Most pregnant women experience low-back pain, which often is associated with sleep disturbance and can affect daily activities. Because of possible risks associated with many pain medications, pregnant women and their prenatal care providers often consider using complementary and alternative medicine (CAM) therapies, such as massage and spinal manipulation, for back pain. In a recent NCCAM-funded study, researchers at the University of North Texas Health Science Center investigated the effects of osteopathic manipulative treatment on back pain during the third trimester of pregnancy.
In this exploratory trial, 144 women in weeks 28–30 of pregnancy received usual obstetrical care only, usual care plus a systematic osteopathic manipulative treatment protocol provided by an osteopathic specialist, or usual care plus a sham treatment in which the specialist applied pressure with a nonfunctional ultrasound instrument. At each of seven 30-minute weekly sessions, researchers measured back-specific functioning (Roland-Morris Disability Questionnaire) and level of back pain (an 11-point scale). At the end of 7 weeks, back-specific functioning deteriorated significantly less in the osteopathic manipulative treatment group than in the other two groups. Average level of back pain decreased in the osteopathic manipulative treatment group, remained unchanged in the sham ultrasound group, and increased in the usual-care-only group; however, the between-group differences were not statistically significant.
Although the results of this preliminary study suggest that osteopathic manipulation may have benefits for back-specific functioning, but not pain, in the third trimester of pregnancy, larger trials are needed before definitive conclusions can be drawn about its efficacy or effectiveness for this purpose. An NCCAM-funded study of the physiological and clinical effects of osteopathic manipulative treatment during pregnancy is under way at the University of North Texas.
As with any CAM therapy, pregnant women should consult their health care provider before using osteopathic manipulative treatment.
Licciardone JC, Buchanan S, Hensel KL, et al. Osteopathic manipulative treatment of back pain and related symptoms during pregnancy: a randomized controlled trial. American Journal of Obstetrics and Gynecology.;202(1):43.e1–43.e8.2010