Acupuncture for the treatment of pregnancy-related low back pain: a systematic review and network meta-analysis

Background Despite the effectiveness of acupuncture in the treatment of musculoskeletal pain, many physical therapists are unwilling to use it on pregnant women. A recent systematic review of acupuncture for pregnant women did not include a comparison with sham acupuncture (SAcu). Thus, we aimed to explore the effects of acupuncture, SAcu, and standard care (SC) on pregnancy-related low back pain. Methods We searched five different medical literature databases (PubMed, Embase, MEDLINE, Springer, and Google Scholar) from inception to September 30, 2022. After screening, the following methods were identified: acupuncture, SAcu, and SC. The primary outcome was visual analog scale (VAS) intensity after the intervention. The secondary outcomes were the overall effects of treatment, quality of life (QOL), and QOL evaluated using the Short Form-36 Health Survey Questionnaire (SF-36). Results The network meta-analysis included eight studies and 864 patients. Acupuncture and SAcu were relatively more advantageous in terms of analgesic effects after intervention than SC, but there were no differences between them. In terms of overall effects in number of remissions and the SF-36, Acupuncture was found to be superior to other methods, and SAcu was better than SC. Acupuncture had the highest surface under the cumulative ranking curve, followed by SAcu and SC for all outcomes. Conclusions Acupuncture performs similarly to SAcu in pain relief and is more efficient than SC. Regarding the effectiveness of treatment and QOL, acupuncture therapy was superior to SAcu and SC.