• Hiebert C
• Alcantara J

• Pregnancy
• Subluxation
• Torque Release Technique
• Twins
• Webster Technique

Objective:  To describe the chiropractic care of pregnant women carrying twins and to examine outcomes in managing patients carrying twins with neuromusculoskeletal complaints and breech presentation.

Clinical Features:  Three pregnant women with twin pregnancies presented with low back pain, hip pain, and/or pelvic discomfort. Two patients also sought care who had breech presentations of their twins. Pain severity ranged from 5 to 8 on an 11-point numeric rating scale. Physical examinations revealed spinal subluxations, hypertonic muscles, and reduced range of motion (ROM) in the cervical, thoracic, and lumbar spine.

Intervention and Outcomes:  Patients were managed with a combination of Torque Release Technique using the Integrator Adjusting Instrument and the Webster Technique at a frequency of twice per week over 6 weeks. Spinal adjustments targeted subluxations and pelvic misalignments to reduce pain and address neurobiomechanical function in the sacral/pelvic region. Across the series, pain severity diminished significantly, enabling patients to resume daily activities. Notably, in one case, twin breech presentations were resolved, confirmed via ultrasound. No adverse reactions to chiropractic care were reported.

Conclusion:  Chiropractic care using the Torque Release and Webster Techniques shows promise in managing neuromusculoskeletal pain and outcomes related to breech presentations in twin pregnancies. While outcomes were favorable, further research is necessary to evaluate its broader applicability and efficacy in similar cases.

Author keywords: pregnancy, chiropractic, vertebral subluxation, adjustment, spinal manipulation, Webster Technique, Torque Release Technique, twins

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