Implications for practice
Moderate quality evidence suggested that acupuncture or exercise,
tailored to the stage of pregnancy, significantly reduced evening
pelvic pain or lumbo-pelvic pain more than usual care alone;
acupuncture was significantly more effective than exercise for reducing
evening pelvic pain and a 16- to 20-week training program
was no more successful than usual prenatal care at preventing
pelvic or LBP. Low-quality evidence suggested that exercise
significantly reduced pain and disability from LBP.
There was low-quality evidence from single trials for other outcomes
because of high risk of bias and sparse data; clinical heterogeneity
precluded pooling. Publication bias and selective reporting
cannot be ruled out.
Physiotherapy, OMT, acupuncture, a multi-modal intervention,
or the addition of a rigid pelvic belt to exercise relieved pelvic or
back pain more than usual care alone. Acupuncture was more effective
than physiotherapy at relieving evening lumbo-pelvic pain
and disability and improving pain and function when it was started
at 26- rather than at 20-weeks’ gestation, although the effects were
small.
There was no significant difference in low-back pain and function
for different support belts, exercise, neuro emotional technique or
spinal manipulation, or in evening pelvic pain between deep and
superficial acupuncture.
Very low-quality evidence suggested a specially-shaped pillow may
reduce night-time LBP.
Further research is very likely to have an important impact on our
confidence in the estimates of effect and is likely to change the
estimates.