Safe Chiropractic Care for Headaches During Pregnancy

Chiropractors offer safe and effective techniques for alleviating headaches during all trimesters of pregnancy.

What are some reasons women experience headaches during pregnancy?

Dr. Gregg Rubinstein: Well, headaches are common in both expecting women, inside and out of pregnancy, obviously. But headaches during the third trimester tend to be more related to poor posture and tension. So, there can be these tension headaches from carrying the extra weight, center of gravity moves forward, the head moves forward, which puts a lot of tension in the suboccipital muscles. So, we can see a lot of headaches there, but most of the time when expecting moms are having headaches, they’re usually like tension headaches.

Headaches during the third trimester can also be caused by a condition called pre-eclampsia, which is high blood pressure that is hard to regulate during the pregnancy. And then when you start to see headaches during the third trimester caused by pre-eclampsia, you also see some swelling. But the headaches are very different and usually they don’t have a major time with headaches in the first and second trimester. If they come on in the third and they come on really strong and they’re associated with high blood pressure and increased swelling, that’s when we need to bring in the medical doctors. But they get these headaches usually due to the postural changes or the blood pressure changes.

Do some women experience migraines or severe headaches? If yes, could that be a sign that something might be wrong with their pregnancy or can that be normal?

Dr. Gregg Rubinstein: Well, I would never say headaches are normal, but they’re common. And sometimes headaches tend to be more common in the first and third trimesters, but they can occur in the second trimester as well. And there are lots of common causes for headaches during pregnancy. It’s important to note that the headache during the second or third trimester that comes with high blood pressure and is associated with that pre-eclampsia, that’s dangerous and usually requires some medical attention.

That pre-eclampsia is a pregnancy related condition that requires evaluation and management by an obstetrician or someone who does maternal fetal medicine because that elevated pressure, high blood pressure, prior to the pregnancy, will put her at risk. So, if they have a history of blood pressure being high, then they’re at increased risk for pre-eclampsia. And then it includes that new headache after 20 weeks with a sudden onset of severe headaches associated with a fever, any mental health changes, elevated blood pressure or visual changes, those are really important to make sure that you see your doctor. So, any headache that’s associated with pre-eclampsia also requires medical attention. Chiropractic can help balance the spine, get some of the pressure off, realign things, but very often medical intervention is required with pre-eclampsia.

And what type of chiropractic treatment works best to alleviate headaches during pregnancy?

Dr. Gregg Rubinstein: Well, all techniques can work, and different people respond to different techniques. Some people are afraid of some of the more energetic chiropractic techniques and some people like the low force and the no force techniques. But over my past 32 years of experience, when we’re dealing with headaches, typically upper cervical work and drop work at the atlas axis combination is usually the most common. So those are the top two vertebrae. And what’s interesting about the atlas is every nerve in your body passes through the ring of atlas before it goes anywhere. So as far as the nerve system is concerned, that’s mission control or mission central right there.

So, for me, as being a chiropractor for 32 years and watching other chiropractors and seeing other techniques done, it doesn’t really matter which technique you employ, you’re always going to employ the technique that you’re best at and that’s going to work best for your patient given that situation. But the good thing to know is that most chiropractors have multiple tools, multiple different techniques that they can use to address headaches and the upper cervical spine. And while some are safer than others for certain people or some will just fit better with certain conditions, it’s the good clinician that knows which technique to use with which person and when. So that’s really how it all works out. All techniques work, but when it comes to pregnancy, upper cervical is great for the headaches and then the Webster technique for the pelvic girdle.

Besides headache relief, what are some other benefits of receiving chiropractic care during pregnancy?

Dr. Gregg Rubinstein: Generally, spine care during pregnancy, because there are additional stresses and strains on the spine, as we’ve talked about ad nauseum over these past couple of weeks, is that when the center of gravity moves forward, the head will follow and that’ll move forward and then we can get more stress and tension in the neck. So, it can help with neck pain, it can help with the lower back pain, it can help with round ligament pain when we do the Webster technique and all that can relieve a lot of the discomfort and lead to shorter delivery times and less need for interventions during the pregnancy.

So, there are many benefits of receiving chiropractic care, but it all stems from the nerve system. Since the nerve system is the master system and chiropractic really deals with that, once we alleviate the pressure on the nerve system, the body can right the ship, heal, run and regulate itself properly. It’s only when the nerve system is compromised or not working at its best or in its most efficient state that we start to see things break down. So general spine care, great for relieving back pain, neck pain and all those things that come with pregnancy, but really just to have a healthy body, a healthy nerve system and a healthy spine are so important to keep the body healthy during pregnancy.

For someone who has never been to a chiropractor and is seeking prenatal chiropractic treatments for headaches, what is a typical office visit and how often should they expect to visit?

Dr. Gregg Rubinstein: Those are good questions. And again, the frequency and severity of the headaches and the type of headaches might dictate what type of treatment they get. But the typical office visit, you’re going to come in and we’re going to take a history, we’re going to find out what’s been going on. How long have you had these headaches? Have you taken anything in the past? Have you seen other doctors? Has anyone taken any x-rays? So, we dive into the history to see if there might be a cause for the headaches there. And then obviously as they gain weight and all these other things come in, we will talk to them about the weight gain, we’ll talk to them about the Webster technique.

But when you’re getting headaches as your primary symptom, it’s usually the upper cervical spine that’s related. So, the stress, tension, and poor posture can create misalignments at the top cervical vertebrae, which can then put pressure either on the spinal cord or the nerves that leave from the neck. A series of adjustments and some of them are very gentle and just use drop work and sometimes we use activator mallets, which are very low force and very specific, and other times we’ll use the more traditional techniques, which sometimes I think work faster and more efficiently.

So, depending on the condition of the patient, the age of the patient, the frequency and the severity of the headaches will help us determine what specific treatment that we would use on that certain patient. So typically, you’re going to go through the full examination, a full consultation and you’ll get treated or adjusted.

If you’re pregnant, we never x-ray expecting moms, it’s just not good business and not good for babies. So, there would never be any x-rays. But once they have the delivery and they’re done breastfeeding, sometimes we would go back and take x-rays. For a lot of people who are coming to the office with headaches that aren’t expecting, x-rays can commonly find the root cause of all or nearly all the problems that people present with.

So typically, it’s just going to be a full examination consultation, digging into the history, do the full orthopedic and neurological workup to rule out anything bad or anything more significant. And then if it’s just stuff related to misalignment and chiropractic, then away we go on the chiropractic adjustments and usually get great results.

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To speak with Dr. Gregg Rubinstein, visit or call (212) 977-7094 to schedule an appointment.

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