Prenatal Chiropractic Care

What Causes Back and Pelvic Pain During Pregnancy

Pregnancy changes the mechanics of the spine and pelvis faster than at any other time in adult life. Most of the aches that bring patients to us are the predictable result of those changes, not a sign that something is wrong.

• A shifting center of gravity. As the belly grows, the low back arches more to keep you upright. The small joints at the back of the lumbar spine take more load, and the muscles along the spine work harder all day.
• Ligament laxity. Hormones loosen the ligaments of the pelvis so the baby can pass through. The same loosening makes the sacroiliac joints and the pubic joint at the front less stable. Pain at the back of the pelvis, the groin, or one side of the low back when rolling over in bed or climbing stairs is usually this.
• Muscle strain and fatigue. The abdominal muscles stretch and provide less support. The hips, glutes and low back pick up the slack and tire.
• Sciatica-like leg pain. Pressure from the uterus and changes in the pelvis can irritate the sciatic nerve or the piriformis muscle it passes beside, sending pain down the buttock and leg.
• Round ligament pain. Sharp, brief pain at the side of the belly or groin with sudden movement, from the ligaments that support the uterus.
• Upper back and rib pain. Breast changes, a widening ribcage and postural shifts load the mid back, which is also where desk workers who commute to Kendall Square are already tight.

Pain from a previous back injury, a disc problem, or a pelvis that was already uneven before pregnancy often gets louder in the second and third trimesters. We treat those too, with techniques adapted to the stage of pregnancy.

How We Diagnose It at 201 Broadway

Dr. Bromberg personally examines every patient. For a pregnant patient, the first visit begins with your pregnancy history: how far along you are, how the pregnancy has gone so far, any complications your OB or midwife is following, and any back or pelvic problems you had before conceiving. We also ask who is managing your prenatal care, so that if you want us to coordinate with your OB or midwife we can.

The physical exam is gentle and adapted to your trimester.

• Posture and gait. How you stand, how the pelvis sits, and how you walk. Our posture and gait analysis often shows one side of the pelvis carrying more load, which explains one-sided pain.
• Pelvic joint testing. Light pressure and specific movements to tell sacroiliac joint pain from pubic symphysis pain from lumbar pain. They feel similar to the patient and are treated differently.
• Spinal motion. Where the low back, mid back and neck move freely and where they do not.
• Nerve screening. Reflexes, strength and sensation in the legs when there is leg pain, to confirm whether it is sciatic irritation or something that needs a different look.
• Muscle assessment. The glutes, hip rotators, low back and the muscles between the ribs, looking for the ones doing too much work.

We do not order X-rays or CT scans during pregnancy. In the uncommon case where imaging is needed, for example leg weakness that is progressing, MRI does not use radiation and can be arranged through your OB with our input. Almost all prenatal back and pelvic pain is diagnosed by history and examination alone.

How We Provide Prenatal Chiropractic Care

Everything we do for pregnant patients is chosen to be gentle, comfortable, and appropriate for the stage you are at. Dr. Bromberg has adapted his approach for pregnant patients over more than 40 years in Cambridge.

Positioning

Our table has drop sections and adjustable supports, and we use pregnancy pillows so that you can lie face down comfortably without any pressure on the belly for as long as that position works for you. Later in pregnancy, most treatment is done side-lying or seated. No treatment position puts pressure on the abdomen.

Gentle Adjustments

The chiropractic adjustments used in pregnancy are low-force. Dr. Bromberg uses light manual techniques, drop-table assistance, and sustained pressure rather than the quicker, firmer adjustments some patients remember from earlier care. The goal is to restore motion to the sacroiliac joints, the pubic joint and the lumbar spine so the pelvis sits level and the surrounding muscles can stop guarding. Many patients find that keeping the pelvis aligned makes late pregnancy more comfortable.

Soft Tissue Work

Hands-on release of the glutes, the piriformis, the hip flexors and the low back muscles is often the part that brings the quickest relief, especially for sciatic-type leg pain. It is done side-lying, with pressure kept at a level you find comfortable.

Movement and Home Care

Based on the gait analysis, we give you a short set of pelvic tilts, hip stretches and stability exercises, plus practical advice: how to get in and out of a car, how to roll over in bed, how to arrange pillows for sleep, and how to set up a desk or lab bench for the months ahead. These are small changes that reduce the strain between visits.

