EMPIRICAL STUDIES doi: 10.1111/j.1471-6712.2009.00704.

Acupuncture treatment of pregnant women with low back and

pelvic pain – an intervention study

Lena Ekdahl RN, RM, MSc (Nurse)1,2 and Kerstin Petersson RNT, PhD
(Associate Professor)2,3
1
Department of Obstetrics and Gynecology, Centrallasarettet, Växjö, Sweden, 2Kronoberg Unit for Research and Development, Växjö,
Sweden and 3Department of Nursing, Section of Caring Sciences, Lund university, Sweden

Short-Form McGill Questionnaire (SF-MPQ), Short-Form-

Scand J Caring Sci; 2010; 24; 175–182
36: Health Survey Questionnaire (SF-36), followed by
Acupuncture treatment of pregnant women with low
telephone interviews 2–3 months after delivery.
back and pelvic pain – an intervention study
Findings: The results of POM-VAS, SF-MPQ and SF-36
Objective: To describe patients’ experience of acupuncture showed a relief of pain in both groups. In group 2, an
treatment in low back and pelvic pain during pregnancy. improvement in several SF-36 variables was noted in spite
Design: An intervention study carried out between Sep- of increased physical restrictions. Telephone interviews
tember 2000 and December 2001, involving 40 pregnant confirmed that expectations of treatment were fulfilled.
women. Using content analysis the main category, limitations in
Participants: The study population consisted of healthy daily life, was identified, with subcategories pain, and
pregnant women presenting with low back and pelvic pain psychological well-being.
at maternity health care centres within a defined area in Conclusion: It may be advantageous to begin acupuncture
southern Sweden. therapy later in pregnancy to maximise pain relief.
Intervention: Two groups of women received acupuncture
treatment from gestational week 20 (group 1) or week 26 Keywords: experiences, low back pain, Pain-O-Meter,
(group 2) respectively, for a period of 6 weeks divided into posterior pain, pregnancy, SF-36, Short-Form McGill
eight sessions of 30 minutes each. Questionnaire.
Measurements: Pain assessment was carried out using
Pain-O-Meter and visual analogue scale (POM-VAS), Submitted 21 April 2008, Accepted 1 March 2009

average in the 18th week and is localised to the sacro-

Introduction
iliac joints and symphysis respectively. It becomes
Low back and pelvic pain during pregnancy is common. difficult to walk and stand for long periods (8). All
Studies have shown that 48–76% of women experience asymmetrical movements such as walking upstairs are
this at some time during pregnancy (1–5). During painful. Pain increases often with repetitive movements
pregnancy a loosening of the pelvic joints occurs due to (3, 8). Often the pain is characterised as stabbing or
the hormone relaxin, the purpose of which is to allow cutting (7).
the pelvis to adjust to accommodate the growing foetus The commonest and most frequently used treatment for
and to prepare the woman for childbirth (6). With posterior pelvic pain remains the sacro–ileac belt (9). An
advancing pregnancy the biomechanical situation in the appraisal of the effect of the belt showed that 82% of
lumbar and pelvic area changes due to the weight of the women with posterior pelvic pain were helped (10). The
uterus. The pregnant woman complains of low back fa- study of Kilstrand et al. (1999) showed that water gym-
tigue and the pain is most often characterised as a dull nastics during the later stages of pregnancy significantly
ache (6, 7). Pelvic pain presents only during pregnancy, reduced the intensity of back/low back pain (11). Kilstrand
delivery and immediately post delivery. Pain appears on et al. (1999) concluded that water gymnastics could be
recommended as a method to relieve back pain and reduce
the need for sick leave. A new form of therapy during
pregnancy is acupuncture. A study by Wedenberg, Moen
Correspondence to: and Norling (2000) demonstrated that acupuncture ther-
Lena Ekdahl, The Department of Obstetrics and Gynaecology, apy of pregnant women with low back and pelvic pain
Centrallasarettet, SE-352 85 Växjö, Sweden. produced more rapid relief and better effect on function
E-mail: lena_m_ekdahl@yahoo.se restrictions than physiotherapy (12).

