Tips on finding a chiropractor (during pregnancy)
February 4, 2019 11:05 PM Subscribe
I'm pregnant and interested in trying out a chiropractor. There are a good dozen or so who claim to specialize in pregnancy-related chiropractic work in my area. Any tips on finding a good one? Anything to watch out for? Thanks!
I went to a chiropracter to relieve pubic symphisis pain during pregnancy. Honestly I don't remember exactly what he did for it but it felt good. He didn't do anything to my neck at all (and I didn't want him to.) He mostly massaged and pressed points on my back if I recall correctly. That part was good (oh, the things he did to my back... he could make every vertebra pop with elegant ease, like playing a piano.) I recall the pubic symphisis pain did lessen, too.
As to how to find a good one, I'm trying to remember how I found my guy. I think I got a recommendation from my ob/gyn.
posted by fingersandtoes at 6:56 AM on February 5, 2019 [1 favorite]
As to how to find a good one, I'm trying to remember how I found my guy. I think I got a recommendation from my ob/gyn.
posted by fingersandtoes at 6:56 AM on February 5, 2019 [1 favorite]
I asked my obstetrician and she offered an enthusiastic recommendation for someone local. (I haven't actually seen him yet, as prenatal massage cleared up the pain, but perhaps I will later on.) Personally I would be very nervous about seeing a chiropractor who was not recommended by a doctor, since at least where I live, there is a lot of room for variation in qualifications and professionalism among that field.
posted by the turtle's teeth at 7:55 AM on February 5, 2019 [1 favorite]
posted by the turtle's teeth at 7:55 AM on February 5, 2019 [1 favorite]
Came in here to emphasize not to let them touch your neck. In addition to the spinal cord injury report koolkat links, the more common issue is vertebral dissection and stroke. You are already in a hypercoagulable state when pregnant (mostly venous, but arterial clots can happen too, especially when there is a dissection for them to hide out); don't risk a large hemispheric stroke.
posted by basalganglia at 8:47 AM on February 5, 2019 [7 favorites]
posted by basalganglia at 8:47 AM on February 5, 2019 [7 favorites]
I am clearly biased, but know what I am talking about when it comes to chiropractors. My dad is one. My brother is one. Five of my uncles are chiropractors. And 13 of my cousins are chiropractors. They all practice out of Kansas under the name Dopps Chiropractic if you want to check.
I have lived with, and around, chiropractors for the past 35 years, and they have collectively seen over 100,000 patients, and not one of them has ever had the neck complications referenced above. I have personally had my neck adjusted hundreds of times with no problems and actual pain relief.
Someone could tell you not to go to a heart surgeon because you might end up with a perforated aorta. That has happened before, after all. But in the same way one incident does not equal a trend, there isn't a lick of sense in telling people to avoid chiropractors because of isolated incidents where there were complications. Chiropractors (in Kansas at least) go through four years of undergrad, then an additional three years of actual medical school. They can't prescribe medicine, but they know the human body inside and out.
I suggest you look for a chiropractor who studied under the Palmer method, as that particular vein seems to avoid most of the quackery some chiropractors end up involved in.
posted by tacodave at 4:03 PM on February 5, 2019 [4 favorites]
I have lived with, and around, chiropractors for the past 35 years, and they have collectively seen over 100,000 patients, and not one of them has ever had the neck complications referenced above. I have personally had my neck adjusted hundreds of times with no problems and actual pain relief.
Someone could tell you not to go to a heart surgeon because you might end up with a perforated aorta. That has happened before, after all. But in the same way one incident does not equal a trend, there isn't a lick of sense in telling people to avoid chiropractors because of isolated incidents where there were complications. Chiropractors (in Kansas at least) go through four years of undergrad, then an additional three years of actual medical school. They can't prescribe medicine, but they know the human body inside and out.
I suggest you look for a chiropractor who studied under the Palmer method, as that particular vein seems to avoid most of the quackery some chiropractors end up involved in.
posted by tacodave at 4:03 PM on February 5, 2019 [4 favorites]
Thank you so much, tacodave.
I worked for a great chiropractor for a couple of years, and saw how many people she helped. It always made me sad when I would hear people dismiss chiropractors out of hand, when I went to work everyday and saw how incredibly beneficial they can be.
