Acupuncture for Pelvic Pain in Pregnancy

A review of the effect of acupuncture on pelvic pain during pregnancy was conducted by researchers in The Cochrane Collaboration.  After searching for all relevant studies, they found three studies done by other researchers.  Their findings are summarised below. 

Please note that this Cochrane review has been updated since the summary below. See the abstract of that update here.

Pelvic pain during pregnancy - why acupuncture?

Many women experience pelvic pain during pregnancy. This pain generally increases as pregnancy advances. It can interfere with daily activities, can prevent women from going to work, and sometimes disturbs sleep.

Acupuncture is part of traditional Chinese medicine and involves the placing of thin needles in specific points on your body. 

Acupuncture is based on a theory that all illnesses are at specific points on the surface of your skin or just below it. These points are placed along "meridians" or lines that go through your body. When the acupuncturist chooses the correct points, you may experience a feeling called "De Qi". "De Qi" has been described as a feeling of fullness, numbness, tingling, and warmth with some soreness around the acupuncture point. Acupuncturists do not agree among themselves whether the effect of acupuncture depends on reaching "De Qi".

Since acupuncture spread to the west several hundred years ago, different styles of acupuncture have developed. Modern acupuncturists use not only traditional meridian acupuncture points, but also use points not necessarily associated with meridians.

What does the research say?

Not all research provides the same quality of evidence. The higher the quality, the more certain we are about what the research says about an effect. The words will (high quality evidence), probably (moderate quality evidence) ormay (low quality evidence) describe how certain we are about the effect. The word slightly means that the effect is small.

The studies showed that for pregnant women with pelvic pain, acupuncture:

  • may make little or no difference to pain
  • may improve pain slightly when turning in bed

None of the studies measured the effect of acupuncture on sick leave or performance of daily activities.

In general, side effects are poorly documented and it is difficult to provide precise information. In these studies, some of the participants experienced minor side effects, including pain or minor bleeding in the area where the needles had been placed; tiredness and weakness; nausea; heat and sweating.

Table of results

What was measured

Usual prenatal care

Acupuncture

Quality of evidence

Pain improved after an average of 1 week77 per 10075 per 100
(65 to 86 per 100)1  
Low
Pain when turning in bed after an average of 1 week73 per 10058 per 100
(49 to 70 per 100)1  
Low
Sick leave

Not measured in these studies

-
Ability to perform daily activities

Not measured in these studies

-
Side effects

Some minor side effects

-

1The numbers in the brackets show the range in which the actual effect could be.

Where does this information come from?

The Cochrane Collaboration is an independent global network of volunteers, dedicated to summarizing research about health care.

This information is taken from this Cochrane Review: Pennick VE, Young G. Interventions for preventing and treating pelvic and back pain in pregnancy. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: CD001139. DOI: 10.1002/14651858.CD001139.pub2.

This summary was prepared by:

Gunn Vist and Claire Glenton, the Nordic Cochrane Centre's Norwegian branch, Norwegian Knowledge Centre for Health Services, on behalf of the Cochrane Complementary and Alternative Medicine Field, and with funding from the US National Center for Complementary and Alternative Medicine (NCCAM) of the US National Institutes of Health (grants number R24 AT001293).

Acupuncture for pelvic pain in pregnancy

Patient or population: patients with pelvic pain in pregnancy 
Settings: Sweden
Intervention: acupuncture

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect 
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk 
(Control)

Corresponding risk 
(Acupuncture)

Reduction in pain
(follow-up: mean 1 weeks)
77 per 10075 per 100
(65 to 86)
RR 0.98 
(0.85 to 1.12)

255
(1)

low1,2,3  

 

Pain when turning i bed
(follow-up: mean 1 weeks)
731 per 1000585 per 1000
(490 to 702)
RR 0.80 
(0.67 to 0.96)

255
(1)

low1,2,3  

 

Use of sick leave

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Not estimable

-

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No included study reported on the use of sick leave

Disability, measure of difficulty undertaking everyday activities

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Not estimable

-

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No included study reported on disability

Adverse events

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Not estimable

-

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No included study reported on adverse events

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CI: Confidence interval; RR: Risk ratio

GRADE Working Group grades of evidence

High quality: Further research is very unlikely to change our confidence in the estimate of effect.

Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.

Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.

Very low quality: We are very uncertain about the estimate.

1 This is a comparison included in a three armed RCT, considerable losses considering size of the study
2 This study included only patients with pelvic pain
3 Only one small study with relatively few events