Cracking Back Pain

Zahira Marty takes us through her pregnancy pain and we at DISC answer her questions and discuss the benefits of pregnancy massage and chiropractic throughout those important 9 months.

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My pregnancy has been relatively symptom-free apart from the back pain I’ve experienced from about 16 weeks onward. There were nights of excruciating pain – trying to wiggle and stretch to find some relief from the pain. A friend of mine recommended seeing a sports clinic and chiropractor, and although hesitant at first, making the decision to start with treatment plan has changed my life!

I’ve come to terms with the fact that the pain will not go away for the remainder of the pregnancy and possibly for a while after. Back pain, from what I understand, is not something that you can ‘cure’ during pregnancy, but with the correct plan in place and knowing your triggers and tipping point – you can manage it and ease the pain it causes.

Needless to say – you should always consult your doctor before doing anything related to your body, particularly during pregnancy, and make sure you do your homework on the specialists you visit.

So, what triggers my back pain?

Busy, long days

The growing belly

High heels

Being on my feet and driving a lot – which can’t be helped with my job.

I made my appointment at the Diversified Integrated Sports Clinic (DISC) and was so impressed with the patient management and experience. The doctor I was recommended to see was Dr Tamara, and although her schedule was packed for quite some time, she fitted me in when I explained how much pain I was in. I was in within a day, and met with very professional staff in a modern and welcoming space that is the clinic – trendy and cutting edge sport feel.

Dr Tamara’s team began the appointment with a firm yet immediately relieving massage that started deep in the buttocks and worked up into both sides of the back.

Tamara joined us and continued with the very firm, very deliberate massage followed by a full adjustment. I cannot begin to tell you how incredible this felt! It made a world of difference, and became a permanent part of my body management through pregnancy.

After the adjustment, my back was strapped with kinesiology tape (Rocktape) for a few days until my follow up appointment. From the second appointment on, I had a full body sports pregnancy massage from Lizzie Thomson (Sports Therapist), and Tamara would join us for 10-15 mins for the adjustment. Lizzie worked deep into the muscles of my buttocks, lower back, upper back, neck and shoulders – working out the tension and pain created from the weight of my baby bump and the resultant muscle strain.

Seeing both Tamara and Lizzie had made such a HUGE difference to my pregnancy. I sat down with these incredible ladies to understand the cause and the treatment of back pain during pregnancy.

I keep joking about wanting to move in at DISC – it’s really that good! I’d recommend the team there to anyone with muscle related concerns, particularly pregnancy, and have experienced the impact proper treatment can have on pain management.

Questions to Lizzie Thomson (Sports Therapist) on back massage and therapy:

There’s a common misconception that you can’t have massages, let alone firm ones, during pregnancy – what are your thoughts, and the facts on that?

Massage can 100% be used throughout the whole duration of your pregnancy as long as the therapist is qualified and knows how to treat a pregnant lady. Firm pressure can also be applied, the majority of the time this is what is needed, your muscles are working so hard and various muscles are overcompensating whilst your body changes shape, you need a deep pressure to reach the deep muscle fibres. For sure, there are areas that firm pressure should not be applied, that can stimulate the uterus and early labour but as long as your therapist/Dr knows where not to dig, you are 100% in safe hands.

What causes the intense back ache during pregnancy?

Back pain is so common during pregnancy due to the changes happening in your body. Your pelvis has to widen which means your sacral ligaments become more supple, this results in the surrounding muscles working extra hard to stabilise your pelvis. Your bodies centre of gravity also changes, you have more weight now around your tummy creating pressure on your hips and uterus therefore applying more pressure to your lower back. You get more of an anterior pelvic tilt which is a small curve in your lumbar spine. Your pregnant body is concentrating everything on growing your baby (especially in the first trimester) therefore some other aches and pains become disregarded.

Tell me about the relationship between massage and chiropractic treatment in the management of the pregnancy back ache?

Massage and chiropractic work hand in hand (literally) in back ache, pregnant or not pregnant. The massage will reduce the muscular tension, promote blood circulation around your body, reduce inflammation and offload pressure from your spine/joints. The chiropractic realignment will then assure all your vertebrae are moving correctly and aren’t locked. Combined, these treatments with reduce your pain and increase your mobility.

How frequently should you/can you come in for sports massage / chiropractic?

