Acupuncture relieves pelvic and low-back pain in late pregnancy. Acta Obstet Gynecol Scand

Department of Anesthesia and Intensive Care, Hospital of Helsingborg, Sweden.
Acta Obstetricia Et Gynecologica Scandinavica (Impact Factor: 2.43). 04/2004; 83(3):246-50. DOI: 10.1080/j.0001-6349.2004.0215.x
Source: PubMed


The study was designed to evaluate the analgesic effect and possible adverse effects of acupuncture for pelvic and low-back pain during the last trimester of pregnancy.
Following individual informed consent, 72 pregnant women reporting pelvic or low-back pain were randomized during pregnancy weeks 24-37 to an acupuncture group (n = 37) or to a control group (n = 35) at three maternity wards in southern Sweden. Traditional acupuncture points and local tender points (TP) were chosen according to individual pain patterns and stimulated once or twice a week until delivery or complete recovery in acupuncture patients. Control patients were given no sham stimulation. Throughout the study period each patient made weekly visual analog scale (VAS) evaluations of maximal and minimal pain intensity as well as three-point assessments of pain intensity during various activities.
During the study period, VAS scorings of pain intensity decreased over time in 60% of patients in the acupuncture group and in 14% of those in the control group (p < 0.01). At the end of the study period, 43% of the acupuncture patients were less bothered than initially by pain during activity compared with 9% of control patients (p < 0.01). No serious adverse effects of acupuncture were found in the patients, and there were no adverse effects at all in the infants.
Acupuncture relieves low-back and pelvic pain without serious adverse effects in late pregnancy.

