Abstract
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 language | English |
|---|---|
| Article number | e4723 |
| Number of pages | 10 |
| Journal | Medicine |
| Volume | 95 |
| Issue number | 38 |
| DOIs | |
| Publication status | Published - 2 Aug 2016 |
Keywords
- Pregnancy
- back pain
- Complementary medicine
Cite this
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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 journal › Review Article › Research › peer-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 -