If you can come in for pregnancy massage on a weekly basis then this is amazing but if once a month is what fits your time, your pain levels and your schedule then this is also ok. Prioritise your body though, this is a super important time for your body to be feeling happy and healthy so make sure you put yourself first. Treatment however does not only happen in the clinic, we will give you your homework including mobility exercises and stretches to keep your body strong, functioning and as pain free as possible.

Walk me through a visit what can be expected from a visit?

Depending on your symptoms, painful areas and requests I will generally work my way up from your ankles (inflammed or not), up to your neck/shoulders. Most pregnant ladies require massage from there hips upwards. I will focus around the sacroiliac joint, gluteals that could be irritating your sciatic nerve and along the lumbar, thoracic and cervical paraspinal muscles. All the treatment tends to be done in side lying with plenty of towels for your comfort, to support your bump and to hide your modesty.

What can be done at home between visits to release / stretch and relieve back pain?

You can still use the foam roller for a bit of self massage if you have been shown how to use it correctly. Heat can be applied to your lower back, neck, shoulders, wherever you are getting the pain to increases blood flow and relieve pain. Stretches, hip mobility and postural stretches. Movement is good remember. As long as your body has been use to exercise, it can still continue but to a lower intensity. Make sure you check with your doctor before hand and are told which exercises to avoid firstly.

Anything that should be avoided in terms of movements, sleep styles etc during pregnancy that may contribute to back pain? 

Sleeping on your stomach and your back after your bump is substantial should be avoided due to pressure. The best position is on your left side which can increase nutrients to your placenta. Try to move as ‘normally’ as possible, whilst bending down bend your knees etc, don’t be scared to continue as normal. High heels can be worn (girls will be girls!!) but it will put your weight distribution onto the balls of your feet which puts more pressure through your quads, hip flexors and therefore lower back, this may cause more discomfort but here is no rule to say no heels. Listen to how your body feels.

Questions to Dr Tamara Ghazi (Medical Director, Doctor of Chiropractic) founded DISC, and despite her schedule makes time for individual attention with patients:

What does chiropractic adjustment during pregnancy actually entail – in terms of it’s effect on the body?

Chiropractic adjustments during pregnancy are similar to all other spinal mobilizations, where we find misalignments and fixations in the spine, in this case caused by increased pressure on the back due to more stomach weight and changing biomechanics of the spine. Usually the lumbar lordosis, which is the inwards shaped low back curve, will end up being more curved and experiencing more joint stress due to shifting the weight bearing points in this area! Also, increasing chest size can put a lot of strain on the shoulders, mid back and neck causing pain in these areas.  Changing pregnancy hormones can cause more relaxation of the spinal joints which are more susceptible to being stuck or fixated. An adjustment will offload the joints, allow for more blood flow and stimulate joint mechanoreceptors to turn off nociceptors (pain) and allow for proper movement.

How safe is it?

Chiropractic mobilisations and manipulations are extremely safe during pregnancy, and patients who are high risk or experiencing bleeding are always ruled out first. Furthermore, most doctors of chiropractic are well trained in soft tissue manipulation and release which can also greatly help alleviate pain.

How frequently can it be done?

It can be done as frequently as once a week, depending on the intensity of pain and spinal dysfunction found. More importantly, we focus on holistic and integrated approaches where the patient is fully evaluated and taught at home exercises to relieve pain and maintain strength, adapting work or home ergonomics to their changing bodies and other preventative techniques!

How does this help with pain relief and other symptoms during pregnancy?

Different chiropractors may use different techniques depending on the patient’s comfort level; some may be more invasive and others much more gentle. Sometimes the “cracking” noise can be heard when a joint is moved but there is no risk to the baby as this is just gas being released from facet joints, and any abdominal pressure is avoided.

What can a pregnant woman expect from an adjustment – in terms of physical activity by the Dr.?

The most common conditions we see are low back pain, mid back pain (around the bra line) anterior hip/ pelvic pain around the pubis from increasing pressure of the stomach on this area causing compression during prolonged sitting, rib pain (from baby changing positions or kicking). These are all easily treatable with a combination of musculoskeletal therapy and exercises. Why live in pain when you can have a healthy and beautiful pregnancy!

Lizzie Thomson

Sports therapist