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Available from: Jonas Åkeson, Jan 24, 2014
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    • "For the patient described in the vignette, only 24% of respondents reported that they would use acupuncture as part of their management, despite evidence from a systematic review that acupuncture is effective for this patient group. Despite the exclusion of pregnancy-related LBP from the guidelines produced by the National Institute for Health and Clinical Excellence [10], acupuncture has been shown to be effective for LBP and PGP during pregnancy in a small number of trials [22] [23] [24] [25] [26], and it has also been shown to be safe [27]. The lower reported use of acupuncture for pregnancyrelated LBP seen in this survey may indicate professional uncertainty or lack of confidence in the use of acupuncture in pregnancy, and concerns about safety [28], and could also be influenced by the lack of specific guidelines about acupuncture for pregnancy-related LBP. "
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    ABSTRACT: Pregnancy-related low back pain (LBP) is very common. Evidence from a systematic review supports the use of exercise and acupuncture, although little is known about the care received by women with pregnancy-related back pain in the UK. To describe current acupuncture and standard care management of pregnancy-related LBP by UK physiotherapists. Cross-sectional survey of physiotherapists with experience of treating women with pregnancy-related LBP from three professional networks of the Chartered Society of Physiotherapy. In total, 1093 physiotherapists were mailed a questionnaire. The questionnaire captured respondents' demographic and practice setting information, and experience of managing women with pregnancy-related back pain, and investigated the reported management of pregnancy-related LBP using a patient case vignette of a specific, 'typical' case. The overall response rate was 58% (629/1093). Four hundred and ninety-nine physiotherapists had experience of treating women with pregnancy-related LBP and were included in the analysis. Most respondents worked wholly or partly in the UK National Health Service (78%). Most respondents reported that they treat patients with pregnancy-related LBP in three to four one-to-one treatment sessions over 3 to 6 weeks. The results show that a range of management strategies are employed for pregnancy-related LBP, and multimodal management is common. The most common reported treatment was home exercises (94%), and 24% of physiotherapists reported that they would use acupuncture with the patient described in the vignette. This study provides the first robust data on the management of pregnancy-related LBP by UK physiotherapists. Multimodal management is common, although exercise is the most frequently used treatment for pregnancy-related LBP. Acupuncture is used less often for this patient group. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
    Full-text · Article · Apr 2015 · Physiotherapy
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    • "'Fertility problems' is the second most common health condition, following pain-related conditions, for which people seek acupuncture treatment in the UK (Hopton et al., 2012). A review of the effects of adjuvant acupuncture on IVF is warranted because acupuncture has been found to be relatively safe among general patient populations (Witt et al., 2011) and also among women at various stages of pregnancy (Smith et al., 2002; Kvorning et al., 2004; Elden et al., 2005), it is low cost, and, if effective in increasing IVF success rates, could potentially reduce the need for an additional high cost IVF cycle. Furthermore, qualitative research suggests that adjuvant acupuncture may help IVF patients deal with the psychological and emotional issues that accompany both subfertility and IVF treatment (de Lacey et al., 2009; Kovarova et al., 2010; Smith et al., 2011; Isoyama et al., 2012). "
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    ABSTRACT: BACKGROUND Recent systematic reviews of adjuvant acupuncture for IVF have pooled heterogeneous trials, without examining variables that might explain the heterogeneity. The aims of our meta-analysis were to quantify the overall pooled effects of adjuvant acupuncture on IVF clinical pregnancy success rates, and evaluate whether study design-, treatment- and population-related factors influence effect estimates.METHODS We included randomized controlled trials that compared needle acupuncture administered within 1 day of embryo transfer, versus sham acupuncture or no adjuvant treatment. Our primary outcome was clinical pregnancy rates. We obtained from all investigators additional methodological details and outcome data not included in their original publications. We analysed sham-controlled and no adjuvant treatment-controlled trials separately, but since there were no large or significant differences between these two subsets, we pooled all trials for subgroup analyses. We prespecified 11 subgroup variables (5 clinical and 6 methodological) to investigate sources of heterogeneity, using single covariate meta-regressions.RESULTSSixteen trials (4021 participants) were included in the meta-analyses. There was no statistically significant difference between acupuncture and controls when combining all trials [risk ratio (RR) 1.12, 95% confidence interval (CI), 0.96-1.31; I(2) = 68%; 16 trials; 4021 participants], or when restricting to sham-controlled (RR 1.02, 0.83-1.26; I(2) = 66%; 7 trials; 2044 participants) or no adjuvant treatment-controlled trials (RR 1.22, 0.97-1.52; I(2) = 67%; 9 trials; 1977 participants). The type of control used did not significantly explain the statistical heterogeneity (interaction P = 0.27). Baseline pregnancy rate, measured as the observed rate of clinical pregnancy in the control group of each trial, was a statistically significant effect modifier (interaction P < 0.001), and this covariate explained most of the heterogeneity of the effects of adjuvant acupuncture across all trials (adjusted R(2) = 93%; I(2) residual = 9%). Trials with lower control group rates of clinical pregnancy showed larger effects of adjuvant acupuncture (RR 1.53, 1.28-1.84; 7 trials; 1732 participants) than trials with higher control group rates of clinical pregnancy (RR 0.90, 0.80-1.01; 9 trials; 2289 participants). The asymmetric funnel plot showed a tendency for the intervention effects to be more beneficial in smaller trials.CONCLUSIONS We found no pooled benefit of adjuvant acupuncture for IVF. The subgroup finding of a benefit in trials with lower, but not higher, baseline pregnancy rates (the only statistically significant subgroup finding in our earlier review) has been confirmed in this update, and was not explained by any confounding variables evaluated. However, this baseline pregnancy rate subgroup finding among published trials requires further confirmation and exploration in additional studies because of the multiple subgroup tests conducted, the risk of unidentified confounders, the multiple different factors that determine baseline rates, and the possibility of publication bias.
    Full-text · Article · Jun 2013 · Human Reproduction Update
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    • "However, Wedenberg et al. (2000) showed that acupuncture produced a better effect on function impairment than physiotherapy when measured by Disability Rating Index (12). In a study by Kvorning et al. (2004), the majority of women receiving acupuncture for low back and pelvic pain experienced a relief of pain during the study period, compared with the control group (24). Guerreiro da Silva et al. (2004) concluded that acupuncture alleviated low back and pelvic pain during pregnancy. "
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    ABSTRACT: To describe patients' experience of acupuncture treatment in low back and pelvic pain during pregnancy. An intervention study carried out between September 2000 and December 2001, involving 40 pregnant women. The study population consisted of healthy pregnant women presenting with low back and pelvic pain at maternity health care centres within a defined area in southern Sweden. Two groups of women received acupuncture treatment from gestational week 20 (group 1) or week 26 (group 2) respectively, for a period of 6 weeks divided into eight sessions of 30 minutes each. Pain assessment was carried out using Pain-O-Meter and visual analogue scale (POM-VAS), Short-Form McGill Questionnaire (SF-MPQ), Short-Form-36: Health Survey Questionnaire (SF-36), followed by telephone interviews 2-3 months after delivery. The results of POM-VAS, SF-MPQ and SF-36 showed a relief of pain in both groups. In group 2, an improvement in several SF-36 variables was noted in spite of increased physical restrictions. Telephone interviews confirmed that expectations of treatment were fulfilled. Using content analysis the main category, limitations in daily life, was identified, with subcategories pain, and psychological well-being. It may be advantageous to begin acupuncture therapy later in pregnancy to maximise pain relief.
    Full-text · Article · Mar 2010 · Scandinavian Journal of Caring Sciences
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