» The neglected pregnant patient
Täby Kiropraktorklinik: En helhetssyn på hälsa

The neglected pregnant patient

The Swedish pregnant patient with pain between the navel and the knees is dismissed with the back of the hand as having temporary hormonal changes that cause pain in the pelvis. Women are not usually examined and at best given a prescription for water gymnastics. These are a series of exercises which bend and twist the spine, which commonly strain the back and pelvis causing more pain. Besides not being offered an examination to determine the cause of pain and discomfort, women are prescribed exercises which are often inappropriate.

Among Swedish practitioners there seems to be a general lack of understanding of the biomechanics of the spine and pelvis, the properties of the tissues and how they are strained and injured. Chiropractors educated outside of Sweden have education giving them expertice in biomechanical health. A unique problem in Sweden is that licensing has been given to two groups here in Sweden who lack adequate education. The Swedish board of education has concluded that the education of Chiropractors and Naprapaths in Sweden is inadequate for licensing. The Board of Health gave these groups licensing before the evaluation was finished and these groups maintain their licensing.

It is important for all patients, but especially so for the pregnant patient to find a chiropractor who has skills to both diagnose the problem and to treat her. The pregnant body is changing and hormones influence the laxity of the joints so treatment needs to be modified. Generally, treatment is more gentle than traditional techniques and can be performed late into the pregnancy. Many woman experience an easier labor if they have treatment during the pregnancy. The uterus is attached to the pelvis in different places, so when the pelvis and lowback function optimally there is less torque in the pelvis allowing for more space for the baby to pass through.

Proper diagnosis and treatment reduces the risk for longer term problems with the back and pelvis. Once the baby is born, there is a significant strain of the lowback with all the lifting, bending and carrying. Exercises are important but must be tailored to the patient who has had back pain and pelvic pain so that the effort to strengthen the back does not strain the injury. Again we see the importance of correct diagnosis so exercises prescribed are also correct.

Don’t settle for less than the best! There are only a few in Sweden who have adequate skills to assess and treat these specialty groups: infants, children and the pregnant patient. Contact us at Täby Kiropraktor Klinik for help.


Refereser:
Pettigrew J. 2014. Utilizing chiropractic for optimal pregnancy and birth outcomes. Midwifery Today Int Midwife.;(110):56-7.

Hensel KL1, Buchanan S2, Brown SK3, Rodriguez M4, Cruser DA5. 2014. Pregnancy Research on Osteopathic Manipulation Optimizing Treatment Effects: the PROMOTE study. Am J Obstet Gynecol. pii: S0002-9378(14)00792-3. doi: 10.1016/j.ajog.2014.07.043. [Epub ahead of print]