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Pregnancy Related Back Pain And Pelvic Girdle Pain
Can IceFire Physiotherapy and needling help?
by Jonathan Clerke & Matthew Clifford

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Unfortunately more than two-thirds of pregnant women experience back pain and almost one-fifth experience pelvic girdle pain. The pain increases as the child inside the women grows in size, and this pain can interfere with work, daily activities and sleep. Many women believe that it is unavoidable, and due to their concerns over drug use during pregnancy they elect to grit their teeth and bear it. But what does the research say about such pain while carrying a child inside your womb?

A systematic review in 2007 (Pennick, 2007) assessed the effects of interventions for preventing and treating back & pelvic pain in pregnant women. The systematic review found that whilst there was nothing that could be done to prevent the pain, the use of acupuncture needling and stabilising exercises relieved pain. The systematic review even noted that the needling was a more effective treatment in reducing evening discomfort then stabilising exercises alone.

Is the use of acupuncture needles risky at any time during pregnancy? It is commonly believed by both patients and health practitioners that acupuncture, dry needling and even trigger point massage techniques are safe during the early stages of pregnancy but inadvisable towards the third trimester. The third trimester begins when your baby is 28 weeks old and continues till it is born. There have long been concerns that there is a risk of an adverse event such as miscarriage, pre-term birth or other obstetric complications if a woman with child is treated in the later stages of their pregnancy.

Much of the hesitancy that has revolved around treating women in the later stages of pregnancy have been based on the needling of certain points being classed as ‘forbidden’ as they may caused the death of the baby inside the woman; that is that this needling may be abortifacient (Carr, 2015). Due to the prevalence of back & pelvic girdle pain in pregnant women, and considering the advancing nature of the pain, there has been significant research done to determine if treatments involving acupuncture needles actually cause these feared adverse events.

A study was carried in Sweden with 386 women and their babies in the womb from 2002-2008 (Elden, et. al, 2008). This study separated the pregnant ladies into three groups: standard prenatal care for 130 women; standard prenatal care plus strong acupuncture twice a week (starting as early as week 14) for 125 women; standard prenatal care plus physiotherapy based stabilising exercises & massage for 131 women. Treatments were given over a maximum period of 6 weeks and then the patients were followed up within 7 days of finishing treatment. All adverse effects were recorded as well as a variety of other health measures, such as: pain during labour, duration of labour, frequency of preterm births, operative delivery such as C-sections / caesarean surgery, and birth weight. The study found that acupuncture administered with stimulation that may be considered strong led to only 64 minor complaints out of the 1,414 acupuncture treatments given to the group of 125 women. These minor complaints were reported by only 43 of the 125 women. The nature of these complaints included pain at the needling site (27 women), headache (2 women), or drowsiness. The authors of the study stated that: ‘in spite of the minor adverse events, the women rated acupuncture favourably... and a majority of them were willing to use the same treatment in the future...’ The most important finding was that there were no serious adverse events among all the women receiving the needling treatment.

A systematic review of 105 studies done in Korea in 2013 (Park, Sohn, White, & Lee, 2014) found that the majority of adverse events are mild and short- lasting with serious adverse events being very rare and all of them evaluated as unlikely to have been caused by the use acupuncture needles.

Take home message

At IceFire Physiotherapy we have had the privilege of treating pregnant women for back and pelvic pain. Our clinic has been caring for people for over 25 years, having moved from Albany Creek to Brendale more than a decade ago. If you are pregnant or know someone who is with child and suffering from lower back pain or pelvic girdle pain that is making it hard to stand, walk, sit or work then the good news is we can often help. Our treatment may include the use of pelvic belts, needling with or without an electrical current (often called electroacupuncture), and the teaching of stabilising exercises. With the use of stabilising exercises and dry needling using acupuncture needles we can often make a difference in lower back pain or pelvic girdle pain felt by pregnant ladies. At our IceFire Physiotherapy clinic in Brendale, we have had the opportunity of being involved in the rehabilitation and recovery of patients from many of the surrounding suburbs including, Albany Creek, Warner, Strathpine, North Lakes and Eatons Hill. To learn more about dry needling, read our blogpost titled: Introduction to Dry Needling by Jonathan Clerke.
Congratulations if you are carrying a child (or two or three!), and we hope that all goes well!

References:

[1] Carr, D. J. (2015). The safety of obstetric acupuncture: forbidden points revisited. Acupuncture in Medicine, 33(5): 413-419.

[2] Elden, H., Ostgaard, H., Fagevik-Olsen, M., Ladfors, L., & Hagberg, H. (2008). Treatments of pelvic girdle pain in pregnant women: adverse effects of standard treatment, acupuncture and stabilising exercises on the pregnancy, mother, delivery and the fetus/neonate. BMC Complementary and Alternative Medicine, 8(1).

[3] Kluge, J., Hall, D., Louw, Q., Theron, G., & Grové, D. (2011). Specific exercises to treat pregnancy-related low back pain in a South African population. International Journal of Gynecology & Obstetrics,113(3), 187-191.

[4] Park, J., Sohn, Y., White, A. R., & Lee, H. (2014). The safety of acupuncture during pregnancy: a systematic review. Acupuncture in Medicine, 32(3): 257-266.

[5] Pennick, V., & Young, G. (2007). Interventions for preventing and treating pelvic and back pain in pregnancy. Cochrane Database of Systematic Reviews, (02).

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