Acupuncture wins for pregnancy pain

Acupuncture and exercise can alleviate the common problem of pelvic pain in pregnancy, a Cochrane review finds.

After reviewing 26 randomised trials, researchers concluded there was “moderate-quality” evidence that acupuncture reduces evening pelvic pain and lumbo-pelvic pain better than usual care alone.

Exercise programs, tailored to the stage of pregnancy, also trumped usual care for both evening pelvic pain and lumbo-pelvic pain, but was inferior to acupuncture, the review found.

 

However there was less support for other interventions such as pelvic support belts, osteopathic manipulation and specially designed pillows for easing nighttime pain: methodological flaws rendered this research too unreliable to draw solid conclusions.

“Given the high incidence of back and pelvic pain in pregnancy and the distress this causes many women in late pregnancy, more research would be helpful to inform the advice given by prenatal practitioners,” the review authors wrote this month in the Cochrane Library.

“Preventive studies beginning early in pregnancy would be welcome to see if any of these interventions will really prevent the development of back and pelvic pain.”

The findings lend support to Australia’s new draft antenatal care guidelines, which advise GPs to tell patients that exercise, acupuncture, physiotherapy and support garments “may provide some pain relief”.

“Reassure the woman that pelvic girdle pain will not harm her or her unborn child, and is likely to resolve after the birth,” the guidelines say.

Patients can also try wearing low-heeled shoes, applying heat to painful areas and avoiding non-essential weight-bearing activities, although there is only “low-level evidence” behind these interventions, the guidelines say.

Cochrane Database of Systematic Reviews 2013; Issue 8, online