With mother’s day just passing recently, it got me thinking about all the mom’s-to-be that I see in the office. Now pregnancy and back pain go together like peanut butter and jelly, we can easily see the mental image of a pregnant woman walking around holding her lower back because the pain is killing her. So it shouldn’t be surprising to hear that 50% of pregnant women will suffer low back pain during their pregnancy? It’s no surprise with the 25-35 pound suggested weight gain and the growing fetus inside. But only about 1 out of 3 women seek out treatment, with massage being number 1, yoga number 2, and chiropractic care with only a 6% utilization rate, that’s low! As the baby develops and the abdomen grows, it increases the stress on the pelvis and lumbar spine. The bladder, urethra, and other structures can be stretched or under pressure, which can refer pain to the lower back and cause muscle spasms. In the last trimester, with the protruding abdomen and forward tipped pelvis, the increased curve of the lumbar spine places added stress on the discs, ligaments and joints of the lower back. This makes them more susceptible to injury or to generate pain.
But there are tremendous benefits to receiving chiropractic care during pregnancy
- It is a drug free therapy, which is always a major concern during pregnancy
- 84% of women who had chiropractic care during pregnancy had relief of their LBP
- Because of the relief of low back pain, it significantly decreases the incidence of back labor. Back labor refers to the discomfort that laboring women feel in their low back. The risk of “Back Labor” is almost 3x greater if back pain was experienced during pregnancy.
- For those women who had low back pain during pregnancy, those who received chiropractic care had 25% shorter labor times compared to those that did not, and that is for first time moms. For those who had given birth before, their labor times were 31% shorter than those that did not receive care.
So if you know someone that is pregnant and struggling with lower back pain, and would like to see them find relief, plus with the potential of cutting their labor time by 25%, a great, safe option is to receive chiropractic care.
Recently in the headlines was a report about acetaminophen, more commonly known as Tylenol. Current clinical guidelines recommend Tylenol as the first in line drug treatment for both low back pain and osteoarthritis (OA). A systematic review of research of 13 randomized controlled trials concluded that the widely used painkiller was ineffective against back pain and offers only minimal benefit to those people with osteoarthritis of the knee or hip. Low back pain and osteoarthritis are among the leading causes of disability in the world. Investigators found that in people with low back pain, acetaminophen was ineffective in either reducing disability or enhancing quality of life. In people with OA, acetaminophen provided only a small, not clinically important benefit in the reduction of pain and disability. Researchers concluded that it is important to reconsider treatment recommendations, as a first line drug choice, given the findings. Similar conclusions were also reached in a study published in another journal, The Lancet in July of 2014, that acetaminophen does not ease low back pain.
The authors of the study also found that acetaminophen increases the likelihood of having abnormal liver function tests, at 4x the rate. So the risk of having liver toxicity outweighs the benefit of taking this drug.
Ongoing and ever increasing concerns about the treatment of musculoskeletal pain with drugs, highlights the importance of non-drug related options. These form the cornerstone of self-management of spinal pain and OA. All patients with OA should receive advice about maintaining or increasing physical activity and optimizing weight (when appropriate). Exercise, manual therapy, and acupuncture, and are also recommended for those with BP. While the effectiveness of exercise for both spinal pain and OA is established, the findings of these studies emphasize that the time has come to shift our attention away from popping pills as the default option for managing chronic musculoskeletal pain. Non-pharmacologic treatments work, are safe, and have benefits that reach far beyond the musculo-skeletal system.
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