Chiropractic Care During Pregnancy: Is It Safe, and Can It Help Back Pain?

If your back started aching somewhere around the second trimester, you have a lot of company. How common it is depends on which study you read and how pain is defined: Cleveland Clinic puts it at about 40% of pregnant women, while a Cochrane review of the research found more than two thirds experience low back pain. Either way, it's one of the most common complaints of pregnancy. It can start at any point, but it's more common in the second and third trimesters.

A few things are happening at once. Your center of gravity shifts forward as your baby grows, and in the second and third trimesters that shift increases the curve in your lower back. The extra weight carried in front strains your back muscles, and your abdominal muscles stretch and weaken, which can lead to poorer posture. On top of that, your ligaments naturally become softer and more flexible to prepare for labor, which puts more strain on the joints of your lower back and pelvis.

None of that means something is wrong. It means your spine and pelvis are working harder than they're used to, and that's the kind of mechanical problem that hands-on care and the right exercises can often help with.

This is the first question most expecting moms ask, and it deserves a straight answer rather than a sales pitch.

A 2012 review, written by researchers at chiropractic colleges, searched the published research specifically for reports of harm after spinal manipulation during pregnancy and after birth. It found only a few: seven patients across five reports. Those ranged from increased pain after treatment to serious injuries, including fracture, stroke, and epidural hematoma. The authors concluded that such injuries may be relatively rare, but because the evidence is so thin (mostly individual case reports), the true level of risk can't be measured, and better reporting is needed.

A short commentary in Canadian Family Physician, written by three practicing chiropractors who declared competing interests, described chiropractic care, including spinal manipulation, as a safe option for mechanical low back and pelvic pain in pregnancy, noting that very few adverse effects have been reported in the literature.

So the honest summary is this: serious problems appear to be rare, and what's been published is reassuring, but it isn't the same as proof of zero risk. That's why it matters who you see, and why your OB or midwife should know you're getting chiropractic care.

Dr. Johns has cared for patients from newborns to the elderly, including pregnant women. With pregnancy, technique and positioning are adjusted to be appropriate as your body changes, so what works comfortably in your first trimester may look different by your third.

There isn't one adjustment that fits every patient. Dr. Johns adjusts differently depending on what someone's spine actually needs, using manual, drop table, or instrument adjusting. Having more than one way to adjust means care doesn't depend on a single position that may stop being comfortable as your belly grows.

Because the research points to combined care (hands-on treatment plus exercise and education) as a reasonable approach, adjustments can be paired with physiotherapy exercises coordinated with the rest of your plan. The goal is to help you keep moving comfortably through the rest of your pregnancy, not just to get through one bad week.

Most pregnancy back pain is mechanical, but back pain can sometimes be a sign of something else, including early labor or a urinary tract infection. Based on NHS and Cleveland Clinic guidance, call your OB, midwife, or doctor right away if you have back pain and: