Acupuncture and Exercise May Help Relieve Pregnancy-Related Pelvic Pain
Many women complain of pelvic girdle pain during pregnancy, and for one-third of these women, the pain is severe.
During pregnancy, there is an increase in the release of the female hormones progesterone and relaxin , which allows connective tissues to relax so that the pelvis can stretch enough during childbirth to deliver a baby. Sometimes, the loosening of the pelvic joints along with the stress of carrying a baby can cause pelvic girdle pain, or pain in the lower pelvis area and possibly the legs.
Standard treatment for pelvic girdle pain among pregnant women may include wearing a pelvic belt, exercising, and learning more about the condition. Evidence supporting the effectiveness of these treatments, however, is lacking. Because of this, some health care professionals are recommending other treatments such as stabilizing exercises and acupuncture.
A new study published March 18, 2005 in the British Medical Journal 's Online First section compared the effectiveness of standard treatment alone, standard treatment plus acupuncture, and standard treatment plus stabilizing exercises in the treatment of pregnancy-related pelvic girdle pain. The researchers found that the addition of acupuncture and stabilizing exercises was significantly more beneficial in reducing pelvic girdle pain than standard treatment alone.
About the Study
This study included 386 pregnant women with pelvic girdle pain, which was confirmed by a series of diagnostic tests conducted by a physiotherapist.
The women were randomized into three groups:
- Standard treatment, which included patient education about pelvic girdle pain, advice about daily activities, a pelvic belt, and a home exercise program designed to increase abdominal and gluteal strength.
- Standard treatment plus acupuncture, which consisted of 30 minute sessions twice a week for six weeks. The needle placement was designed to target sensitive spots identified during diagnosis.
- Standard treatment plus stabilizing exercises, which involved six hours of training over the course of six weeks. The exercises were aimed at stabilizing the pelvis, back, and hips, and the participants were given instructions to integrate these exercises in their daily activities. Each training session included massage and stretching.
The participants scored their intensity of pelvic pain on a scale of 1–100 every morning and every evening in a diary. Before and after the study, the participants met with an examiner who assessed their recovery from symptoms of pelvic girdle pain.
In the standard treatment group, pelvic girdle pain remained constant during treatment.
Both the acupuncture and the stabilizing exercise groups showed significant benefits over the standard treatment group. Specifically, compared with the standard treatment group, the stabilizing exercise group had a 9-point reduction in pain in the morning and a 13-point reduction in the evening.
The acupuncture group had even more pronounced reductions, with a 12-point reduction in the morning and a 27-point reduction in the evening. And when compared to the stabilizing exercise group, the acupuncture group had significantly less pain in the evening, with a 14-point reduction in pain.
While these findings are compelling, this study did have one major limitation. The women in the acupuncture group were not compared to another group of women receiving “sham” acupuncture, nor were the women in the stabilizing exercises group compared to women performing different exercises. For this reason, the women receiving acupuncture or stabilizing exercises may have expected the treatments to work and therefore reported less pain unrelated to the effects of the treatments.
How Does This Affect You?
These findings suggest that adding acupuncture or stabilizing exercises to standard treatment for pregnancy-related pelvic girdle pain may be more beneficial than standard treatment alone. And since standard treatment showed no clear benefit in this study, physicians should consider a combination of the three treatments when advising women how to help alleviate pelvic girdle pain.
While this study did not address how acupuncture and stabilizing exercises may help relieve pregnancy-related pelvic girdle pain, there are many good reasons women suffering from this condition may want to consider these therapies. First, acupuncture is a safe alternative treatment when performed by experienced, licensed practitioners. However, keep in mind that acupuncture can be expensive and few insurers fully cover acupuncture therapy. Furthermore, incorporating stabilizing exercises into your daily routine can afford many benefits. Just be sure to consult with your physician to identify a program that is safe while you are pregnant.
American Pregnancy Association
National Center for Complementary and Alternative Medicine
Elden H, Ladfors L, Olsen MF, Ostgaard H-C, Hagberg H. Effects of acupuncture and stabilising exercises as adjunct to standard treatment in pregnant women with pelvic girdle pain: randomised single blind controlled trial. BMJ, doi:10.1136/bmj.38397.507014.E0 (published March 18, 2005).
Last reviewed Mar 24, 2005 by ]]>Richard Glickman-Simon, MD]]>
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