Interventions for preventing and treating low-back and pelvic pain during pregnancy

2015 Sep 30   Cochrane Database of Systematic Reviews   Liddle SD, Pennick V

There is low‐quality evidence that exercise (any exercise on land or in water), may reduce pregnancy‐related low‐back pain and moderate‐ to low‐quality evidence suggesting that any exercise improves functional disability and reduces sick leave more than usual prenatal care. Evidence from single studies suggests that acupuncture or craniosacral therapy improves pregnancy‐related pelvic pain, and osteomanipulative therapy or a multi‐modal intervention (manual therapy, exercise and education) may also be of benefit. Clinical heterogeneity precluded pooling of results in many cases. Statistical heterogeneity was substantial in all but three meta‐analyses, which did not improve following sensitivity analyses. Publication bias and selective reporting cannot be ruled out. Further evidence is very likely to have an important impact on our confidence in the estimates of effect and change the estimates. Studies would benefit from the introduction of an agreed classification system that can be used to categorise women according to their presenting symptoms, so that treatment can be tailored accordingly.