How pregnancy changes the picture
Pregnancy puts the lumbopelvic region through a large mechanical change in a short window. The pelvis widens, ligaments soften under relaxin, the centre of gravity shifts forward, the abdominal wall lengthens, and the lumbar curve deepens. Most adults would have back pain if their body changed that much in nine months — which is worth saying, because a lot of patients arrive assuming they are simply coping badly.
A 2024 systematic review covering more than 31,000 pregnant women put lumbopelvic pain prevalence at roughly 63%, split across low-back pain, pelvic girdle pain, and both together. Around a third describe it as severe.
Low-back pain or pelvic girdle pain?
They are managed differently, so distinguishing them matters:
- Low-back pain — typically a central or one-sided ache in the lumbar spine, often worse with prolonged standing or at the end of the day.
- Pelvic girdle pain — felt at the sacroiliac joints, the pubic symphysis, or both. Classically provoked by walking, stairs, rolling over in bed, and getting in or out of a car.
- Round ligament pain — sharp, brief anterior groin pain with sudden movement. Uncomfortable but generally benign.
What care looks like by trimester
First trimester. Often mild and intermittent, and frequently more hormonal than mechanical. Sleep position, hydration, and gentle walking do most of the work.
Second trimester. Usually when mechanical pain becomes prominent. This is the stage where hands-on care and a home program tend to be most useful, alongside pelvic-floor physiotherapy where indicated.
Third trimester. The most demanding stage for most patients. In my practice this usually means shorter, more frequent visits — fifteen to twenty minutes every week or two rather than longer sessions further apart — because the body is changing faster.
Being honest about the evidence
Reported adverse events in pregnancy and the postpartum period are rare, and where they occur they are usually a day or two of soreness. That is reassuring. What the research cannot yet do is prove how much chiropractic care helps — the effectiveness studies are small and methodologically limited, and a 2017 systematic review said so directly.
So the honest position is: the risk profile looks low, many patients report meaningful relief, and anyone telling you the research proves it works has gone further than the literature does. If a clinic is promising outcomes for your pregnancy, that is a reason for caution.
What needs a physician first
Some symptoms are not mine to treat. Seek obstetric care rather than chiropractic for vaginal bleeding or fluid loss, sudden severe pain unlike your usual pattern, fever or chills with back pain, upper abdominal pain with headache or vision changes, regular contractions before 37 weeks, or new and progressive leg weakness or numbness.
Pregnancy care at the St. Albert clinic
Pregnancy and postpartum care is a focus of the practice, and a common reason patients choose a female practitioner. Care is offered at the St. Albert clinic inside Eden Health & Wellness, with patients travelling in from Morinville, Sturgeon County, and Legal.
Related: low-back pain and sciatica · pediatric care · what happens at a first visit
Frequently asked questions
Is chiropractic care safe during pregnancy?
Reviews of adverse events during pregnancy and the postpartum period find serious events are rare, with short-lived soreness the most commonly reported effect. The evidence on how much it helps is more limited, because the available studies are small. Care is modified throughout, and some symptoms need obstetric assessment first.
When does pregnancy back pain usually start?
Pain often becomes noticeable in the second trimester and tends to peak in the late second or early third trimester as the abdomen grows and the lumbar curve increases. Roughly 63% of pregnant women experience lumbopelvic pain at some point.
How is a chiropractic adjustment modified for pregnancy?
Side-lying positioning with pillow support or a pregnancy-specific table is used instead of lying face down, force is reduced in favour of gentler mobilization, and soft-tissue work targets the round ligaments, glutes, and lumbar musculature. Visits often become shorter and more frequent in the third trimester.
What is pelvic girdle pain?
Pain felt at the sacroiliac joints, the pubic symphysis, or both, rather than in the low back itself. It is often provoked by walking, stairs, rolling over in bed, or getting in and out of a car, and it is distinct from typical low-back pain.
When should pregnancy back pain be checked by a doctor first?
Seek obstetric assessment before chiropractic care for vaginal bleeding, sudden severe pain unlike your usual pattern, fever or chills with back pain, upper abdominal pain with headache or vision changes, regular contractions before 37 weeks, or new progressive leg weakness or numbness.
Do you see pregnant patients in St. Albert?
Yes. Pregnancy-related care is offered at the St. Albert clinic inside Eden Health & Wellness, and patients travel in from Morinville, Sturgeon County, and Legal.