Review
Obstetrics
Acupuncture for pelvic and back pain in pregnancy: a systematic review

https://doi.org/10.1016/j.ajog.2007.11.008Get rights and content

The objective of our study was to review the effectiveness of needle acupuncture in treating the common and disabling problem of pelvic and back pain in pregnancy. Two small trials on mixed pelvic/back pain and 1 large high-quality trial on pelvic pain met the inclusion criteria. Acupuncture, as an adjunct to standard treatment, was superior to standard treatment alone and physiotherapy in relieving mixed pelvic/back pain. Women with well-defined pelvic pain had greater relief of pain with a combination of acupuncture and standard treatment, compared to standard treatment alone or stabilizing exercises and standard treatment. We used a narrative synthesis due to significant clinical heterogeneity between trials. Few and minor adverse events were reported. We conclude that limited evidence supports acupuncture use in treating pregnancy-related pelvic and back pain. Additional high-quality trials are needed to test the existing promising evidence for this relatively safe and popular complementary therapy.

Section snippets

Materials and Methods

We searched the following electronic databases from their inception until July 2006:

The Cochrane Central Register of Controlled Trials (CENTRAL), National Library for Health Complementary and Alternative Medicine Specialist Library, CINAHL, EMBASE, AMED, and Acubriefs. We searched MEDLINE from its inception until November 2006. Due to funding limitations, we only searched for trials written in or translated into English.

We based our MEDLINE search strategy on the Cochrane highly sensitive

Results

The Figure summarizes the trial flow. We found 10 papers from our MEDLINE search and 421 papers from searching other databases. We excluded the vast majority of papers after a careful initial screen because we found them to be duplicates, not randomized controlled trials (RCTs), or not pertaining to acupuncture for pelvic/back pain in pregnancy. We found 1 ongoing trial of acupuncture for back pain in pregnancy (CRISP-Computer Retrieval on Scientific Projects. Acupuncture and Low Back Pain

Comment

Limited evidence suggests that acupuncture given in addition to standard treatment is more effective than standard treatment alone, physiotherapy, or stabilizing exercises in relieving pelvic and back pain in pregnancy. Although the trials found in our review were small in number and clinically heterogeneous, the trial by Elden et al35 is well-conducted and provides good evidence for the effectiveness of acupuncture in pregnancy-related pelvic pain.

Difficulties in this review included making

References (45)

  • M. Zib et al.

    Symptoms during normal pregnancy: a prospective controlled study

    Aust N Z J Obstet Gynaecol

    (1999)
  • I.M. Mogren et al.

    Low back pain and pelvic pain during pregnancy: prevalence and risk factors

    Spine

    (2005)
  • H.C. Ostgaard et al.

    Reduction of back and posterior pelvic pain in pregnancy

    Spine

    (1994)
  • W.H. Wu et al.

    Pregnancy-related pelvic girdle pain (PPP), I: terminology, clinical presentation, and prevalence

    Eur Spine J

    (2004)
  • W.H. Wu et al.

    Pregnancy-related pelvic girdle pain (PPP), I: terminology, clinical presentation, and prevalence

    Eur Spine J

    (2004)
  • S.M. Wang et al.

    Low back pain during pregnancy: prevalence, risk factors and outcomes

    Obstet Gynecol

    (2004)
  • A. Hansen et al.

    Pregnancy associated pelvic painII: symptoms and clinical findings

    Ugeskr Laeger

    (2000)
  • E.C. Larsen et al.

    Pregnancy associated pelvic painI: prevalence and risk factors

    Ugeskr Laeger

    (2000)
  • R.W. Stones et al.

    Pelvic girdle pain in pregnancy

    BMJ

    (2005)
  • B. Stuge et al.

    Physical therapy for pregnancy-related low back and pelvic pain: a systematic review

    Acta Obstet Gynecol Scand

    (2003)
  • J. Depledge et al.

    Management of symphysis pubis dysfunction during pregnancy using exercise and pelvic support belts

    Phys Ther

    (2005)
  • G. Young et al.

    Interventions for preventing and treating pelvic and back pain in pregnancy

    Cochrane Database Syst Rev

    (2002)
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    1

    Carolyn Ee was funded by General Practice Education and Training Australia.

    2

    Eric Manheimer was funded by grant number R24 AT001293 from the National Center for Complementary and Alternative Medicine (NCCAM) of the US National Institutes of Health.

    3

    Adrian White was supported by the DH-National Coordinating Centre for Research Capacity Development (NCC RCD).

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