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CME Released: 3/21/2005
Valid for credit through: 3/21/2006
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March 21, 2005 — Stabilizing exercises and acupuncture are helpful for pelvic girdle pain during pregnancy, according to the results of a randomized, single-blind trial published in the March 18 Online First edition of the British Medical Journal.
"Standard treatment may consist of a pelvic belt, a home exercise programme, and patient education," write Helen Elden, from the Sahlgrenska Academy, East Hospital, in Gothenburg, Sweden, and colleagues. "Current treatment increasingly includes stabilising exercises and acupuncture. However, insufficient evidence is available to give strong recommendations for or against any particular treatment modality for pelvic girdle pain."
At East Hospital and 27 maternity care centers in Sweden, 386 pregnant women with pelvic girdle pain were randomized to six weeks of standard treatment (n = 130), standard treatment plus acupuncture (n = 125), or standard treatment plus stabilizing exercises (n = 131). The primary outcome measure was pain on the visual analog scale (VAS), and the secondary outcome measure was assessment of severity of pelvic girdle pain by an independent examiner before and after treatment.
After treatment, the group receiving stabilizing exercise had less pain than the standard group in the morning (median difference, 9; 95% confidence interval [CI], 1.7 to 12.8; P = .0312) and in the evening (median difference, 13; 95% CI, 2.7 to 17.5; P = .0245).
The group receiving acupuncture had less pain in the evening than did the stabilizing exercise group (median difference, −14; 95% CI, −18.1 to −3.3; P = .0130). The acupuncture group also had less pain than the standard treatment group both in the morning (median difference, 12; 95% CI, 5.9 to 17.3; P < .001) and in the evening (median difference, 27; 95% CI, 13.3 to 29.5; P < .001). The independent examiner determined that reduction of pelvic girdle pain was greatest in the acupuncture group.
"Acupuncture and stabilizing exercises constitute efficient complements to standard treatment for the management of pelvic girdle pain during pregnancy," the authors write. "Acupuncture was superior to stabilising exercises in this study.... Each method needs to be evaluated individually, however, before combinations can be recommended for future research, and only after that should recommendations for treatment be made."
The Vardal Foundation, the Dagmar Foundation, the Trygg-Hansa Insurance Company, and the Sahlgrenska University Foundation funded this study. The authors report no competing interests.
BMJ. Published online March 18, 2005.
