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Manual treatment successfully treated pregnancy symptoms in 91 After the second treatment, out of a total 56 patients, the treatment was completely successful in 40 The highest success rate was in eliminating headache Manual therapy in pregnancy is a drugless, etiological, usually highly effective therapy. It is a low cost, rapid, safe, and well tolerated treatment for pregnancy symptoms which frequently has an immediate effect, thus making it an optimal treatment for pregnancy symptoms.

Pregnancy symptoms have high incidence and almost all women experience them during pregnancy. Due to their high frequency, most physicians consider pregnancy symptoms as a normal phenomenon or sign of pregnancy. Pregnancy symptoms are considered as normal changes of the organism to the newborn condition. Zib et al. A total of 38 symptoms occurred with a significantly different frequency mainly increased. On the other hand, it has been suggested that nausea, vomiting, headache, dizziness are the most frequent symptoms in pregnancy.

These symptoms usually appear together and lead to a lower quality of life and limit functionality 2 , 3. Still others have observed frequent micturition and fatigue to be the two most frequent symptoms followed by low back pain, headache, sleep disorder, nausea vomiting and heartburn 2. Chiropractic is a form of alternative medicine, which is focused on the diagnosis and treatment of mechanical disorders of the musculoskeletal system, especially the spine 4.


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Many studies have evaluated the effectiveness of chiropractic treatments in treating various disorders, but with contradictory results. The treatment of back pain is the only proven benefit of chiropractic treatments 5. Chiropractic considers subluxation as the root cause of many visceral dysfunctions and diseases 6.

The aim of this study is to evaluate effectiveness of manual treatment of the spine in reducing and eliminating pregnancy symptoms.

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The inclusion criteria were the presence of pregnancy symptoms that appeared for the first time during pregnancy. Study participants made no lifestyle or dietary changes, did not use medication or any other treatment for their symptoms except manual treatment. The study included randomly selected pregnant women with normal pregnancies. Pregnant women were enrolled in the study when they came for their regular pregnancy control visits.

To determine the possible recurrence, side effects, complications and impact of the manual treatment on the kind of birth and its outcomes, the effects of treatment were followed until the end of the pregnancy.

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All participants were informed of all the details of the study and all signed and informed consent form confirming their voluntary participation in the study. The study was carried out in accordance with Declaration of Helsinki. All of the pregnant women had a controlled pregnancy and the outcome of manual treatment was followed until delivery. Treatment was considered fully successful if, after a maximum of three treatments, the pregnancy symptoms no longer appeared until the end of pregnancy.

It was considered partially successful if the pregnancy symptoms were less intensive than before the treatments, and unsuccessful if after the treatments there was no disappearance or mitigation of pregnancy symptoms. Every pregnant woman was given a questionnaire which asked for: their age, occupation, previous diseases and injuries before pregnancy, date of their last period, pregnancy due date, the number of childbirths, the number of intentional abortions, the number of spontaneous abortions, difficulties in the previous pregnancies, diseases in the previous pregnancy, stress in the present pregnancy, diseases in the present pregnancy, medications used in the present pregnancy.

They were also asked to disclose the week of the pregnancy in which symptoms first appeared, how many weeks symptoms persisted before the first treatment, and the time elapsed between manual treatment and the alleviation of symptoms. The rotation of the head to the left and right sides in degrees was measured. After that, the manual treatment of the cervical and thoracic spine was done.

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Treatment of patients with pregnancy symptoms consisted of three manual interventions: on the cervical spine, on the upper part of the thoracic spine and on the lower part of the thoracic spine. During treatment the patient was sitting with a therapist standing on her left. The blocked vertebral segment was found using the fingertips. It was unblocked using a quick small amplitude tap. The same procedure was repeated on the other side of the cervical spine. The patient was standing during treatment, with the therapist standing behind her. The patient interweaves her fingers and rests her palms on the nape of her neck.

The therapist slipped his forearm between the upper arm and forearm of the patient who then pulls her elbows together. The therapist gently pulled the patient back and leaned the upper part of her thoracic spine to the front of his chest so that it was fixed. The indiscriminate traction of the upper thoracic spine and unblocking of the vertebrae are done performed in this manner. During treatment the patient was standing, with the therapist standing behind her. The pregnant woman put her left palm over her left eye and right over her right eye.

She put her elbows together and drew them against her chest.

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The therapist held the woman around the lower part of her chest with their hands so that their fists were holding her elbows. Indiscriminate traction of the lower thoracic spine and unblocking of the vertebrae are performed in this manner. The manual treatment lasted for minutes, it was painless and very well tolerated. At After a minimum of three days or maximum at the next gynecological consultation, it was ascertained whether the treatment of the pregnancy symptoms was successful, partially successful or unsuccessful.

Any new problems which occurred after the treatment were noted. Any adverse reactions after the treatment, or eventual relapse after successful treatment and the time elapsed since the disappearance or alleviation of pregnancy symptoms were also recorded. Data analysis was performed analyzed using SPSS Patient socio-demographic and medical history data are shown in Table 1. The table 1 shows that the participants were Approximately one third of the patients were nulliparous, while half were uniparous.

Most patients did not have spontaneous or intentional abortions. About one fifth of patients has serious illness, surgery, significant injury or health problems before pregnancy.

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Of the 79 patients who had a previous pregnancy including one miscarriage , 74 Several patients experienced more pronounced stress, disease or used certain medications prior to study participation. The onset of pregnancy symptoms was in the first trimester of pregnancy. The patients had manual treatment performed approximately one month after the appearance of symptoms Table 2.

Sound phenomena were most pronounced in the cervical spine. Most of the patients went into labor on their expected due date and had a vaginal delivery Table 2. The most frequent symptom was nausea following by heartburn, vomiting and hyperosmia. Headache was present in a similar frequency as heartburn and vomiting. Most patients required only one treatment Table 3. After treatment, all patients were asked about new symptoms, outcomes and adverse events.

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The distribution of patients regarding first, second and third treatment is presented in table 5. A small number of patients had new symptoms after the first and second treatments, but no new symptoms presented after the third treatment. The majority of patients had completely successful treatment, following by partially successful. Only two patients had unsuccessful first and second treatments. Results of our study suggest that manual treatment of the cervical and the thoracic spine is effective in reducing pregnancy symptoms. The majority of patients exhibited an immediate alleviation of symptoms, while a small number required two or three manual treatments with complete or partial results.

The therapy was unsuccessful in only 2 of patients. The majority of patients reported the treatment as being completely successful. There were no adverse effects on pregnancy outcome and no complications were observed during the manual treatment.


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  8. Complications of manual treatments are usually very rare and according to Haldeman et al. Majority of pregnant women in this study indicated that they have had an easy and fast delivery. Based on the average age, we can conclude that the sample is representative, consisted of women of different socioeconomic status and education. Ulf Ulmsten and Gunnar Sundstrom found that pregnant women have a lower esophageal pressure, slower esophageal peristalsis with smaller amplitudes and higher intragastric pressure than women who are not pregnant, thus encouraging reporting of gastroesophageal reflux disease GERD in pregnancy 8.