It also always makes me sad when people trot out the extremely rare cases of stroke caused by neck adjustment as a reason to never see a chiropractor. It makes as little sense as saying you shouldn't see any other kind of doctor because once in a blue moon those types of doctors cause X problem. Yes, doctors are people and flawed and sometimes make mistakes. Properly-trained chiropractors do not make more mistakes than other doctors. In fact, from statistics I've seen, they seem to make far fewer significant mistakes.
As far as choosing a chiropractor, I would avoid those who believe that chiropractic can cure everything. Stick to those who focus on helping with lessening muscle and joint pain and improving posture, alignment and movement. Chiros can have a wide range of skills that they incorporate. Some of them are closer to massage therapists, some closer to PTs, some closer to sports kinesthesiologists. The ideal thing would be to ask another pregnant woman in your circle to see if anyone has any recommendations for a chiro who helped them.
posted by nirblegee at 5:48 PM on February 5, 2019 [2 favorites]
I worked for a great chiropractor for a couple of years, and saw how many people she helped. It always made me sad when I would hear people dismiss chiropractors out of hand, when I went to work everyday and saw how incredibly beneficial they can be.
It also always makes me sad when people trot out the extremely rare cases of stroke caused by neck adjustment as a reason to never see a chiropractor. It makes as little sense as saying you shouldn't see any other kind of doctor because once in a blue moon those types of doctors cause X problem. Yes, doctors are people and flawed and sometimes make mistakes. Properly-trained chiropractors do not make more mistakes than other doctors. In fact, from statistics I've seen, they seem to make far fewer significant mistakes.
As far as choosing a chiropractor, I would avoid those who believe that chiropractic can cure everything. Stick to those who focus on helping with lessening muscle and joint pain and improving posture, alignment and movement. Chiros can have a wide range of skills that they incorporate. Some of them are closer to massage therapists, some closer to PTs, some closer to sports kinesthesiologists. The ideal thing would be to ask another pregnant woman in your circle to see if anyone has any recommendations for a chiro who helped them.
posted by nirblegee at 5:48 PM on February 5, 2019 [2 favorites]
From a recent review article on the subject:
901 cases of cerebral artery dissections have been reported in the literature in relation to chiropractic manipulation. In 707 of these cases, the patient went on to develop some type of stroke [34]. Notably, a study focused on malpractice data from the Canadian Chiropractic Protective Association (CCPA) showed a low incidence of neurological symptoms attributable to cervical manipulation and arterial dissection following chiropractic manipulation [35]. Specifically, data from the report suggests that a chiropractor will be aware of an arterial dissection occurring following cervical manipulation only once in 8.06 million office visits with only one in forty-eight chiropractors experiencing such an event in their entire careers [emphasis mine]
I suspect chiropractors underestimate the risk because unlike a heart surgeon dealing with a perfed aorta, they don't often see the follow-up stroke that occurs several days later, the neurologist does. Even as a non-stroke neurologist, I've taken care of more people than I can remember who had a post-dissection stroke, ranging in age from 16 to 60. That simply doesn't jive with the claim that's a rare complication.
Is this the most common cause of stroke? No. Is it still devastating? Yes. A layperson saying well they've never heard of it happening is like a layperson saying that their Grandpa Joe smoked like a chimney and lived to 104. Don't smoke, and don't let anyone rotate your neck, no matter how many years of training they have had.
Chiropractors are fantastic for low-back pain, and a personal/local recommendation from your OB or a fellow pregnant person is probably best. If you're not having neck pain, I don't know why they would mess with your neck anyway, and I would be giving some heavy-duty side-eye to any professional who does risky procedures on patients without necessity.
posted by basalganglia at 7:30 PM on February 5, 2019 [1 favorite]
901 cases of cerebral artery dissections have been reported in the literature in relation to chiropractic manipulation. In 707 of these cases, the patient went on to develop some type of stroke [34]. Notably, a study focused on malpractice data from the Canadian Chiropractic Protective Association (CCPA) showed a low incidence of neurological symptoms attributable to cervical manipulation and arterial dissection following chiropractic manipulation [35]. Specifically, data from the report suggests that a chiropractor will be aware of an arterial dissection occurring following cervical manipulation only once in 8.06 million office visits with only one in forty-eight chiropractors experiencing such an event in their entire careers [emphasis mine]
I suspect chiropractors underestimate the risk because unlike a heart surgeon dealing with a perfed aorta, they don't often see the follow-up stroke that occurs several days later, the neurologist does. Even as a non-stroke neurologist, I've taken care of more people than I can remember who had a post-dissection stroke, ranging in age from 16 to 60. That simply doesn't jive with the claim that's a rare complication.
