The effectiveness of complementary manual therapies for pregnancy related back and pelvic pain: a systematic review with meta-analysis

Helen Hall, Holger Cramer, Tobias Sundberg, Lesley Ward, Jon Adams, Craig Moore, David Sibbritt, Romy Lauche

Research output: Contribution to journalReview ArticleResearchpeer-review

Abstract

Background:Low back pain and pelvic girth pain are common in pregnancy and women commonly utilize complementary manual therapies such as massage, spinal manipulation, chiropractic, and osteopathy to manage their symptoms.
Objective: The aim of this systematically review was to critically appraise and synthesize the best available evidence regarding the effectiveness of manual therapies for managing pregnancy-related low back and pelvic pain.
Methods: Seven databases were searched from their inception until April 2015 for randomized controlled trials. Studies investigating the effectiveness of massage and chiropractic and osteopathic therapies were included. The study population was pregnant women of any age and at any time during the antenatal period. Study selection, data extraction, and assessment of risk of
bias were conducted by 2 reviewers independently, using the Cochrane tool. Separate meta-analyses were conducted to compare manual therapies to different control interventions.
Results: Out of 348 non-duplicate records, 11 articles reporting on 10 studies on a total of 1198 pregnant women were included in
this meta-analysis. The therapeutic interventions predominantly involved massage and osteopathic manipulative therapy. Meta-analyses found positive effects for manual therapy on pain intensity when compared to usual care and relaxation but not when compared to sham interventions. Acceptability did not differ between manual therapy and usual care or sham interventions.
Conclusions: There is currently limited evidence to support the use of complementary manual therapies as an option for managing low back and pelvic pain during pregnancy. Considering the lack of effect compared to sham interventions, further high-quality research is needed to determine causal effects, the influence of the therapist on the perceived effectiveness of treatments, and adequate dose–response of complementary manual therapies on low back and pelvic pain outcomes during pregnancy.
Original languageEnglish
Article numbere4723
Number of pages10
JournalMedicine
Volume95
Issue number38
DOIs
Publication statusPublished - 2 Aug 2016

Keywords

  • Pregnancy
  • back pain
  • Complementary medicine

Cite this

Hall, Helen ; Cramer, Holger ; Sundberg, Tobias ; Ward, Lesley ; Adams, Jon ; Moore, Craig ; Sibbritt, David ; Lauche, Romy. / The effectiveness of complementary manual therapies for pregnancy related back and pelvic pain: a systematic review with meta-analysis. In: Medicine. 2016 ; Vol. 95, No. 38.
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abstract = "Background:Low back pain and pelvic girth pain are common in pregnancy and women commonly utilize complementary manual therapies such as massage, spinal manipulation, chiropractic, and osteopathy to manage their symptoms.Objective: The aim of this systematically review was to critically appraise and synthesize the best available evidence regarding the effectiveness of manual therapies for managing pregnancy-related low back and pelvic pain.Methods: Seven databases were searched from their inception until April 2015 for randomized controlled trials. Studies investigating the effectiveness of massage and chiropractic and osteopathic therapies were included. The study population was pregnant women of any age and at any time during the antenatal period. Study selection, data extraction, and assessment of risk ofbias were conducted by 2 reviewers independently, using the Cochrane tool. Separate meta-analyses were conducted to compare manual therapies to different control interventions.Results: Out of 348 non-duplicate records, 11 articles reporting on 10 studies on a total of 1198 pregnant women were included inthis meta-analysis. The therapeutic interventions predominantly involved massage and osteopathic manipulative therapy. Meta-analyses found positive effects for manual therapy on pain intensity when compared to usual care and relaxation but not when compared to sham interventions. Acceptability did not differ between manual therapy and usual care or sham interventions.Conclusions: There is currently limited evidence to support the use of complementary manual therapies as an option for managing low back and pelvic pain during pregnancy. Considering the lack of effect compared to sham interventions, further high-quality research is needed to determine causal effects, the influence of the therapist on the perceived effectiveness of treatments, and adequate dose–response of complementary manual therapies on low back and pelvic pain outcomes during pregnancy.",
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The effectiveness of complementary manual therapies for pregnancy related back and pelvic pain: a systematic review with meta-analysis. / Hall, Helen; Cramer, Holger; Sundberg, Tobias ; Ward, Lesley ; Adams, Jon; Moore, Craig ; Sibbritt, David ; Lauche, Romy.

