Interventions for preventing and treating pelvic and back pain in pregnancy
Summary (1 min read)
Background
- More than two-thirds of pregnant women experience low-back pain (LBP) and almost one-fifth experience pelvic pain.
- Pain increases with advancing pregnancy and interferes with work, daily activities and sleep.
Main results
- The authors included 26 randomised trials examining 4093 pregnant women in this updated review.
- Diagnoses ranged from self-reported symptoms to the results of specific tests.
- All interventions were added to usual prenatal care and unless noted, were compared to usual prenatal care.
- Low-quality evidence from single trials suggested that adding a rigid belt to exercise improved average pain but not function; acupuncture was significantly better than sham acupuncture for improving evening pain and function, but not average pain; and evening pain relief was the same following either deep or superficial acupuncture.
Authors’ conclusions
- Moderate-quality evidence suggested that acupuncture or exercise, tailored to the stage of pregnancy, significantly reduced evening pelvic pain or lumbo-pelvic pain more than usual care alone, acupuncture was significantly more effective than exercise for reducing evening pelvic pain, and a 16- to 20-week training program was no more successful than usual prenatal care at preventing pelvic or LBP.
- Low-quality evidence suggested that exercise significantly reduced pain and disability from LBP.
- There was moderate-quality evidence that acupuncture reduced evening pain better than exercise; both were better than usual care (one RCT), also known as Pelvic pain.
- 3Interventions for preventing and treating pelvic and back pain in pregnancy Copyright © 2013 The Cochrane Collaboration.
- Further research is likely to have an important impact on their confidence in the estimate of effect and may change the estimate, also known as Moderate quality.
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Frequently Asked Questions (11)
Q2. What are the future works mentioned in the paper "Interventions for preventing and treating pelvic and back pain in pregnancy" ?
Further research is very likely to have an important impact on their confidence in the estimates of effect and is likely to change the estimates. Future research would benefit from the introduction of an agreed classification system that can be used to categorise women according to presenting symptoms. Further research is likely to change the estimates of effect of these interventions. GRADE Working Group grades of evidence High quality: Further research is very unlikely to change their confidence in the estimate of effect.
Q3. What is the way to prevent pelvic pain in pregnancy?
Randomised controlled trials (RCTs) of any treatment to prevent or reduce the incidence or severity of pelvic or back pain in pregnancy.
Q4. What was the evidence for acupuncture?
Low-quality evidence suggested that exercise significantly reduced lumbo-pelvic-related sick leave (RR 0.76; 95% CI 0.62 to 0.94, two RCTs, N = 1062), and improved function.
Q5. What did the researchers find to be the evidence for acupuncture?
From single trials: exercise plus a rigid belt improved average pain but not function; acupuncture was better than sham acupuncture for evening pain and function, but not average pain.
Q6. What is the way to prevent pelvic pain during pregnancy?
P L A The authorN L A N G U A G E S U M M A R YInterventions for preventing and treating pelvic and back pain in pregnancyMany women experience low-back (LBP) or pelvic pain during pregnancy.
Q7. What was the mean pain intensity in the intervention groups?
The mean pain intensity in the intervention groups was 0.80 standard deviationslower (1.07 to 0.53 lower)SMD -0.80 (-1.07, -0.53) 543(6 studies)⊕⊕©© low1,2Disability measured by Roland Morris Disability Questionnaire and Oswestry Disability Index
Q8. What was the mean disability in the intervention groups?
The mean disability in the intervention groups was 0.56 standard deviations lower(0.89 lower to 0.23 lower)SMD -0.56 (-0.89 to -0. 23) 146 (2 studies)⊕⊕©© low1,3*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes.
Q9. What is the way to prevent and treat pelvic pain in pregnancy?
For LBP, there was low-quality evidence that in general, the addition of exercise significantly reduced pain (standardised mean difference (SMD) -0.80; 95% confidence interval (CI) -1.07 to -0.53; six RCTs, N = 543), and disability (SMD -0.56; 95% CI -0.89 to -0.23; two RCTs, N = 146); and water-based exercise significantly reduced LBP-related sick leave (risk ratio (RR) 0.40; 95% CI 0.17 to 0.92;1Interventions for preventing and treating pelvic and back pain in pregnancy (Review) Copyright © 2013 The Cochrane Collaboration.
Q10. What were the 11 trials that examined LBP?
Eleven trials examined LBP (N = 1312), four examined pelvic pain (N = 661), and 11 trials examined lumbo-pelvic (LBP and pelvic) pain (N = 2120).
Q11. What was the difference between acupuncture and sham acupuncture?
Low-quality evidence from single trials suggested that adding a rigid belt to exercise improved average pain but not function; acupuncture was significantly better than sham acupuncture for improving evening pain and function, but not average pain; and evening pain relief was the same following either deep or superficial acupuncture.