Expert: J.R. Strecker, B.S., D.C. - 5/22/2008

Question
My chiropractor says that I have a hiatal hernia.  I am presently 29 weeks pregnant & he did the hiatal hernia "stomach" push ~ where he pressed his hands into and below my last rib on my left side and push down repeatedly.   It was pretty uncomfortable (not painful) ~ just difficult to breath... but, I'm also pregnant.   Is this safe to do during pregnancy ?  Is there any risk to the baby when doing this ??  I worry a lot ~ but it just seems a little risky

Answer
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Hello C.,

Thanks for trusting me with your health.  My first response to your question is have you been diagnosed as having a hiatal hernia, and how was this diagnosed?  I know sometimes certain chiropractors will perform these adjustments on patients without a true hiatal hernia.  That won't cause any harm or anything, but there's no sense in even doing the adjustment if there is no hernia.  I'm assuming you have had this diagnosis from an MD or it was discovered on an x-ray or other special study.  If there was no x-ray or other special study performed, then I would be curious how you were diagnosed as having a hiatal hernia.  The reason why, is because I know muscle testing is sometimes performed by chiropractors, which is not scientifically valid.  Just make sure you have been diagnosed by a special study before receiving these adjustments.

The efficacy of hiatal hernia adjustments is controversial.  Again, it won't cause any harm (unless it delays care or referral for urgent situations).  However, your concern is due to your pregnancy.  I understand and respect your concern.  I would say that it honestly will not harm your developing baby, but rather than take any risks, I would avoid it for the time being.  It also depends on the force used during the adjustment.  I was trained to not use too much force.  So I don't know exactly how your chiropractor is doing it.  Again, there is no major need for concern.  But if you are uncomfortable with the thought of having the chiropractor push on your stomach, then just let him/her know you'd like to delay treatment of the hiatal hernia until you have delivered your child.  If your hernia is more urgent and needs medical management, you may need a consultation with an MD to determine the most appropriate plan of action.

Remember, healthcare should be a partnership between you and your doctors.  If at any point anything makes you feel uncomfortable, let your doctor know.  If your doctor dismisses your concerns, it's always best to get a second opinion.  Just the same if this chiropractor tells you the hiatal hernia adjustment is necessary, then perhaps it would be a good idea to get a second opinion with a different chiropractor.

I hope this helps guide you a bit.  Best of luck!

Dr. J.R. Strecker, D.C.