 2010 The Authors. Journal compilation  2010 Nordic College of Caring Science 175
176 L. Ekdahl et al.

Back pain during pregnancy is considered by some to be The study population comprised healthy pregnant wo-
a welfare problem. MacLennan (1991) suggested that it is men who presented with low back and pelvic pain at
more common in Scandinavia than elsewhere in the world maternity health care centres within an area in southern
(13). On the other hand, a study by Björklund and Sweden. The expected response was achieved after four to
Bergström (2000) showed that, in socio-economic terms, five treatments. All forms of treatment involve certain
there were no geographical differences. The frequency of risks, and to minimise side effects the exclusion criteria
pelvic pain in pregnancy was 49% in Uppsala, Sweden and were: treatment with cortisones, anticoagulants or
66% in Rufiji, Tanzania, 77% in Jakobstad, Finland immunosuppressive drugs, heart disease, diabetes, pace-
and 81% in Zanzibar Town, Zanzibar, with comparable site makers, epilepsy, hepatitis, HIV or AIDS, acute infection,
and severity of pain (14). psychiatric disease, haematological disorders, renal disease,
To experience pain involves a deal of suffering for the premature contractions and needle phobia (18).
individual. Should that pain endure, there is a risk of
development of a chronic situation, which influences daily
Instruments
life (15). It is therefore important to understand how pain
influences the will to work, family life, company, leisure Midwives’ experience from care of pregnant women with
time and sleep (16). An important development in health low back and pelvic pain influenced the choice of instru-
care for women is to be able to use both medical and ments for data collection, being both clinically and scien-
nonmedical care to complement alternative treatment tifically approved (19–22).
such as acupuncture, and to measure results using quality- Pain-O-Meter (POM) is a small instrument, which
of-life instruments (17). measures pain dimensions: intensity, quality, locality and
As we saw tendencies of improvements of quality of life duration. A 10 cm visual analogue scale (VAS) is located
for the pregnant women turn of less pain, improved by POM (POM-VAS) which shows pain intensity where 0
mobility, better night sleep and an over all improved describes ‘no pain whatsoever’ and 10 ‘worst possible
general health, therefore the hypothesis was to start the pain’. This measuring method is adjusted for application
treatment with acupuncture already in pregnancy 20. in clinical work. There is also a list reflecting different
The aim of this intervention study was to describe dimensions of pain’s 12 sensory and 11 emotional
women’s experience of acupuncture to alleviate low descriptive terms on POM (POM-VAS), which are scored
back and pelvic pain in week 20 and 26 of pregnancy 0–5. POM measures both the sensory and emotional pain
respectively. intensity and quality. There was a high correlation be-
tween POM-VAS (r = 0.88) och POM-WDS (r = 0.84) in
patients with rheumatoid arthritis (RA) with initial or
Methods
repeated pain intensity (test–retest reliability) (19). In this
study only POM-VAS is shown. The Short Form McGill
Participants
Questionnaire (SF-MPQ) is constructed around three
The study included a total of 40 pregnant women from the word groups: sensory, emotional and appraisal; which
same demographic area of which 20 commenced therapy patients use to describe their experience of pain. It has
in gestational week 20 (group 1) and 20 in week 26 (group shown itself to be able to measure the result of thera-
2). The experience gained by the acupuncture team since peutic treatments and therefore this instrument was
coming into operation in 1997 suggested that the pregnant chosen for this study. SF-MPQ measures pain quality and
woman sought treatment often several weeks, (median intensity by using 15 descriptors where the sum of the
gestational age 31.5 weeks, range 26–34) after the on intensity rank values of the words is graded from 0–3, the
come of pain, (median gestational age 22 weeks, range maximum total being 45 (20, 21). The formula has been
18–28) hence these group divisions. tested for reliability and validity on patients with RA and
When the woman had been diagnosed, a request was fibromyalgia (21). The Short Form-36 Health Survey
forwarded to the acupuncturist at the hospital where Questionnaire (SF-36) is a short questionnaire that is
randomisation to one or other of the groups was carried used internationally (22) and consequently it was chosen
out. The women were notified by telephone as to when for this study. SF-36 contains 36 questions, which mea-
they would begin their course of treatment after ultra- sure eight health dimensions; physical function (PF), so-
sound examination and receipt of expected date of cial function (SF), function limitation due to physical
delivery. problems (RP), function limitation due to emotional
At the acupuncture unit the midwife took a clinical problems (RE), mental health (MH), vitality (VT), pain
history of the pregnant woman prior to start of therapy. (BP) and general health (GH). Analysis has shown that
Individual advice and instruction was given concerning SF-36 is able to distinguish between psychological and
posture correction and how to avoid asymmetrical physical ill health, and between positive and negative
movements. health (22).

