It took almost a year, but Amy was finally pregnant. As the weeks turned into months, her body underwent many transformations. Amy expected the expanding belly and weight gain. But she was surprised by the other body changes including heartburn, body aches, stretch marks, back pain and other “joys” of pregnancy.

In the 5-month appointment with her OBGYN doctor, Amy complained about significant pain in her back near the hip bone. Her OBGYN provider suggested that she try lying down, resting and applying ice or heat. It didn’t work. Amy hadn’t slept in four days and was in constant pain. When those interventions were not successful, Amy’s OBGYN doctor referred her me.

I am a member of the Osteopathic Manipulative Medicine Department (OMM) at Tanana Valley Clinic. I am a board certified physician and have completed undergraduate, medical school and residency programs. In addition to my standard clinical training, I am also specially trained in the Fascial Distortion Model (FDM). FDM is a model within OMM that involves a particular way of assessing and treating the strained or injured connective tissue (fascia) that surrounds the body and creates support to the low back. The goal of OMM treatment is to ease muscle or joint pain, increase overall mobility, and generally promote healing.

I have extensive experience treating the aches and pains of pregnancy, safely and effectively.  

When Amy came to me, she was in pain and indicated she was at a “7” on the 0-10 pain scale. Her primary source of pain was in her back, but during the course of the appointment, I was able to:

• Relieve Amy’s back pain. 

It turned out that Amy had what is commonly referred to as a “knot” in her low back that was causing most of her pain. Utilizing my training in FDM, I recognized that this type of knot occurs when some fascial fibers get pulled through some of the other fascial layers. I treated it by using my thumb to guide the tissue back where it belonged. Amy also had some rotations in her lumbar spine and pelvis that were easily straightened out by having her contract specific muscles against my resistance.

• Address postural changes due to pregnancy. 

In pregnancy, one of the reasons that women experience pain is related to the postural changes that occur as the growing belly changes the mother’s center of gravity. In the third trimester, growing breasts also contribute to these changes. Although this is a normal part of pregnancy, there are stretches that can be of tremendous help in counteracting the side effects. OMM can also loosen up any tight areas that are exacerbating the postural changes.  

• Relieve upper and lower extremity swelling. 

Another “side effect” of pregnancy is the fact that the body holds on to more water than normal, which can lead to swelling in the limbs. Even when it is not enough to cause visible swelling, it can be just enough to put extra pressure on the median nerve in the wrist, causing carpal tunnel syndrome. OMM can help by relieving the tension in key spots where fluid tends to get blocked up. For the upper extremities, this is the neck and across the tops of the shoulders and for the lower extremities it is the pelvis and low back. For carpal tunnel specifically, OMM can also relieve tension in the arm and wrist itself. 

• Tackle breathing difficulties. 

As the baby grows, it is common for it to put pressure on the ribs from underneath. Sometimes this results in the fascia surrounding specific ribs to get knotted up, which is painful, sometimes it results in the entire ribcage not moving up and down as much as it is supposed to with breathing. Whether it is pain that makes breathing difficult for an expectant mother or the whole ribcage being stiff, OMM can help the ribs move better so that breathing is easier.

Amy delivered a healthy baby boy. Her labor and delivery were easier than expected, maybe in part because of her prenatal OMM treatment that prevented tension from building up in her pelvis. Bonding with her new son was Amy’s top priority.

About 3 months later, Amy called the office for another appointment. The original back pain was gone, but had resurfaced in other parts of her body. Luckily for Amy, many OMM techniques can help postpartum women relax tight muscle tissue, reduce joint pain and alleviate ligament strain. In fact, preliminary results of a study in the Journal of the American Osteopathic Association demonstrated that OMM treatments help reduce acute pain in postpartum women, regardless of whether they delivered vaginally or via cesarean. 

In addition to prenatal and postpartum treatments for moms, I also treat newborns. Research shows that over 90% of healthy newborns examined between 6 and 72 hours of life had misalignments in their head, neck, or lower back regions. These can occur due to the birthing process or, perhaps, positioning in the uterus during pregnancy. Most babies are able to correct them without any problems, however, sometimes they can contribute to feeding difficulties (such as latching problems or not opening the mouth wide enough), GERD, colic, torticollis (tight neck), and plagiocephaly (misshapen head). OMM gently releases tight muscles and corrects the misalignments.

Pregnancy is a time when a women’s body undergoes many changes, often resulting in some form of musculoskeletal complaint. Osteopathic manipulation can serve as a valuable complementary therapy to normal obstetrical care. By providing relief from pain, maintaining homeostasis and circulation, and supporting labor and delivery - pregnancy can be a more comfortable and enjoyable experience.

As I like to tell my pregnant patients, “just because pregnancy is causing your symptoms, doesn’t mean you have to be miserable!”

Dr. Mary Joy is a valued member of the OMM Department at Tanana Valley Clinic. She has extensive medical training in the OMM field of practice. Dr. Joy is Board Certified in Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine. She treats all sorts of pain complaints, both acute and chronic, in all age groups. Dr. Joy is especially interested in helping athletes (including weekend warriors) return to play quickly, helping people avoid surgery, and helping people with symptoms that they thought they just had to put up with. She particularly enjoys treating pain complaints during pregnancy and the postpartum period.