Pregnancy-Related Low Back Pain and Complementary and Alternative Medicine (CAM) Treatment
Condition: Low Back Pain
MeSH terms: Back Pain; Low Back Pain
Study type: Interventional
Phase: Phase 2

Summary: 
      This study compares three treatments for low back pain that started during pregnancy. The
      study hypothesizes that exercise, spinal manipulation, and a mind-body technique called
      neuroemotional technique (NET) equally affect pain intensity and disability associated with
      pregnancy-related low back pain. The study also hypothesizes that pain intensity and
      disability levels do not influence maternal heart rate variability (a measure of stress) and
      intrauterine attachment (a measure of relationship quality). Ten women will additionally
      provide blood and salivary oxytocin samples during pregnancy and periodically for three
      months after birth. These women and their babies will also be videotaped playing for 5
      minutes at 2 weeks, 6 weeks, and 3 months postpartum.
    

Detailed description: 
      Pregnancy-related low back pain is experienced by over half of all pregnant women. In the
      United States it is thought of as a normal constituent of pregnancy. However, in Europe low
      back pain associated with pregnancy is treated. In the United States pregnancy-related low
      back pain is thought to resolve with birth. However about 1/3 of women who experience
      pregnancy-related low back pain continue to experience back pain for one year postpartum.
      Those women whose low back pain persists into the postpartum period are more at risk of
      experiencing comorbidities such as postpartum depression.

      In the extrauterine life maternal pain limits a mother's ability to securely attach with her
      child. Furthermore, interpretation of pain intensity is influenced by the type of attachment
      the individual has with her parents. Little is known how maternal pain may influence
      intrauterine attachment. Similarly, heart rate variability is influenced by pain and by
      spinal manipulation in non-pregnant populations. However, normal non-pregnant patterns of
      heart rate variability are altered during the second and third trimesters of pregnancy, and
      little is known about why this happens or what this means.
    

Intervention name(s): Exercise; Spinal Manipulation; Neuroemotional Technique (NET)
Intervention type(s): Behavioral; Procedure; Procedure
Intervention description(s): Study visits follow the normal prenatal care schedule (once monthly until 28 weeks, twice monthly until 36 weeks, weekly thereafter). Additional study visits may be necessary if the pain is too intense and requires additional visits.; Study visits follow the normal prenatal care schedule (once monthly until 28 weeks, twice monthly until 36 weeks, weekly thereafter). Additional study visits may be necessary if the pain is too intense and requires additional visits.; Study visits follow the normal prenatal care schedule (once monthly until 28 weeks, twice monthly until 36 weeks, weekly thereafter). Additional study visits may be necessary if the pain is too intense and requires additional visits.
Other intervention name(s): pelvic tilts; stretch; strengthen; glut squeeze; SMT; CMT; chiropractic manipulative therapy; OMT; osteopathic manipulative therapy; adjustment; NET; Mind-body therapy
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Pregnancy; Pain; Low back pain; Pubic symphysis pain; CAM; Complementary & Alternative Medicine; Exercise; Chiropractic; Spinal manipulation; Adjustments; Neuroemotional technique; Mind body; Mind body therapy; Attachment; Maternal Fetal relationship; Intrauterine attachment; Heart rate variability; VAS; Visual analog scale; Roland Morris Disability Index