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Does Acupuncture Help Lower Back Pain During Pregnancy?

Does Acupuncture Help Lower Back Pain During Pregnancy?

 

Due to the weight gain, the center of gravity changes, and hormones relaxing the ligaments in the pelvis, lower back pain is a common complaint among pregnant women.  In fact, seventy-two percent of women complain of lower back and pelvic pain during pregnancy. [1]

Effectiveness of Traditional Treatments Lower Back Pain in Pregnancy

Though traditional therapies include physiotherapies such as massage and exercise, no strong evidence exists confirming the effectiveness of these treatments for the prevention or treatment of back and pelvic pain related to pregnancy. [2]

Effectiveness of Acupuncture for Lower Back Pain in Pregnancy

Because lower back pain is the leading cause of sick leave during pregnancy in Sweden, researchers from the Department of Obstetrics and Gynecology, Vrinnevi Hospital, Norrköping, Sweden conducted a prospective randomized study comparing acupuncture with physiotherapy for low-back and pelvic pain in pregnancy.  The trial included sixty pregnant women already suffering from lower back pain (LBP).  Half received physiotherapy treatments including water gymnastics and massage while the other half received acupuncture treatments only.  The study concluded that acupuncture relieved pain and diminished disability in low-back pain during pregnancy better than physiotherapy. [3]

In an interesting turn, 66% of the participants in the physiotherapy group dropped out before the study was complete while no acupuncture participants dropped out indicating that acupuncture may also serve the benefit of being a treatment that patients may actually accept and complete. (4)

National Institutes of Health Not Yet Sold

The US Department of Health and Human Services’ National Center for Complementary and Alternative Medicine (NCCAM) is the Federal government’s leading agency for scientific research on complementary and alternative medicine.  Their mission is to “define, through rigorous scientific investigation, the usefulness and safety of complementary and alternative medicine interventions and their roles in improving health and health care”.  It merits pointing out that though this agency acknowledges preliminary promising results, it has yet to recognize acupuncture as an effective treatment for pregnancy-related pelvic and back pain citing the lack of research. [5]

Resources

[1] Mogren IM, Pohjanen AI. Low back pain and pelvic pain during pregnancy: prevalence and risk factors. Spine (Phila Pa 1976) 2005;30:983–991. [PubMed]

Along with the prevalence cited in this research, this study was designed to find the risk factors for low back and pelvic pain (LBPP) during pregnancy.  The researchers found that women who suffered from LBPP during pregnancy had significantly higher pregnancy weight, end-pregnancy weight, and higher BMI.

[2] Stuge B; Acta Obstet Gynecol Scan
Physical therapy for pregnancy-related low back a pelvic pain: a systematic review
2003; Volume: 82; No: 11; Pages: 983-990 [PubMed]

In this meta-analysis, the researchers only found nine studies to analyze of which they only considered three to be high-quality.  Two of the three studies considered in the analysis showed no difference between the pain experienced by the exercise groups versus the control group.

[3] Wedenberg, KAJ; Acta Obstet Gynecol Scand
A prospective randomized study comparing acupuncture with physiotherapy for low-back and pelvic pain in pregnancy
2000; Volume: 79 Pages: 331–335
http://www.hawaii.edu/hivandaids/A_Prospective_Randomized_Study_Comparing_Acupuncture_with_Physiotherapy_for_Low-Back_and_Pelvic_Pain_in_Pregnancy.pdf

The study authors do not definitively pinpoint why acupuncture may be effective in treating pain but suggest that the somatic and autonomic nervous systems as well as the neuroendocrine system are most likely involved.

[4] Wedenberg, KAJ; Acta Obstet Gynecol Scand
A prospective randomized study comparing acupuncture with physiotherapy for low-back and pelvic pain in pregnancy
2000; Volume: 79 Pages: 331–335
http://www.hawaii.edu/hivandaids/A_Prospective_Randomized_Study_Comparing_Acupuncture_with_Physiotherapy_for_Low-Back_and_Pelvic_Pain_in_Pregnancy.pdf

The study authors speculate several reasons for the dropout rate of the pregnant women in the physiotherapy group.  They hypothesize that the women may have perceived that the physiotherapy was more difficult than acupuncture, the acupuncture was considered new and alternative, and/or the women perceived that the acupuncture was more effective.  They also suggested that because the physiotherapy group received treatment as a group, the acupuncture patients may have received the benefit of a closer relationship to their caregivers.

[5] National Center for Complementary and Alternative Medicine (NCCAM)
Acupuncture
Web. 2 Oct. 2013 [NCCAM]
Interestingly, though the NCCAM describes the evidence on the effectiveness of acupuncture for lower back pain as insufficient, the clinical practice guidelines issued by the American Pain Society and American College of Physicians 2007 list acupuncture as one of several CAM therapies physicians should consider for patients with lower back pain who do not respond to traditional therapies.

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