Three Things to Know about Pregnancy, Pain, and Exercise

I recently created an infographic about common misconceptions about pregnancy, exercise, and chiropractic care. I found it hard to fit all of the information on one page, so I wanted to expand on it here! I’ve included links to helpful resources and important references, in case you want to dive even deeper. If you have any questions about this information, or feedback for which topic I should cover next, let me know! I’m always happy to hear from you.

-Dr. B

Is low back pain common during pregnancy?

Yes! Low back pain and pelvic pain—wherein “pelvic” refers to the area between the “dimples” at the base of your low back and the gluteal folds at the bottom of your buttocks—is very common. In a sample of pregnant women in Ontario, 76.6% of the sample reported experiencing low back pain, pelvic pain, or both at some point during their pregnancy (1). Pain may present in the low back, the pelvic region including the pubic joint, or even the sides of the hips or inner thighs. Just because back pain is common does not mean it is normal, or that you should expect to manage it yourself for the rest of your pregnancy. Speaking with your chiropractor can help you to find relief.

If you want more information on low back and pelvic anatomy, click here for our previous blog post!

Is exercise safe during pregnancy?

Not only is exercise safe for most pregnant people, it can actually reduce your risk for certain pregnancy complications such as gestational diabetes, and help with low back pain (2,3). The Canadian guidelines recommend pregnant people without contraindications achieve at least 150 minutes of moderate activity over at least three days per week (but being active every day is better!), including both aerobic and resistance training. Even if you cannot reach the recommended amount of exercise, it is likely you’re still receiving some health benefit from exercise (2).

I’m pregnant and want to exercise. What safety precautions should I take?

While exercise is recommended in most pregnancies, there are a number of pregnancy-related contraindications to exercise (listed in the link here), so you should absolutely have a conversation with your primary care provider before changing your routine. There are activities in which you should not participate such as scuba diving, and you should avoid contact sports such as rugby and hockey, and sports with a higher chance of falling such as cycling on rough terrain. During pregnancy your biomechanics and center of mass change rapidly making it more difficult to prevent falls. While most exercise types are safe, if you ever feel light-headed or ill, you should stop activity and seek advice for how to modify it to be more comfortable for you.

How much should I exercise during pregnancy?

The 2019 Canadian Guideline for Physical Activity Throughout Pregnancy, give some guidelines on this matter:

1. All pregnant persons without contraindications should be physically active throughout pregnancy. Even if you were not active before pregnancy, gradually getting into physical activity might be right for you!

2. Pregnant persons should perform at least 150 minutes of moderate-intensity physical activity per week.

3. Physical activity should take place during three or more days per week, however activity every day is encouraged.

4. Pregnant persons should take part in a variety of resistance training and aerobic exercises. In addition, yoga or gentle stretching may also be helpful.

5. Pelvic floor muscle training (also known as Kegel exercises) may be performed on a daily basis to reduce risk of urinary incontinence. Instruction on proper technique is recommended!! (Emphasis mine.)

6. Pregnant persons that experience nausea, light-headedness, or otherwise feel unwell when performing exercise flat on their back should modify their programs to avoid this position.

These guidelines are a great place to start, but a health or fitness professional well-versed in exercise for pregnant persons can give recommendations for type of exercise, how much, how often, and other questions you might have.

Is chiropractic care safe during pregnancy?

Not only is chiropractic care safe during pregnancy (4,5), aches and pains such as low back or pelvic pain may be relieved with chiropractic care (6,7). Two recent reviews looked into adverse events following spinal adjustments, one of the manual care tools that chiropractors use. The authors of the studies found that most reported events are mild, for example worsening of symptoms that resolves after a day or two (4,5). The authors found only a handful of cases of serious adverse events, and suggested these events are likely rare, but reporting systems for adverse events should be improved so we may continue research in this area (4,5). Your chiropractor should discuss the risk of both mild and severe adverse events with you before providing any treatment.

Can a chiropractor help with my low back pain during pregnancy?

Absolutely a chiropractor can help with pregnancy-related low back or pelvic pain! When you visit your chiropractor, you may receive a combination of advice, muscle therapy, adjustments or mobilizations of joints, exercise instruction, or other intervention. Unfortunately, the quality of evidence for these therapies is relatively poor, but the results for patients in the studies are often favourable (6,7). Ultimately, talking to a qualified and experienced health or fitness professional can start you on your way to recovering from aches and pains during pregnancy.

If you’d like to chat more about whether chiropractic care is right for you, please give us a call at 519-389-7078.

If you’d like a copy of our “Three Things to Know about Pregnancy Exercise, and Pain” infographic including references, please contact us.

If you’re ready to start your journey today, click the link below.

References:

1. Weis CA, Barrett J, Tavares P, Draper C, Ngo K, et al. Prevalence of Low Back Pain, Pelvic Girdle Pain, and Combination Pain in a Pregnant Ontario Population. J Obstet Gynaecol Can. 2018; 40(8):1038-1043. Available from PubMed: https://pubmed.ncbi.nlm.nih.gov/30103876/.

2. Mottola MF, Davenport MH, Ruchat S-M, Davies GA, Poitras VJ. 2019 Canadian guideline for physical activity throughout pregnancy. Br J Sports Med. 2018; 52:1339-1346. Available from BJSM: https://bjsm.bmj.com/content/52/21/1339.

3. Connell G, Weis CA, Hollman H, Nissen K, Verville L et al. Physical activity throughout pregnancy: guideline critical appraisal and implementation tool. J Can Chiropr Assoc. 2021; 65(1):50-58. Available from chiropractic.ca: https://chiropractic.ca/jcca-online/issue/april-2021-volume-65-no-1/.

4. Stuber KJ, Wynd S, Weis CA. Adverse events from spinal manipulation in the pregnant and postpartum periods: a critical review of the literature. Chiropr Manual Ther. 2012; 20:8. Available from PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3348005/.

5. Weis CA, Stuber K, Murnaghan K, Wynd S. Adverse events from spinal manipulations in the pregnant and postpartum periods: a systematic review and update. J Can Chiropr Assoc. 2021; 65(1):32-49. Available from chiropractic.ca: https://chiropractic.ca/jcca-online/issue/april-2021-volume-65-no-1/.

6. Weis CA, Pohlman K, Draper C, daSilva-Oolup S, Stuber K, et al. Chiropractic Care for Adults with Pregnancy-Related Low Back, Pelvic Girdle Pain, or Combination Pain: A Systematic Review. J Manipulative Physiol Ther. 2020; 43(7):714-731. Available from Science Direct: https://www.sciencedirect.com/science/article/pii/S0161475420301287.

7. Stuber KJ, Smith DL. Chiropractic Treatment of Pregnancy-Related Low Back Pain. J Manipulative Physiol Ther. 2008; 31(6):447-454. Available from: Science Direct: https://www.sciencedirect.com/science/article/abs/pii/S0161475408001711.