AACP 2018: Is acupuncture beneficial for pregnancy-related back and pelvic pain?

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It was laid by Cheryl Mason, an acupuncturist at a private clinic in Leeds who has experience in NHS nursing, midwifery and pain management teams.

In her presentation at the event in Reading on May 19, she described research findings that indicate acupuncture can provide relief to pregnant women suffering from these types of pain.

“A 2006 study (Van de Pol et al) showed that acupuncture appeared to reduce lower back pain and pelvic girdle pain during pregnancy, increasing people’s ability to exercise and carry out their day-to-day activities,” she said.

“Another study in 2009 (Wang et al), using one week of continuous auricular acupuncture on the ears, showed a significant reduction in pain compared to sham acupuncture control groups.”

She also cited findings from a 2016 feasibility study and randomized pilot trial that evaluated acupuncture and standard care for pregnant women with back pain. It was led by CSP member Nadine Foster of Keele University.

The study compared three groups of pregnant women with back pain. One group received standard care including 2-4 individual physiotherapy sessions and a self-management booklet.

The second group received standard care plus 6-8 acupuncture sessions. While the third group received standard care plus non-penetrating sham acupuncture.

“At the eight-week follow-up, they found that 74% of participants were in favor of adding acupuncture,” Mason said.

Mechanisms of action for pain relief

She told delegates that acupuncture can relieve pain in three possible ways: via local mechanical action, neurological action or hormonal action.

“The needles create a local trauma response – a flood of antihistamines, a mast cell response,” Ms. Mason said.

“And they influence the muscle spindle, which is great if you’re dealing with pelvic girdle pain because you can treat local points and get results with muscle, tissue and fascia.

“We also know that acupuncture produces a neurological effect. For example, there is the work of Hugh McPherson, who appeared on the BBC’s Trust Me I’m a Doctor show in October 2014, using MRI scanners to show that pain modifying centers in the brain light up during acupuncture.

“A lot of scientific research shows that it is not a placebo. There are real effects produced by the needles.

Avoid contraindicated points

Delegates learned that acupuncture can also affect hormones, so it was important not to prick contraindicated points when treating pregnant women.

“We know that acupuncture can stimulate the production of serotonin and oxytocin, as well as other neurotransmitters,” Mason said.

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Acupuncturist Cheryl Mason speaking at the AACP conference

“During pregnancy, the nervous system and the endocrine system are quite delicate and predisposed to work. If we stimulate the production of oxytocin by inserting needles at certain points, we could theoretically stimulate labor. We need to know which stitches are safe to use.

She referred to a Cochrane Database review on acupuncture or acupressure for labor induction, published in October 2017. The review pointed out that acupuncture has some benefits for improving cervical maturity, making it more conducive to work. Therefore, using the wrong points could potentially lead to this effect.

A safe approach, but more research is needed

Ms Mason said there had been more than 8,000 randomized controlled trials of acupuncture over the past eight years.

“But there is still some confusion about its effectiveness, so we need more quality research,” she said.

“What we do know, however, is that acupuncture has a good safety profile and is particularly relevant for pregnancy and the treatment of pelvic girdle pain and other pregnancy-related conditions.”

She added that, if participants were planning a treatment protocol for women with pregnancy-related pelvic girdle and lower back pain, research by Matthew Bauer (2016) indicated that 16 or more acupuncture treatments had the highest success rates.

Author: Robert Millette

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