Pregnancy is one of the most physically demanding experiences the human body undergoes. Over the course of approximately 40 weeks, your spine adapts to a growing belly, your pelvis loosens to prepare for delivery, your center of gravity shifts dramatically, your hormones cause ligaments to soften throughout the body, and your weight increases by 25 to 35 pounds. It is no surprise that more than half of pregnant women experience significant back, hip, or pelvic pain at some point during their pregnancy.
Here is the difficult part: many of the medications and interventions used for non-pregnancy back pain are off the table during pregnancy. NSAIDs are not recommended, particularly in later trimesters. Imaging is restricted. Many physical therapy modalities are limited. Patients are often told some version of "this is just part of pregnancy" and encouraged to grin and bear it.
Chiropractic care is one of the few effective, evidence-supported, drug-free options available to pregnant patients. At Bromberg Chiropractic, we have been providing safe prenatal care to expecting mothers in Cambridge and the greater Boston area for decades. This post explains what to expect, why it works, and what makes pregnancy chiropractic different from standard care.
Why Pregnancy Causes Back, Hip, and Pelvic Pain
Pregnancy creates a perfect storm of mechanical and biochemical changes that stress the musculoskeletal system. Understanding these changes helps explain why pain develops and why specific treatment approaches help.
Postural and Biomechanical Changes
As the uterus grows, the abdomen extends forward, dramatically shifting the body's center of gravity. To compensate, most pregnant women develop an exaggerated lumbar curve (lordosis), an anterior pelvic tilt, and a forward-shifted upper body. These postural changes overload the lumbar spine, the sacroiliac joints, and the hip flexors. Mechanical strain is unavoidable.
Hormonal Ligament Laxity
The hormone relaxin, which surges during pregnancy, increases the laxity of ligaments throughout the body. This is essential for delivery, allowing the pelvic outlet to expand. But it also means that joints throughout the spine and pelvis become less stable, increasing the risk of misalignments and creating opportunities for inflammation and pain.
Pelvic Floor and Round Ligament Strain
The growing uterus places direct pressure on the pelvic floor and stretches the round ligaments that support the uterus. Round ligament pain is a sharp, stabbing sensation in the lower abdomen or groin, particularly with sudden movement.
Pubic Symphysis Dysfunction
The pubic symphysis is the joint at the front of the pelvis where the two pubic bones meet. During pregnancy, this joint can become unstable due to ligament laxity, producing sharp pain in the front of the pelvis, especially when standing, walking, or rolling over in bed. This is sometimes called symphysis pubis dysfunction or SPD.
Sciatica
The combination of postural changes, ligament laxity, and the growing uterus pressing on nerve structures can produce sciatica during pregnancy. Patients describe sharp pain shooting from the lower back through the buttock and down the leg.
Is Chiropractic Safe During Pregnancy?
The short answer is yes. Chiropractic care has an excellent safety record during pregnancy, with no specific contraindications for healthy pregnancies. Major chiropractic professional organizations, including the International Chiropractic Pediatric Association (ICPA), recognize prenatal care as a routine and appropriate scope of practice.
That said, prenatal chiropractic care requires modifications that not every chiropractor knows or implements:
Specialized Pregnancy Tables and Pillows
Standard chiropractic tables are not designed for pregnant patients in their second or third trimesters. Specialized tables with adjustable abdominal cutouts, or pregnancy pillow systems that allow comfortable face-down positioning even with a substantial belly, are essential. Without these accommodations, treatment becomes uncomfortable or impossible.
Modified Adjustment Techniques
Many traditional adjustment techniques put the patient in positions that are inappropriate during pregnancy. Side-lying techniques, drop-table adjustments, and instrument-assisted methods (like the Activator) are commonly used as alternatives. Pressure is reduced, force vectors are modified, and certain positions are avoided entirely.
Trimester-Specific Considerations
Treatment evolves throughout pregnancy. Early in pregnancy, when the pregnancy is not yet showing, most standard techniques work well with minor modifications. Mid-pregnancy treatment focuses heavily on the lumbar spine and pelvis. Late pregnancy treatment often emphasizes pelvic alignment and may include the Webster Technique (described below).
