Acupuncture Relieves Pelvic and Low Back Pain in Late Pregnancy

Pelvic and low back pain is one of the most common complaints during pregnancy, affecting between 49% and 76% of pregnant women, especially in the third trimester. This condition can be quite uncomfortable and limiting, interfering with daily activities and quality of life during a period already filled with physical and emotional changes. Traditionally, treating this pain during pregnancy has been a challenge for clinicians, since many analgesic options are avoided due to concern about possible adverse effects on the fetus. In this context, complementary therapies such as acupuncture have drawn growing interest as safe and effective alternatives for pain management during gestation.

This prospective, randomized study was conducted by Swedish investigators with the aim of scientifically evaluating whether acupuncture could provide effective relief of pelvic and low back pain in the third trimester of pregnancy, as well as to verify the safety of the technique for mother and baby. The research was carried out at three maternal care centers in southern Sweden over a two-year period. Initially, 100 pregnant women with pain in the pelvic or lumbar region between weeks 24 and 37 of gestation were enrolled and randomly divided into two groups: one group received acupuncture treatment and the other served as a control group without intervention. After exclusions for various reasons, including very short follow-up periods and dropouts, 72 women completed the study — 37 in the acupuncture group and 35 in the control group.

The acupuncture protocol followed traditional Chinese medicine principles, using specific points selected according to each patient's individual pain pattern. Acupuncturists stimulated both traditional points and locally tender points, applying needles once or twice a week until delivery or until full recovery. Throughout the study period, participants completed weekly visual analog scales to rate maximum and minimum pain intensity, and answered questionnaires about how pain affected daily activities such as sleeping, getting up, sitting, walking, and working.

The results demonstrated significant benefits of acupuncture compared with the control group. During the study period, 60% of patients who received acupuncture had a decrease in pain intensity, while only 14% of women in the control group experienced this improvement. This difference was statistically significant and clinically relevant. In addition, 43% of patients treated with acupuncture reported less discomfort during physical activities at the end of the study, compared with only 9% of women in the control group.

Two patients in the acupuncture group became completely pain-free during the last three weeks of pregnancy, an outcome that did not occur in the control group. Notably, women in the control group used significantly more other pain-relief methods, including analgesic medications, transcutaneous electrical nerve stimulation, pelvic belts, and physical therapy.

For pregnant women and clinicians, these findings represent important evidence about a promising therapeutic option for pain management during pregnancy. Acupuncture proved capable of providing significant pain relief without compromising maternal-fetal safety. No serious adverse effects were observed in the mothers, and all infants were born healthy, with normal Apgar scores and appropriate birth weights. Reported side effects were mild and transient, including local pain at the needle site, sensation of warmth, small hematomas, mild fatigue, nausea, and weakness — symptoms that can be considered acceptable given the benefits obtained.

For clinicians, this study offers scientific evidence that may support recommending acupuncture as an integral part of prenatal care for women with pelvic and low back pain.

The study has some important limitations that should be considered when interpreting the results. First, the open-label design without a placebo group may have influenced results because of the positive psychological effect of active treatment. The investigators chose not to use sham acupuncture to avoid additional stress for the pregnant women and because of the technical difficulties of creating an adequate placebo for acupuncture. Second, the control group received less professional attention, which may have contributed to the difference in results.

Third, the sample size, although adequate to detect statistical differences, is still relatively small for definitive safety conclusions. Finally, the high reported rate of side effects may have been influenced by active and detailed surveillance of these events by the investigators.

In conclusion, this study provides encouraging evidence that acupuncture may be a valuable tool for relieving pelvic and low back pain in late pregnancy, offering a safe alternative to conventional medications. However, the investigators emphasize the need for larger, placebo-controlled studies to definitively confirm these findings and to establish standardized treatment protocols. For pregnant women suffering from this type of pain, it is worth discussing this option with their clinicians, always considering the importance of seeking acupuncturists qualified and experienced in the care of pregnant women.