 2010 The Authors. Journal compilation  2010 Nordic College of Caring Science
 Acupuncture treatment of pregnant women 177

Tape recorded telephone interviews concerning experi- 16–18. This meant that treatment could begin at the ear-
ences of acupuncture treatment and daily life were carried liest in week 20.
out with the women 2–3 months after delivery. The treatment options traditionally available have been
the trocanter belt, physiotherapy and sickness certificate
(10). Acupuncture treatment was therefore limited to eight
Procedure
sessions so as to be able to offer patients those alternative
Pain measurement using POM-VAS and SF-MPQ was car- treatment forms both prior to and after acupuncture
ried out prior to treatment in the acupuncture unit. SF-36 treatment.
was carried out prior to commencement of treatment and at The women received acupuncture for 6 weeks, divided
every fourth and eighth treatment session. The author (LE) into eight sessions of 30 minutes each. In the first 2 weeks,
conducted 22 consecutive telephone interviews (11 in each two treatments per week were received and there after once
group) 2–3 months after delivery during the period April– per week. Case notes were kept of all procedures and an
September 2001. The interviews dealt with the experienced appraisal was carried out after each treatment occasion. The
quality of life of pregnant women concerning pain, sleep and initial response was expected after four to five treatments
mobility after acupuncture treatment. An interview guide (18). The first session lasted 20 minutes and the number of
was used on a total of five open questions. The goal was to get needles was limited to five. Subsequent sessions were of
a deeper understanding of the state of being of a pregnant 30 minutes duration and the number of needles limited to
woman and to determine whether it was correlated with 10. All women received the same treatment. Foetal sound
the health questionnaire answers. Each interview took was measured before and after each treatment occasion.
20 minutes. Interviews and analysis of material ran in par- Indications for the use of acupuncture in obstetrics have
allel and in the absence of any new category arising, which been described with beneficial results with both clinically
changed the overall content a maximum of 22 interviews and scientifically accepted data (12, 24–26). Using known
was considered to be sufficient (23) (Fig. 1). anatomical sites as reference points the acupuncture sites
are defined, more easily if they are tender (18). Needle
sensitivity is called ‘deqi’ in Chinese and means ‘arrival of
Intervention
energy’ and according to western research deqi-sensitivity
All women were informed by midwives at their respective is due to stimulation of deep muscle afferent’s. Once the
maternity health care centres prior to gestational week 20, needle has been placed and the specific needle sensitivity
after a physician’s diagnosis of back and pelvic pain, of the (deqi) has developed the needle is left in place 20–
possibility of taking part in the study. The diagnostic test 30 minutes (16). Since the 70’s it has been recognised that
used was the provocation test of the posterior pelvis (3). the body produces morphine-like substances – endorphins,
The test was carried out with the patient lying on her back and that the pain relieving effect of acupuncture is in part
and with 90 inflection of the sacroiliac joint on the side similar to prolonged muscle use (18).
being investigated. The investigator stabilised the pelvis
with one hand while carefully pressing on the femurs long
Statistical analysis
axis with the other hand, which produced a posterior
pelvic pain which the patient recognised (10). The collected data was analysed in the SPSS program (Sta-
An acupuncture course of therapy consists of eight to 12 tistical Package for Social Sciences) version 11.0 (SPSS Inc.,
treatments (18) given by a midwife trained in acupuncture Chicago, IL, USA). Mean between the groups and within
technique. After an interval, the treatment can be repeated the groups were compared with modified t-test on the
if required. Acupuncture is considered to be relatively instruments POM-VAS and SF-MPQ. For each of the eight
contraindicated during the first trimester, where there is a SF-36 scales the differences between and within the groups
perception that acupuncture can initiate premature labour were tested with the Friedman test. The Mann–Whitney
pains that lead to miscarriage. Later on during pregnancy, U-test was used for testing differences between groups for
when low back and pelvic pain normally occurs, the risks each SF-36 scale at every measurement occasion. Differ-
are most probably diminished (18). ence within groups between visits was tested when a sig-
Acupuncture treatment was offered during pregnancy nificant difference occurred, using Wilcoxon test.
after routine ultrasound examination in gestational week

Qualitative content analysis

Start 2–3 month > partus
Sept 2000 telephone interviews
Intervention 1 2 3 4 5 6 7 8 Analysis and work up of the material was conducted
Instruments POM-VAS POM-VAS POM-VAS POM-VAS POM-VAS POM-VAS POM-VAS POM-VAS
SF-MPQ SF-MPQ SF-MPQ SF-MPQ SF-MPQ SF-MPQ SF-MPQ SF-MPQ
simultaneously with the data collection. The method used
SF-36 SF-36 SF-36
for interview analysis was qualitative content analysis,
Figure 1 Flow chart after selection and randomising for group 1 and which dealt with how the women experienced their reality
group 2 with start in September 2000–December 2001. in relation with their existing knowledge and previous

