Pregnancy associated pain and GI conditions Pregnancy most often is accompanied with both pain and gastrointestinal conditions throughout all three trimesters. Many medications that would normally treat these conditions are not available for women during pregnancy as they pose adverse side effects to the fetus. This leaves the pregnant woman to seek alternatives to medication to treat symptoms of both conditions. One effective and safe way to help a woman with these symptoms is therapeutic massage and/or pelvic floor therapy. It is important to note that pregnancy is unique to each individual, and not all of these conditions or symptoms may apply. It is important to consider risk factors, stage of pregnancy, and doctor’s recommendations before creating a treatment plan. Common gastrointestinal conditions that can affect a woman throughout pregnancy are heartburn, nausea/vomiting, hemorrhoids, and abdominal cramping. As mentioned, medications that are available to treat the heartburn and nausea/vomiting are antacids containing calcium carbonate or magnesium. These are typically safe for use in pregnant woman with supervision and recommendation from a doctor. Doxylamine may be prescribed in cases of sever morning sickness and vomiting. For both conditions, one of the first lines of defense can be B-6 supplements and ginger. For hemorrhoids, baths, a high fiber diet, and cortisones creams are all perfectly safe options as treatments. Therapeutic massage can be a very helpful alternative therapy for women who are suffering from any of the GI conditions. Treating the acupressure point Pericardium 6 on the wrists, reflexology, and gentle cranial sacral massage can help alleviate nausea and vomiting (Memorial Sloan Kettering Cancer Center, 2022). For heartburn, gentle downward strokes from the throat and chest can help soothe muscle tension that contributes to heartburn. For someone who is actively experiencing heartburn and is pregnant, prone positions (even if you have a pregnancy sling table) or side lying position may not be available. Be sure you are ready to design a treatment plan working Case study The management of pain and GI discomfort with therapeutic massage in pregnancy. Name : Lynda Age: 32 Gestational Age : 25 weeks Medical history : Patient is generally healthy and participates in regular exercise. She is a nonsmoker with no preeclampsia or special circumstances in the pregnancy. Patient is experiencing heartburn and intense lower back pain. This is the patient’s first pregnancy. Presenting symptoms : Lynda to date is a healthy female who is 25 weeks pregnant and who up until this past two weeks has had little to no discomfort, nausea, or pain. She has however the past two weeks been experiencing intermittent heart burn, and intense low back pain to the point that it is interfering with her regular diet and exercise regimen. Pain is interfering with her job duties where she is required to sit for long periods of time, which has now become very difficult due to the sacral discomfort. Assessment : Upon assessment from Lynda’s healthcare provider, they confirmed that her pregnancy was processing well with no major complications. They believe the pain and GI symptoms were merely common symptoms that are associated with pregnancy. The growing uterus in pregnancy causes increased pressure on both the digestive organs and musculoskeletal system.
entirely in the supine position or even sitting position, with extra pillows to prop up the head and chest of the client. The general circulatory benefits of manual therapy may be helpful to heal pregnancy induced hemorrhoids, even though therapists should never work directly on or near the affected area. The most common pain conditions that pregnant women can experience during pregnancy are lower back pain, joint and ligament pain, and headaches. Acetaminophen (paracetamol, Tylenol ® ) is generally considered safe to treat any of these pain conditions but should be monitored and approved by a doctor. NSAIDs or prescription pain medications are not available to women during pregnancy because they can have negative side effects on the fetus. In addition to therapeutic massage, acupuncture, yoga, pelvic or physical therapy, and regular exercise are options for pregnant women to treat pain. Therapeutic massage is a very effective treatment for back pain for a pregnant woman. Applied correctly by avoiding pressure points that could activate contractions, even deep tissue or trigger point techniques can be safely used from the second trimester on to relieve muscle tension. For ligament pain, gentle circular techniques and stretching can be applied to help release joints and help reduce pain. For headaches, circulatory massage, and scalp or sacral massage, occiput tension releases and reflexology are particularly helpful for reducing symptoms. Manual therapy for pregnant women is a safe and effective alternative for women who are suffering from either pain and or GI conditions throughout their pregnancy. It is recommended to receive proper training or certifications before offering prenatal massage or therapy. Working together with the primary care doctor or obstetrician gynecologist can be an excellent way to create a cohesive treatment plan for therapists. Treatment plan : Given the severity of Lynda’s discomfort, a multidimensional approach was suggested. This approach would implement both complementary medicinal approaches and involve minimal pharmaceutical intervention. ● Lifestyle and diet changes : Lynda was told to avoid spicy and greasy foods for the heartburn. Also, she was advised to not lie down directly after eating, and to eat smaller but more frequent meals. ● Prenatal massage and physical therapy : Lynda opted to receive prenatal massage therapy from a licensed prenatal massage therapist to help relieve her lower back pain. The therapist focused on cross fiber frictions across the sacrum, pertrisage and kneading techniques on the quadriceps and hamstrings, and gentle round circulatory massage on ligaments around the hip flexors. The therapist also used gentle abdominal massage and circulatory techniques to ease muscle tension around the esophagus and chest to help with heartburn symptoms. Lynda also has begun seeing a therapist who specializes in pelvic health. Therapy has showed her stretching and strengthening techniques to improve flexibility and improve core strength, hopefully decreasing the strain on the low back. Therapy has provided her with a lumbar brace to wear below the pregnancy belly for support. ● Medications : In consultation with her healthcare provider, Lynda began taking antacids containing calcium corbonate as needed to help relieve more
EliteLearning.com/Massage-Therapy
Book Code: MIL1226
Page 76
Powered by FlippingBook