Researchers estimate that between 45-75% of pregnant women will experience low back pain at some stage of their pregnancy. (1-5) Here are 4 clinical pearls pertaining to this common malady:

  • Pregnancy-related low back pain typically starts between the fifth and seventh months.
  • A history of lower back pain doubles the risk of developing pregnancy-related low back pain.
  • Almost 75% of women undergoing chiropractic manipulation report significant pain reduction and clinically significant improvements in disability.
  • Healthy women may begin or continue moderate intensity aerobic exercise for at least 150 minutes per week. Women should not begin vigorous exercise during pregnancy.

Unfortunately, 40% of women who experience pregnancy-related LBP continue to suffer six months post-partum, and 20% report pain three years later. (6) However, a recent study by Schwerla et al. shows that, like pregnancy related LBP, postpartum LBP also responds to spinal manipulation- approximately 10 times better than watchful waiting. (7) The authors concluded:

“Spinal manipulation applied 4 times led to clinically relevant positive changes in pain intensity and functional disability in women with postpartum LBP. Pain intensity decreased in the manipulation group from 7.3 to 2.0 and in the control group (no treatment) from 7.0 to 6.5.”

The recent (84th) ChiroUp protocol details the “current best practice” management for pregnancy-related low back pain. Check our recent post on Modality Use During Pregnancy for related information. Members may review the entire protocol online, including video demonstrations of all pertinent assessments, treatments and exercises with a pregnant patient.

1. Wu WH, Meijer OG, Uegaki K, Mens JM, van Diee¨n JH, Wuisman PI, et al. Pregnancy related pelvic girdle pain (PPP), I: terminology, clinical presentation, and prevalence. Eur Spine J 2004;13:575-89.
2. Pierce H, Homer C, Dahlen H, King J. Pregnancy related low back and/or pelvic girdle pain: listening to Australian women. Abstract presented at the XI International Forum for Low Back Pain Research in Primary Care, Melbourne, Australia, 15-18 March 2011.
3. Diakow P.R.P., Gadsby T.A., Gadsby J.B., Gleddie J.G., Leprich D.J., Scales A.M. Back pain during pregnancy and labor. J Manipulative Physiol Ther. 1991;14(2):116-118.
4. Berg G., Hammer M., Moller-Nielsen J., Linden U., Thorblad J. Low back pain in pregnancy. Obstet Gynecol. 1988;71:71-75.
5. Mogren IM, Pohjanen AI. Low back pain and pelvic pain during pregnancy: prevalence and risk factors. Spine . 2005 Apr 15;30(8);983-91.
6. Norén L, Östgaard S, Johansson G, Östgaard HC. Lumbar back and posterior pelvic pain during pregnancy: a 3-year follow-up. Eur Spine J. 2002;11:267-71.
7. Schwerla F, et al. Osteopathic manipulative therapy in women with postpartum low back pain and disability: A pragmatic randomized controlled trial. J Am Osteopath Assoc. 2015 Jul;115(7):416-25.