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Acupuncture, Stabilizing Exercise Ease Pelvic Pain During Pregnancy


 

Acupuncture and stabilizing exercises are effective adjuncts to standard treatment for pelvic girdle pain in pregnancy, Swedish researchers reported.

When combined with standard therapy, both acupuncture and stabilizing exercises provided more pain relief than standard therapy alone. Acupuncture combined with standard therapy produced the best pain relief, said Helen Elden, a midwife at East Hospital, Sahlgrenska Academy, Gothenburg, Sweden, and her associates.

“This study shows that methods other than structured physiotherapy may be effective in treating pelvic pain in pregnancy and that acupuncture presents an effective alternative,” the researchers said (BMJ 2005;330:761).

The study included 386 pregnant women with pelvic girdle pain. The average age was 30 years, and all were singleton pregnancies. About 54% said they had previously experienced low back pain.

The women were randomized to 6 weeks of standard treatment (education, pelvic belt, and abdominal and gluteal strengthening exercises); standard therapy plus 30-minute acupuncture treatments twice a week; or standard therapy plus 6 hours/week of exercises for stabilizing pelvis and back and increasing hip rotator circulation and massage and stretching of hip extensors.

Pain was assessed by a visual analog scale at baseline at 1 week following the conclusion of therapy.

Those on standard therapy plus acupuncture had the biggest decrease in pain; morning pain scores fell from 23 to 15, and evening scores fell from 65 to 31.

The group on standard therapy plus stabilizing exercises improved, but not as much; morning scores fell from 22 to 18. Evening scores fell from 60 to 45.

In the standard-therapy group, morning scores rose from 23 to 27. Evening scores fell from 63 to 58.

It's not clear how stabilizing exercises reduce pelvic pain, but research has shown that contraction of the transversus abdominis decreases laxity of the sacroiliac joint. Massage and stretching also may have contributed to relief, they noted.

They speculated that acupuncture relieved pain by activating the segmental pain inhibitory system and boosting secretion of endogenous opioids.

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