Is this the most common cause of stroke? No. Is it still devastating? Yes. A layperson saying well they've never heard of it happening is like a layperson saying that their Grandpa Joe smoked like a chimney and lived to 104. Don't smoke, and don't let anyone rotate your neck, no matter how many years of training they have had.
Chiropractors are fantastic for low-back pain, and a personal/local recommendation from your OB or a fellow pregnant person is probably best. If you're not having neck pain, I don't know why they would mess with your neck anyway, and I would be giving some heavy-duty side-eye to any professional who does risky procedures on patients without necessity.
posted by basalganglia at 7:30 PM on February 5, 2019 [1 favorite]
Someone could tell you not to go to a heart surgeon because you might end up with a perforated aorta.
To me it is all about the level of risk versus the potential level of benefit. If you are having heart surgery, it is likely that without the surgery you would be dead. Therefore the risk in the heart surgery (that you might die) compared to the risk of not having the surgery (you will die) is necessary. I wouldn't suggest that someone should have heart surgery for a sore back.
To apply it to cervical dislocations and other neck issues vs back pain is quite similar to me. You come in with lower back discomfort. By all means go to a chiropractor and have them massage and manipulate your lower back. Especially as that area is significantly stronger and more well supported. They are extremely unlikely to dissect your spinal column by fiddling with your lower back (ie risk is nearly zero). Conversely it is possible to have an adverse event from neck manipulations and their outcomes can be quite severe (ie risk is low but significantly higher that the lower back alone). They might be rare, but to me the risk benefit analysis doesn't lie enough toward the benefit for my liking. This is solely examining the risk and not even beginning to look at the efficacy vs placebo of any treatment. I've already had a comment deleted for mentioning placebo before, but this comment is not taking any sides as to the efficacy of chiropractic treatment and is solely looking to minimise risk. Hopefully this will stand, but lets see.
posted by koolkat at 1:06 AM on February 6, 2019
To me it is all about the level of risk versus the potential level of benefit. If you are having heart surgery, it is likely that without the surgery you would be dead. Therefore the risk in the heart surgery (that you might die) compared to the risk of not having the surgery (you will die) is necessary. I wouldn't suggest that someone should have heart surgery for a sore back.
To apply it to cervical dislocations and other neck issues vs back pain is quite similar to me. You come in with lower back discomfort. By all means go to a chiropractor and have them massage and manipulate your lower back. Especially as that area is significantly stronger and more well supported. They are extremely unlikely to dissect your spinal column by fiddling with your lower back (ie risk is nearly zero). Conversely it is possible to have an adverse event from neck manipulations and their outcomes can be quite severe (ie risk is low but significantly higher that the lower back alone). They might be rare, but to me the risk benefit analysis doesn't lie enough toward the benefit for my liking. This is solely examining the risk and not even beginning to look at the efficacy vs placebo of any treatment. I've already had a comment deleted for mentioning placebo before, but this comment is not taking any sides as to the efficacy of chiropractic treatment and is solely looking to minimise risk. Hopefully this will stand, but lets see.
posted by koolkat at 1:06 AM on February 6, 2019
Response by poster: Thanks for the interesting discussion. Two different doulas recommended the same place, so I'm planning to go there, and I'll bring up this neck thing. I don't think it'll be necessary anyway, as I think most of the pregnancy related stuff is about the pelvis (e.g., the Webster Technique, whatever that is). Any other thoughts are welcome, thanks.
posted by slidell at 2:29 AM on February 8, 2019
posted by slidell at 2:29 AM on February 8, 2019
This thread is closed to new comments.
posted by koolkat at 1:24 AM on February 5, 2019 [8 favorites]