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Pregnancy, or gestation, is defined as the period in which a fetus develops inside a female’s uterus. There are physiologic changes that occur as a consequence of pregnancy, which include cardiovascular changes (such as an increase in cardiac output), an increase in smooth muscle relaxation secondary to progesterone, and musculoskeletal changes. More importantly, these musculoskeletal changes, which include an increase in lumbar lordosis, forward neck flexion, and joint laxity, can result in several complaints with lower-back, pelvic and neck pain being the most prevalent. Osteopathic manipulative medicine (OMM) can play a vital role to help alleviate these conditions throughout a woman’s pregnancy course.
HOW OMT CAN HELP
OMT, otherwise known as osteopathic manipulative techniques, are methods utilized to treat somatic dysfunctions, which are impairments in the function of different parts of the body including skeletal, joint, myofascial structures and their related vascular, lymphatic, and neurologic elements.1
Cervical soft-tissue OMT: In order to relieve strain to the cervical region, secondary to patients’ necks being in forward flexion, an osteopathic physician may apply cervical soft-tissue techniques to the area of concern. Upon diagnosing a somatic dysfunction, a physician may apply soft force and traction to the muscles in your neck until relaxation or a “release” is felt. The physician will then reassess the area to ensure the “dysfunction,” or the key point causing the neck pain is relieved.2
Seated forward-leaning thoracic spine articulator: In this technique, the physician stands in front of the patient using their knees to stabilize the patient on the table. The physician then asks the patient to cross her arms and lean forward against the physician while they wrap arms around the patient, contacting key articular components of the thoracic spine. The patient is drawn forward and various movements are introduced into this technique such as side bending and rotation to release the tension and increase the mobility of the patient’s spine.3
Pubic decompression: This technique involves alternating relaxation and contraction of muscles. The patient’s hips and knees are flexed and held together while the patient tries to pull them apart against the physician’s counterforce. This is done multiple times with the patient’s knees sequentially spread apart at each interval. The goal of this manipulation is to relieve any strain in the pelvic diaphragm and the pubic symphysis.3
SOURCES
Ward RC. Foundations for Osteopathic Medicine. 1997; Lippincott Williams & Wilkins.
DiGiovanna EL, Schiowitz S, Dowling DJ. An Osteopathic Approach to Diagnosis and Treatment. 2005; Lippincott Williams & Wilkins.
Hensel KL, Carnes MS, Stoll ST. Pregnancy research on osteopathic manipulation optimizing treatment effects: the PROMOTE Study Protocol. J Am Osteopath Assoc. 2016;116(11):716-724. doi:10.7556/jaoa.2016.142