The Webster Technique
The Webster Technique is a specific chiropractic protocol developed by Dr. Larry Webster for pregnant patients. It is designed to reduce stress on the pelvic and uterine structures, optimizing pelvic balance and creating optimal conditions for fetal positioning.
The technique involves a specific sacral adjustment combined with soft tissue work on the round ligaments. Many midwives and OBs in our area refer patients for the Webster Technique, particularly when there is concern about breech presentation or other positioning issues. Research on Webster Technique outcomes has shown encouraging results, though more high-quality studies are still needed to establish definitive efficacy claims.
If your provider has recommended the Webster Technique, or if you are nearing your due date with positioning concerns, mention this when scheduling. We will determine whether you are a candidate.
What Pregnancy Chiropractic Care Treats
Specific conditions that respond well to prenatal chiropractic care include:
- Lower back pain: The most common pregnancy complaint, affecting more than half of pregnant patients.
- Sciatica: Sharp pain radiating from the lower back into the buttock and leg.
- Sacroiliac joint dysfunction: Pain at the back of the pelvis, often felt in one or both buttocks.
- Symphysis pubis dysfunction: Sharp front-of-pelvis pain with movement.
- Round ligament pain: Sharp lower abdominal pain with movement.
- Upper back and neck pain: Often related to postural changes and breast changes during pregnancy.
- Headaches: Pregnancy-related headaches with a cervical component.
- Hip pain: From altered weight distribution and ligament laxity.
- Pelvic alignment optimization: Including the Webster Technique for positioning concerns.
For broader information, see our pregnancy care page.
What to Expect at Your First Visit
Your initial visit during pregnancy includes everything we cover with non-pregnant patients, with additional focus on pregnancy-specific factors.
History: We discuss your pregnancy history, current trimester, any complications, your provider's recommendations, your current symptoms, and how the pregnancy is affecting your function and quality of life.
Examination: We perform an appropriately modified examination that focuses on the structures most likely to be involved, while avoiding any positions or maneuvers that could be uncomfortable or inappropriate at your stage of pregnancy.
Treatment: Most patients receive their first treatment on the same day as their initial visit, using gentle techniques appropriate for their pregnancy stage.
Communication with your OB or midwife: If you would like, we coordinate with your prenatal provider, sharing notes and ensuring everyone is on the same page about your care.
Continuing Care Through Pregnancy
Frequency of visits depends on your symptoms and stage. Many patients benefit from weekly or biweekly visits during the second and third trimesters. Some choose monthly maintenance visits during stable periods, with more frequent care during flare-ups.
Most pregnant patients can continue care up to their due date, and many find that treatment in the final weeks helps them feel more comfortable and prepared for delivery.
Postpartum Recovery
The musculoskeletal demands of pregnancy do not end at delivery. The postpartum period brings its own challenges: returning posture and alignment to baseline, addressing diastasis recti, recovering from the physical demands of delivery, and adapting to the strain of carrying and feeding a newborn.
Most patients can resume chiropractic care within a few weeks postpartum (or sooner if cleared by their obstetric provider). Postpartum care is often a critical step in returning to pre-pregnancy function and preventing chronic pain patterns from setting in.
What Your OB or Midwife Should Know
Most obstetric providers are supportive of chiropractic care during pregnancy, particularly when patients are dealing with significant pain that limits their activities. If your provider has questions, we are happy to communicate directly with their office and share information about our approach. Open communication between providers leads to the best outcomes for our shared patients.
Schedule Your Prenatal Consultation
If you are dealing with pregnancy-related back, hip, or pelvic pain, you do not have to white-knuckle through the next few months. Contact Bromberg Chiropractic to schedule a prenatal evaluation. We have been helping pregnant patients in Cambridge stay comfortable and active throughout their pregnancies for over 40 years, and we look forward to supporting you through yours.
