resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
News in Brief
NBCE Launches Computer-Based Testing Era; California Chiropractors Get Expanded DOT Exam Privileges; New Jeff Hays Documentary.
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
Medicalization and Mindfulness
The past several years have seen a veritable explosion of research on mindfulness. Research abstracts we've published in each issue of Health Insights Today under the heading "Mind-Body News" have increasingly reported on studies about mindfulness interventions.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
The Problem With Prolonged Sitting
We need to constantly talk to our patients about spending less time sitting and about what can go wrong with poor sitting postures. The fact is we sit too long in repetitive malpositions.
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
Help Secure Our Future by Sharing It
The National Board of Chiropractic Examiners (NBCE) conducts one of the most comprehensive surveys of the U.S. chiropractic profession every 4-5 years.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
February, 2001, Vol. 01, Issue 02
Pelvic Pain in Pregnancy
By Kate Jordan, NCTMB
The most common reason women seek the services of massage therapists during pregnancy is for back pain. In order to treat such discomfort effectively, it is helpful to differentiate between pain originating in the lumbar spine and pain arising from dysfunction in the posterior pelvis.
Pregnancy places unique stresses on weightbearing joints in the torso.As a woman's pregnancy progresses, her uterus enlarges, moving her center of gravity forward of her feet. This causes her to rotate her rib cage posteriorly, shifting her weight to the lumbosacral joint and the sacroiliac joints in the pelvis.
Numerous studies of back pain in pregnancy have found that as many as 50% of pregnant women experience some back pain, and 10% experience severe pain. About 30% of these women had no history of previous back pain.
When women make pain drawings of their back pain, only 25% show pain in the lumbar area. More than 50% draw their pain below the crest of the ilium and lateral to the sacrum. They describe this pain as deep in their gluteal area, traveling down the back of the thigh. Even though this appears to be "sciatic" pain, only about one of every 10,000 pregnant women have actual disc disease in pregnancy, and usually those who do had disc problems before they got pregnant.
The number of women complaining of back pain in pregnancy has increased in the past 20 years perhaps because more women are working, often in ergonomically stressful jobs. In one study in Sweden, 70% of all working pregnant women took sick leave, mostly for back pain.
It's important to differentiate between lower back pain and pelvic pain. They should be approached in different ways, and the treatment for back pain may make pelvic pain worse. A woman whose back pain comes from her pelvis will locate it in her gluteal region on one or both sides; she will have a free range of motion in her back and hips; and her pain will not be constant, but related to the movements she makes.
There is a simple test that will confirm that a womens pain originates in the pelvis, rather than being referred from another area. This is called the posterior pelvic pain provocation test. With your client well-supported in a side-lying position, with her painful side facing up, position her upper leg in 90 degrees of hip flexion, with flexed knee on a pillow support. With one hand stabilizing her sacrum, compress the knee and femur into the acetabulum. If this pressure reproduces her pain, either in the symphysis pubis or the sacroiliac area, her pain is likely to be coming from one of the ligaments around those joints.
Pelvic changes in pregnancy were noticed as far back as the days of Hippocrates. The pregnancy hormones relaxin, estrogen and progesterone cause a measurable widening of the pubic symphysis anteriorly, and a shifting of the SI joint posteriorly. Widening of the pubic symphysis begins as early as the eighth week of pregnancy. Any pain felt in the pubic symphysis is a direct result of dysfunction in the sacral area.
Pelvic pain may be noticed around the 18th week of pregnancy. Women experience higher pain intensity with pelvic pain than back pain, and the higher a woman's relaxation levels, the more pain she will experience. This pain is caused by stretching of the pelvic ligaments, causing the pelvic muscles to attempt to establish stability by increasing muscle tension, leading to chronic pain in the area. Because the discomfort is primarily caused by hormonal changes, it cannot be prevented during pregnancy.
On the other hand, secondary muscle pain can be prevented. If your client receives supportive bodywork during her pregnancy, she is likely to have no further pain after her baby is born. Some studies have shown that more than 35% of women who had no treatment during pregnancy suffered persistent pelvic pain afterward.
In particular, if a woman has pelvic pain, she should not be encouraged to do back exercises, or any kind of vigorous exercise. Exercise will only increase her pain, especially the following day. She should avoid stairs, standing on one leg, extensive walking, extreme ranges of motion of her back and pelvis, standing, heavy lifting and prolonged sitting. She should also avoid bed rest, since this will weaken supportive muscles. One of the most helpful support measures for pelvic pain is the use of a pelvic belt. These should be worn throughout the pregnancy whenever your client is upright. Bodywork techniques should focus on the pelvic musculature, particularly the gluteus maximus,gluteus medius, lateral hip rotators, the hamstrings, hip adductors, the rectus femoris, and the quadratus lumbuorum. Techniques that will be particularly effective for pelvic pain include neuromuscular therapy, muscle energy techniques, and positional release techniques. Clients should also be taught side-lying positioning that supports a neutral pelvis (no rotation) for sleeping and resting.
After giving birth, posterior pelvic pain disappears in most women within three months. When a woman begins to exercise again, she should start with strengthening exercise for her pelvic muscles, before she begins any back exercise.
Click here for previous articles by Kate Jordan, NCTMB.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.