination. Our assessment process will enable us to identify what the problems are so that we can agree an effective and comprehensive management strategy. We can help you whether you are an elite athlete who needs to get fit for your sport, or if you are having problems with day to day tasks, such as bending forwards or turning in bed. Whatever your lifestyle, career or sporting aspirations, we will create a Physio treatment program that caters for your unique needs.

    Physio boosts your recovery

    At Stretch, our approach looks to boost your recovery, getting you better as quickly as possible and back to the things that you enjoy. However, we believe that the sign of a truly great Physio is one that can empower you to maintain the progress that you’ve made in clinic, inspiring you stay fit, healthy and injury free over the longer term. We want to see you back on the pitch or running up the stairs past our clinic on your way to your Pilates or yoga class.

    At Stretch you’re in control

    We believe in the importance of empowering you to manage your problem, we know that when you feel in control, your pain level will reduce and your problems will feel smaller. We will provide you with all the information and advice you need in order to look after yourself. We may use mobilization, manipulation, acupuncture and rehabilitation as part of your treatment. However, before we do anything, we’ll make sure that you understand the nature of your problem, the relevant science and how we’re going to help. Your treatment will be evidence-based and unique to you. We believe that the success of our treatment relies on you understanding exactly what is going on and how, with our help, you can get back to doing all the things you enjoy in life.

    When you need a little extra help

    All our Physiotherapists are highly trained and have experience in the interpretation of scans and other diagnostic tests. We also have good links with Neurosurgeons, Orthopaedic Surgeons, Rheumatologists, Pain Management Specialists and Councilors. So, if we feel that you need more than Physiotherapy treatment, we will let you know and, with your permission, we can liaise with your GP, or arrange a direct Consultant referral.

    Our therapists are registered with all the leading Health Insurance companies including BUPA, AXA PPP, Aviva, Cigna and Pru Health.

    What to expect

    Your initial assessment will last up to 45 minutes, during which we will go over the history of your problem and conduct a physical examination, discussing everything with you in full. The initial assessment gives us the opportunity to accurately evaluate your problem and implement an effective management strategy. As well as the assessment and evaluation, your initial appointment will also include some Physiotherapy treatment. Our follow-up Physiotherapy treatments last up to 30 minutes.

    Massage Clinics

    Sports massage

    Sports massage is a firmer deep tissue massage, which may help you to recover from a soft tissue sports injury. Sports massage can help you to manage the demands of your training program and will give you time out to relax and refocus. Your preparation for a competition can be assisted with Sports Massage, as well as aiding recovery and dealing with the pressures of a busy competition schedule.

    Holistic, hot and cool stone massage

    Holistic massage promotes your overall health and well-being, helping you to relax, unwind and release muscle tension. Hot stone massage is also a holistic massage treatment that uses the power of heat, rather than increased pressure to provide you with a deeper, totally relaxing massage experience. Cool stone massage can also be used to sooth a specific area of tenderness, during your massage treatment.

    Pregnancy massage

    Pregnancy massage can help to support you through your pregnancy. Our pregnancy massage therapists have specific training and understand the changes that you’re going through during your pregnancy. Pregnancy massage treatments will be adapted to suit your individual needs. We will take care of you from the moment that you walk through our door, leaving you feeling relaxed and able to enjoy your pregnancy.

    Our intuitive therapists

    Our massage therapists are all wonderfully intuitive. Whichever type of massage you choose, they will select the techniques most appropriate for your needs, so that you feel relaxed and revitalized. We offer evening and weekend appointments and we are open on both Saturdays and Sundays, allowing you to book some you time around your busy schedule.

    What to expect

    With Stretch you can choose to book either a 45-minute or one hour massage therapy appointment. Your appointment will start with a chat about your needs, general health and lifestyle, followed by an assessment of any injuries or problem areas you may have. Once your massage therapist has discussed the type of treatment they recommend, you can simply lie down and relax to enjoy your massage. We will also provide you with after-care advice in order to ensure that you get the most out of your treatment.

    At Stretch we see Pilates as beneficial to your overall well-being, whether it becomes part of your general exercise program, strength conditioning training, pre- and postnatal care, pain relief or relaxation. We value its positive effects in helping to promote improved postural awareness. We find that its benefits are felt well beyond your session in our studio.

    One-to-one Pilates Sessions

    Our bespoke Pilates sessions help you to improve your day-to-day life by focusing on functional movements and the importance of relaxation. We understand that changes in postural and movement awareness as well as an inability to relax over-active muscles, coupled with an increasing lack of confidence when moving, all contribute to ongoing pain and an inability to move normally. Our sessions, give you what you need to relax and move feely, teaching you to relax over-active muscles, retain those that need a gentle reminder to work and to help you restore normal, healthy movement patterns, improving how you feel every day.

    Postural Assessments and Postural Awareness

    Our Pilates sessions include postural assessments and an analysis of how you perform certain functional tasks, using our expert Physio skills. Our analysis of your postural signature and functional movement strategies helps us to determine which Pilates exercises are most useful to you. Following our assessment, we will then teach you these Pilates exercises. Our teaching style is always adapted to suit your particular needs. During your sessions, we may use small Pilates equipment such as mini balls, gym balls or resistance bands to augment the exercises. We may also use our state of the art large equipment, including an Align Pilates Cadillac and Reformer.

    What we love about Pilates

    We love the fact that Pilates exercises can be so diverse and allow for gently graded exercises. Our programs, are tailored to how you feel when you turn up at our studio. We design each session specifically to address any goals that you may have. We will work with you to rectify any movement dysfunctions that need to be addressed in order to relieve pain. We will help you to understand what makes good posture and will help you to optimize yours. We will give you the knowledge, understanding and home practice exercises to ensure that you are able to maintain it effectively during your daily life.

    The Pilates repertoire

    Pilates movements are slow and precise. Exercises focus on breathing and body awareness. The exercises are gently and safely progressed for optimal progress. At Stretch, our Physios trained with the Austrailian Institute of Physiotherapy & Pilates (APPI). APPI is a series of modified Pilates exercises that take into account your specific musculoskeletal or issues with your health. APPI Pilates is an ideal approach for those in pain or suffering from health problems. Ellie, our Clinical Director is an extremely experienced teacher and is also developing a keen interest in yoga, bringing her knowledge and experience in this area into her Pilates practice.

    Relax and enjoy regular practice

    Our clients feel totally relaxed and confident following one of our Pilates sessions. We believe that, with regular practice, you will achieve a greater balance between body and mind, improved well-being, a sense of achievement and the feeling that you wouldn’t want to miss your regular sessions!


    Does Acupuncture Help Lower Back Pain During Pregnancy?