In: Medicine, Vol. 95, No. 38, e4723, 02.08.2016.

Research output: Contribution to journalReview ArticleResearchpeer-review

TY - JOUR

T1 - The effectiveness of complementary manual therapies for pregnancy related back and pelvic pain: a systematic review with meta-analysis

AU - Hall, Helen

AU - Cramer, Holger

AU - Sundberg, Tobias

AU - Ward, Lesley

AU - Adams, Jon

AU - Moore, Craig

AU - Sibbritt, David

AU - Lauche, Romy

PY - 2016/8/2

Y1 - 2016/8/2

N2 - Background:Low back pain and pelvic girth pain are common in pregnancy and women commonly utilize complementary manual therapies such as massage, spinal manipulation, chiropractic, and osteopathy to manage their symptoms.Objective: The aim of this systematically review was to critically appraise and synthesize the best available evidence regarding the effectiveness of manual therapies for managing pregnancy-related low back and pelvic pain.Methods: Seven databases were searched from their inception until April 2015 for randomized controlled trials. Studies investigating the effectiveness of massage and chiropractic and osteopathic therapies were included. The study population was pregnant women of any age and at any time during the antenatal period. Study selection, data extraction, and assessment of risk ofbias were conducted by 2 reviewers independently, using the Cochrane tool. Separate meta-analyses were conducted to compare manual therapies to different control interventions.Results: Out of 348 non-duplicate records, 11 articles reporting on 10 studies on a total of 1198 pregnant women were included inthis meta-analysis. The therapeutic interventions predominantly involved massage and osteopathic manipulative therapy. Meta-analyses found positive effects for manual therapy on pain intensity when compared to usual care and relaxation but not when compared to sham interventions. Acceptability did not differ between manual therapy and usual care or sham interventions.Conclusions: There is currently limited evidence to support the use of complementary manual therapies as an option for managing low back and pelvic pain during pregnancy. Considering the lack of effect compared to sham interventions, further high-quality research is needed to determine causal effects, the influence of the therapist on the perceived effectiveness of treatments, and adequate dose–response of complementary manual therapies on low back and pelvic pain outcomes during pregnancy.

AB - Background:Low back pain and pelvic girth pain are common in pregnancy and women commonly utilize complementary manual therapies such as massage, spinal manipulation, chiropractic, and osteopathy to manage their symptoms.Objective: The aim of this systematically review was to critically appraise and synthesize the best available evidence regarding the effectiveness of manual therapies for managing pregnancy-related low back and pelvic pain.Methods: Seven databases were searched from their inception until April 2015 for randomized controlled trials. Studies investigating the effectiveness of massage and chiropractic and osteopathic therapies were included. The study population was pregnant women of any age and at any time during the antenatal period. Study selection, data extraction, and assessment of risk ofbias were conducted by 2 reviewers independently, using the Cochrane tool. Separate meta-analyses were conducted to compare manual therapies to different control interventions.Results: Out of 348 non-duplicate records, 11 articles reporting on 10 studies on a total of 1198 pregnant women were included inthis meta-analysis. The therapeutic interventions predominantly involved massage and osteopathic manipulative therapy. Meta-analyses found positive effects for manual therapy on pain intensity when compared to usual care and relaxation but not when compared to sham interventions. Acceptability did not differ between manual therapy and usual care or sham interventions.Conclusions: There is currently limited evidence to support the use of complementary manual therapies as an option for managing low back and pelvic pain during pregnancy. Considering the lack of effect compared to sham interventions, further high-quality research is needed to determine causal effects, the influence of the therapist on the perceived effectiveness of treatments, and adequate dose–response of complementary manual therapies on low back and pelvic pain outcomes during pregnancy.

KW - Pregnancy

KW - back pain

KW - Complementary medicine

U2 - 10.1097/MD.0000000000004723

DO - 10.1097/MD.0000000000004723

M3 - Review Article

VL - 95

JO - Medicine

JF - Medicine

SN - 0025-7974

IS - 38

M1 - e4723

ER -