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Back pain during pregnancy?
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May 09, 2007

There's some good news for expecting women. A new review has found that stretching exercises, special pillows and acupuncture could help relieve back and pelvic pain that often occur during pregnancy.

The review looked at eight studies that examined the effect of adding pregnancy-specific strengthening exercises, water exercises, acupuncture and other pain-relief interventions to regular prenatal care. None of the studies dealt specifically with back or pelvic pain prevention.

The studies involved 1,305 pregnant women from Sweden, Iran, Brazil, Thailand and Australia.

"When you're pregnant, your centre of gravity is off. You have to arch your back to balance this huge tummy, so you end up with extra strain on your back and pelvic muscles," said Victoria Pennick, MHSc, registered nurse and lead review author.

Women who participated in a variety of intervention programmes felt some relief from back and pelvic pain, said Pennick, a senior clinical research project manager at the Institute for Work & Health in Toronto.

Although the conclusions of this update did not differ significantly from the previous 1998 and 2002 reviews, Pennick noted the addition of five trials available for analysis.

"We were able to group trials about women who had back pain alone, women who had pelvic pain alone and both. You don't have that luxury when you have only three studies," she said, adding that this was the case with the earlier reviews.

The review authors found that women who participated in prenatal exercise programs reported significant decreases in back pain compared to women who received the usual prenatal care.

The intervention programmes taught moms-to-be movements to stretch the pelvic muscles, strengthen the abdominal and hamstring muscles and increase spinal flexibility.

In one study that evaluated work absenteeism during pregnancy, only 12.9 per cent of the pregnant women who participated in water gymnastics missed work due to lower back pain, compared with 21.7 per cent of the women who received usual prenatal care.

Another study evaluated whether a special pillow called the Ozzlo pillow, a curved, soft cushion designed to support the pregnant abdomen when lying down, reduced back pain. Although manufacturers no longer make the pillow, it proved superior to a regular pillow in relieving back pain in pregnant women.

In one study of women with both back and pelvic pain, 60 percent who received acupuncture reported less intense pain, compared to 14 percent of women who did not. The study found no complications associated with the use of acupuncture on pregnant women.

On an average, women who followed through with the pelvic or back pain interventions experienced some pain relief and reported less need for pain medication, physical therapy and posture-support belts.

Both Pennick and Shu-Ming Wang, MD, associate professor in the department of anaesthesiology at Yale School of Medicine, US, urged women to be careful when they considering interventions to reduce back or pelvic pain during pregnancy, especially if they were looking at options they had not practised before conception.

"For example, if you've never had acupuncture, it may not be the intervention of choice for you. It's really important to talk it over with your own primary care provider and decide together what's right for you," Pennick said.

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration.

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