By Lynn Wilkes
This particular case involves a twenty seven-year-old female with a history of sciatica, who is twenty-one weeks pregnant at the commencement of treatment. It demonstrates that Chiropractic treatment can relieve those symptoms to allow the expectant mum to enjoy the experience of pregnancy.
Glossary Of Terms
Misalignments / Subluxations – bony misalignment or loss of continuity of the joint
Parathesia – numbness or pins and needles
Rotation – Tilt – Torsion – refers to the position of the pelvis
Trimester- three months, in this case the first three months of the pregnancy.
Presenting Symptoms
She presented with parasthesia (numbness/pins and needles) to the left thigh and pain centred around the coccyx and right scacro-iliac joint. The pain radiated down the back of the right thigh to the knee. She also had bilateral shoulder pain.
She had sciatica twelve months ago which required several months off work and a course of physiotherapy. The pain had remained as a dull ache. As the pregnancy advanced, the pain had increased to a throbbing sensation and included pain at right sacro- iliac joint and increased parasthesia to the left thigh. The long-standing bilateral shoulder pain was triggered by her work at the bank. It originally started whilst working as a cashier, lifting bags of coins. It continued when she spent more time at a desk sitting at a computer.
McTimoney Chiropractic treatments are completely safe after the first trimester, as it is a drug free care system. It is important to keep the body in alignment to facilitate a quicker delivery. Self-care during pregnancy maintains skeletal integrity and a follow up treatment as close to the birth as possible is advised.
Blood pressure was checked at the beginning and re-checked at the end of the treatment.
Treatments Received
Her first treatment was at 21 weeks pregnant
The plan was then for 3 – 4 monthly treatments
Then 2 fortnightly treatments Followed by weekly treatments until the birth
Following the first treatment, the patient was warned that she may experience treatment reactions which, if they do occur, usually only last for a maximum of forty-eight hours. She was also advised to drink a pint of water to reduce the risk of stiffness and/ or baths and not to use any localised heat source if she felt and pain or muscle soreness, which may be experienced following a treatment. To avoid hot showers spasm. By using heat it allows this muscles in spasm to release but in the direction Of the spasm, thus leaving the bones in misaligned state causing pressure or irritation to the nerves, when the source of heat is removed the spasm reoccurs. To avoid strenuous exercise particularly in the first forty-eight hours, as this is when the patient is most susceptible to re- misalign the spine.
Whilst watching television she agreed not to sit with her legs crossed or tucked under her on the sofa or to lie down in bed all evening, as all three create poor posture and result in misalignments of the lumbar spine and rotation /torsion/ tilt of the pelvis.
To look at her working environment, the chair should have the seat slightly wedged, to allow the pelvis to sit at right angles to the spine hips knees and ankles. Check that the computer is at the correct height, as she can touch type the screen should be at eye level and to use a footrest if her feet do not reach the floor comfortably.
Three treatments at monthly intervals: at 26 weeks, 31 weeks and 35 weeks
At 26 weeks only experiencing pain if she lies on the floor and then the pressure feels as if it is on the sciatic nerve.
Following the second treatment she borrowed a wedge cushion to use at home To enable her to sit correctly whilst watching television. Advised re the need to drink a pint of water following the treatment / avoid localised heat source and Strenuous exercise.
To be aware of poor posture when drying her hair, to stand with her legs at hip width to spread the weight evenly down both legs and avoids any rotation of the pelvis.
Discussed diet to include lots of fibre (because of the slower motility of the bowel), vitamins and iron to help maintain her good health and for the correct development of the foetus.
Exercise with yoga being the most gentle with Tai Chi the relaxation this creates and the correct breathing techniques, planned short bursts of exercise is better, rather than concentrated longer sessions which will result in exhaustion.
Rest and sleep are also important, it is during this time your body has a chance to restore equilibrium. In the later stages of pregnancy, you may need to place a cushion under your knees in bed to relax the sacro-iliac joint and to prevent twisting of the pelvis.
Use a lumbar roll when driving if your seat does not adjust to accommodate your Increasing Lordosis especially if you drive long distances, making sure you have lots of breaks and gets out to stretch your legs.
Use ice therapy flexible sports pack or bag of frozen peas wrapped in a towel for twenty minuets and then leave it for at least one hour this should relieve any muscle spasm. Avoiding any localised heat source. Monitor for parathesis on her thighs if this re occurs to ring me and come in for a treatment.
At 31 weeks: -lots of stress at work may lose her job experiencing pain mid Thoracics on her left side and in both her thighs.
At 35 weeks: -bilateral hip pain, felt like it was seizing up. No further problems with sciatica or parathesia left thigh, or shoulder pain.
Two treatments at two week intervals: 37 and 39 weeks
37 weeks: – bilateral hips aching at the end of each day, no other symptoms.
39 weeks: – No pain midwife pleased 3/5ths engaged.
Two treatments at weekly intervals: 40 and 41 weeks
40 weeks: no back pain but wrenched right shoulder vacuuming. Also diagnosed with thrush so upset this may affect the baby.
41 weeks: Overdue and feels more uncomfortable with her urinary frequency than with back pain.
We discussed her diagnosis of thrush and the treatment, and the incidence of this occurring during pregnancy. Confirmed that this infection will not affect the baby. If she hasn’t delivered by next week she will attend again Ninth treatment: Now overdue and feels good. She hoped the treatment would induce the delivery but I explained that although we provide holistic treatment we do not induce labour.
Following his birth both mum and baby did well. No pain for mum. Baby came for first chiropractic treatment when four weeks old.
Six months post delivery mum came in for maintenance treatment. Her daughter has no problems.
Conclusion
McTimoney Chiropractic treatment is the perfect way to treat a
Pregnant lady because it is mild, non-invasive treatment. It adapts the way treatment is administered to the needs of the individual. It looks after the physical body as a whole, which helps with the relaxation of muscles, and mind, ensuring that mother and baby remain healthy and happy during the pregnancy and have the best chance of securing a successful and as pain free a labour as possible. The advice, exercises and after care given ensure that the skeletal integrity of the Mother remains intact.
[boxibt style=”success”]About The Author
Lynn Wilkes DC MMCA RGN DON
Lynn Wilkes graduated as a Chiropractor in 1999 having trained for four years at the McTimoney Chiropractic College in Oxford. She is a member of the McTimoney Chiropractic Association, a member of the College of Chiropractors. Lynn is also both an clinic tutor and has been a technique instructor for many years
Lynn practises at
Lynn Wilkes McTimoney Chiropractic Clinic
58 Beechwood Park Rd,
Solihull, West Midlands B91 1ES
0121-705-9030 or 07956421447
Before training as a Chiropractor Lynn worked as a Nurse for twenty- eight years in most of the Birmingham Hospitals specialising for nineteen years in a rehabilitation setting with patients following Strokes, Parkinson’s Disease, Motor Neurones, Multiple Sclerosis, and Orthopaedics (gained a Diploma in Orthopaedics 1974) Lynn also worked as a continence liaison Nurse. Lynn maintains her link with the Royal Orthopaedic Hospital, as she is the Secretary to the Nurses and Physiotherapist League.[/boxibt]