Coordination With Your OB or Midwife

Chiropractic care runs alongside your prenatal care, not in place of it. When you ask, Dr. Bromberg coordinates with your OB or midwife, shares his findings, and defers to them on anything related to the pregnancy itself. If you have a question about whether treatment is appropriate for your situation, we are glad to have that conversation before you book. Our blog post on whether chiropractic care is safe during pregnancy covers the common concerns in more detail.

What Your Visits Look Like

First visit. History, the gentle exam described above, a clear explanation of what is causing your pain, and a plan. Treatment usually starts the same day. You leave knowing what to do at home and what to expect over the next week. No referral is needed; Massachusetts allows direct access to chiropractic care. Walk-ins are welcome during office hours, and we hold same-day slots for patients in pain.

Follow-up visits. Each visit begins with a brief check-in on pain, sleep and function, and a quick re-examination of the pelvis and spine. Treatment is then adjusted to what is happening that week, which matters in pregnancy because your body changes from one visit to the next.

Visit frequency by trimester.

• First trimester. Many patients do not need care yet. Those with existing back problems, or early pelvic pain, are usually seen every one to two weeks until comfortable.
• Second trimester. This is when most patients first come in. A typical pattern is weekly for a few weeks while pain settles, then every two to three weeks for maintenance as the body keeps changing.
• Third trimester. Weekly or every other week is common in the final two months, when pelvic pressure and low back strain peak. Visits are shorter and focused on comfort and pelvic alignment.
• Postpartum. After delivery, we see patients once their provider has cleared them, usually within the first few weeks. Postpartum care addresses the pelvis after labor, the low back strain of lifting and feeding a newborn, and the neck and upper back pain that comes with looking down at a baby for hours a day.

How progress is measured. We track pain with daily activities, how well you sleep, how far you can walk comfortably, and what the pelvic joint tests show at each visit. Plans are reassessed on real progress. We do not sell prepaid packages.

What to Expect: Outcomes and Timelines

Most patients feel noticeably better after the first one to three visits, particularly with sacroiliac pain and sciatic-type leg pain. Because the pregnancy continues to change the body, the goal is not a one-time fix but keeping you comfortable and moving well through delivery. Patients who come in early, before pain has been building for weeks, usually need fewer visits and get more predictable results.

What slows progress:

• Long hours sitting without breaks, especially in the third trimester
• Sleeping without pillow support between the knees and under the belly
• Carrying a toddler or heavy bags on one hip
• Pelvic joint laxity in late pregnancy, which can make gains harder to hold and calls for more frequent, gentler visits

When symptoms are not responding, Dr. Bromberg changes the approach rather than repeating it. If leg weakness, numbness that is spreading, or pain that does not fit a musculoskeletal pattern appears, he refers you back to your OB or midwife, or to a specialist, and tells you plainly why. We are honest about what chiropractic care can and cannot do: it relieves musculoskeletal back and pelvic pain and helps you move more comfortably. It does not treat conditions of the pregnancy itself.

After delivery, most postpartum pelvic and low back pain improves over four to eight weeks of care combined with gradual return to activity. Patients who had a long labor, a cesarean, or who are managing diastasis recti often take longer and benefit from working alongside a pelvic floor physical therapist, which we can help arrange.

When to See Someone Else First

Back and pelvic pain in pregnancy is usually musculoskeletal and safe to bring to us. Call your OB, midwife or labor and delivery line first, or go to the emergency room, if you have:

• Back or pelvic pain that comes in regular waves, tightens the belly, or feels like contractions before 37 weeks
• Vaginal bleeding or fluid leaking
• Pain with fever, chills, or burning with urination
• A severe headache, vision changes, or sudden swelling of the face and hands
• Numbness in the groin or inner thighs, or a change in bowel or bladder control
• Leg weakness that is getting worse, or a calf that is swollen, warm and painful on one side
• Decreased fetal movement

If none of those apply, call (617) 494-1166 or walk in. We are a six-minute walk up Broadway from the Kendall/MIT Red Line station, with free street parking on Broadway and nearby side streets and a first-floor entrance with no stairs.