German researchers found osteopathic manipulative therapy (OMTh) decreased postpartum low back pain by over 70 percent in women who had given birth at least three months before beginning treatment, according to a new study published in July issue of the Journal of the American Osteopathic Association.
Osteopaths can also help to prepare exercise and stretching programs, and provide advice on posture and stress management for improved general health and wellbeing.
The eight week study, devised as a pragmatic randomized controlled trial, surveyed 80 women experiencing low back pain three to 15 months postpartum. Women in the study group received four OMTh treatments at two week intervals. Participants in the control group did not receive OMTh and were not allowed to receive any additional pain relief treatment, such as medication or therapy.
On average, those who received OMTh reported a 73 percent decrease in pain, compared to only seven percent in the control group. Pain was assessed by a 10-point Visual Analogue Scale and functional disability as measured by the Oswestry Disability Index.
'Women who've recently given birth are rarely studied beyond screening for postpartum depression and delivery complications, even though it's well documented that low back pain is a common issue that hinders their quality of life during an already stressful time," said Jennifer Caudle, DO, assistant professor of family medicine at Rowan University School of Osteopathic Medicine. "This study shows that osteopathic manipulative therapy can relieve their pain without medication that could be passed to a breastfeeding infant."
It's estimated that about 50 percent of pregnant women suffer from some kind of lower back pain either during or after their pregnancies. The symptoms may start during the first trimester of pregnancy, during labour or in the postpartum period.
Question: What is Osteopathic Manipulative Therapy?
Melinda Banks: Osteopathic manipulative treatment, or OMT, is hands-on care. It involves using the hands to diagnose, treat, and prevent illness or injury. Using OMT, your osteopath will move your muscles and joints using techniques including stretching, gentle pressure and resistance.
OMT is medication or drug free which is really important during pregnancy and breastfeeding as there are so many medications that can affect the health of the foetus and baby and are contraindicated for woman at this time.
Question: How does Osteopathic Manipulative Therapy decreases low back pain in postpartum women?
Melinda Banks: Osteopathic Manipulative Therapy (OMT) for low back pain in postpartum women works in a similar way to OMT for low back pain patients generally. Treatment may address restriction in articular structures that have nociceptive capacity. OMT also addresses myofascial strain patterns that can produce altered biomechanical function and pain. OMT addresses alterations in tissue tone and impaired mobility of the Lumbopelvic region which are common after pregnancy and childbirth.
Question: Can you talk about the results you've had with this treatment?
Melinda Banks: In my years of practice I have managed many patients experiencing low back pain during pregnancy and also after birth. Osteopathic management involves not only the physical hands on treatment of these conditions but exercise and lifestyle advice as well. Unfortunately, I have treated many patients with low back pain that have been advised that it is normal and they just need to put up with it. Low back pain is a condition that can be managed and treated conservatively with good clinical outcome. So, it is important that women know they have options in treating their pain.
Hormonal changes affect the tone of ligaments, biomechanical and postural changes occur during pregnancy and after birth. For example the hormone Relaxin affects soft tissue tone, and during pregnancy a woman's centre of gravity and biomechanical function alter to accommodate the growing fetus. Osteopathy helps to support a patient through these various changes through pregnancy and after birth. Because osteopaths have a range of gentle treatment styles patients can be treated throughout these various stages with good clinical outcomes. Often times women experience pelvic girdle pain and pubic symphysis pain in conjunction with low back pain, which in my experience, also responds well to osteopathic management.
Question: What can cause lower back pain during pregnancy and after?
Melinda Banks: A range of different factors can cause a patient to experience low back pain during pregnancy and after birth. Some of these factors can be biomechanical and postural in nature due to the adaptations the patient has had to make to accommodate pregnancy and birth. As well as adapting to feeding postures and other aspects of parenting. Hormonal influences can also be a factor. Sometimes woman have pre-existing problems that exacerbate with pregnancy and birthing. For this reason it can be helpful for women to consider osteopathy as part of their preconception care to ensure good biomechanical functioning prior to pregnancy.
Question: How soon after giving birth can a woman visit an Osteopath?
Melinda Banks: Patients can seek osteopathic treatment soon after giving birth unless they have any significant complications that may prevent them from doing so. A qualified osteopath will always take into account the various factors that may be affecting the patient at this point and adapt the treatment plan accordingly.
Question: Can women be treated by an Osteopath during pregnancy?
Melinda Banks: Yes we commonly treat women during pregnancy for a range of problems such as low back pain, pelvic girdle pain, carpal tunnel and sciatic pain. The osteopath is educated and understands how to modify treatment protocols for patients during pregnancy. Many patients have regular treatment during pregnancy as part of their general health management.
Question: What types of exercise and stretching programs will an Osteopath provide a postpartum women?
Melinda Banks: Exercise and lifestyle advice for women postpartum will vary between patients depending on their individual problem and presentation. For example women recovering from Caesarean Section require different management to woman who have vaginal births. The osteopath will make recommendations that are specific to the patient and their needs at the time of consultation.
Interview by Brooke Hunter