Acupuncture may treat low back, pelvic pain during pregnancy

Acupuncture improved pain, function and quality of life in pregnant women experiencing low back and/or pelvic pain, according to a meta-analysis published in BMJ Open.

“Acupuncture is considered as a safe, nonpharmacological treatment option that is being increasingly used for relieving discomfort during the pregnancy,” Jiaman Yang, a doctorate student and research assistant at the Fifth Clinical College of Guangzhou University of Chinese Medicine in China, and colleagues wrote. “Nevertheless, several studies have shown that there was insufficient clinical evidence for acupuncture for low back and/or pelvic pain during the pregnancy, and the results of previous studies were also inconsistent.”

Yang and colleagues searched the PubMed and Embase databases, Web of Science and the Cochrane Library for randomized controlled trials published through Jan. 15, 2022. They identified 10 studies of 1,040 women conducted in Sweden, the United Kingdom, the United States, Spain and Brazil that compared acupuncture with other, placebo or no treatment for low back and/or pelvic pain during pregnancy.

Primary outcomes were pain as measured by the Visual Analogue Scale, functional status as measured by the Disability Rating Index and quality of life as measured by the SF-12 Health Survey. Other outcomes were overall effects — which was evaluated using a questionnaire on treatment satisfaction administered within 1 week after treatment — use of analgesic drugs, 5-minute Apgar scores and adverse events.

Across all studies, acupuncture significantly improved pain (mean difference, 1.7; 95% CI, 0.95-2.45). However, heterogeneity was high even after excluding outliers. Despite this, the findings stayed the same after excluding outliers.

Analysis of the four studies examining functional status revealed that acupuncture improved function (mean difference, 12.44; 95% CI, 3.32-21.55). However, there was high heterogeneity.

In five studies evaluating quality of life, data suggested acupuncture improved this measure (mean difference, –8.98; 95% CI, –11.9 to –5.88). The studies had moderate heterogeneity. Excluding extreme outliers eliminated the heterogeneity, but the results remained the same.

In four studies with low heterogeneity, there were significant differences in overall effects between acupuncture and other or no interventions (OR = 0.13; 95% CI, 0.07-0.23). However, there were no significant differences in the use of analgesic drugs between people using acupuncture vs. no treatment. There were also no differences in 5-minute Apgar scores between people using acupuncture vs. other or no treatments.

There was limited data on preterm labor and adverse pregnancy outcomes. Two studies reported preterm birth, “but all infants were in good health at birth despite preterm contractions,” Yang and colleagues wrote.

The researchers said their findings support acupuncture as “a relatively safe and effective intervention in the treatment of low back and/or pelvic pain during pregnancy.”

Moving forward, larger randomized controlled trials are needed to support the findings of this meta-analysis, the researchers wrote.