 2010 The Authors. Journal compilation  2010 Nordic College of Caring Science
178 L. Ekdahl et al.

and health survey questionnaire and the qualitative study

Limitations in based on the categories previously stated.
Pain Psychological
daily life
well-being
Result of pain measurement
Figure 2 Experiences of acupuncture for low back and pelvic pain.
At the commencement of treatment the women in both
experience. To check if the categorisation into one cate- groups estimated their pain occurrence and intensity
gory and two subcategories was relevant (23), three roughly alike (Figs 3 and 4).
independent experts in the field and the study mentor The mean pain intensity by POM-VAS was significantly
reviewed the material. The analysis produced a main cat- lower (p = 0.001) in group 2 compared with group 1. The
egory, limitations in daily life, and subcategories pain and mean improvement between treatments 1 and 8 was sig-
psychological well-being (Fig. 2). nificantly greater (p = 0.003) in group 2. Group 2 showed
a significant improvement between treatments 1 and 8
(p < 0.001) while group 1 showed no significant difference
Ethics
(p = 0.56).
The study was approved by the Ethics Committee (LU 175– The mean pain experience by SF-MPQ was significantly
00) of the Medical Faculty of the University of Lund. Mid- lower (p = 0.016) in group 2 compared with group 1. The
wives at maternity health care centres within the health mean improvement between treatment 1 and 8 was sig-
district together with midwives at the acupuncture unit nificantly greater (p = 0.042) in group 2. Both group 1
were informed both verbally and in writing. The pregnant (p = 0.025) and group 2 (p < 0.001) showed significant
women inclusion in the study was based upon informed improvements in pain experience between treatments
consent, which could be withdrawn at any time without 1 and 8.
providing a reason and without affecting treatment.

6 Pain intensity
Findings
5
The population 4
POM-VAS

The mean ages of groups 1 and 2 were 28.6 and 27.9 years 3
respectively. In both groups the majority of the women 2 Group 1 n = 16
were employed in health care, service and administration.
1 Group 2 n = 16
The mean for onset of pain was gestational week 14 in
group 1 and week 13 in group 2. The provocation test was 0
1 2 3 4 5 6 7 8
positive in 16 (produced posterior back pain) and negative
in four. Of the four women with a negative test, two had Number of treatments
symphiolysis (anterior pelvic pain) and two awoke with Figure 3 Estimation of pain intensity by Pain-O-Meter and visual
pain on turning in bed. In group 2, 15 were positive and analogue scale (POM-VAS). Means for both groups treated by
five negative. Of the five with negative tests two had acupuncture on eight occasions.
symphiolysis and the remaining three awoke with pain on
turning in bed.
Pain experience
20
Internal noncompliance
Group 1: two women terminated their treatment, one due 15
SF-MPQ

to premature contractions and the other gave no reason.

Two women failed to complete the full course of treatment 10
due to illness. Group 2: four women terminated treatment,
two due to premature contractions and the other due to 5 Group 1 n = 16
the beneficial effect of the treatment. One woman failed to Group 2 n = 16
complete the course due to illness. 0
Of the 16 women in each group who completed the full 1 2 3 4 5 6 7 8
course of treatment, five in group 1 and seven in group 2 Number of treatments
were primiparous. Figure 4 Pain experience by Short-Form McGill Questionnaire (SF-
The results are presented in the following way: the MPQ). Means for both groups treated by acupuncture on eight
quantitative study using the pain measuring instruments occasions.

 2010 The Authors. Journal compilation  2010 Nordic College of Caring Science
 Acupuncture treatment of pregnant women 179

I worked half time during the final month…it worked very

Results of the health survey questionnaire
well…thanks to the acupuncture… (6)
Significant differences were recorded only for pain I was on sick leave 50%... but I couldn’t have worked at all
(p < 0.000) and VT (p < 0.033) within the group (n = 16) had it not been for the acupuncture (14)
and between the groups in two-way analysis. Significant … worked full time until two months before and then went
differences within groups over time (three measurement down to half time prior to the birth. The treatment was excellent
occasions) were noted in group 1 for SF-36 variables and enabled me to carry on working (19)
physical function (PF) and BP. Physical function deterio-
The majority of women in both groups experienced a
rated significantly (p < 0.023) between treatment session
reduction of pain, increased mobility and they were able to
one and eight and pain decreased significantly (p < 0.028)
sleep better after acupuncture treatment.
between all three measurement occasions. For group 2,
The role of the family was also shown to be significant;
differences within the group were registered for BP, GH,
the pregnant woman needed the help and support of
VT and social function (SF). BP decreased significantly
someone close to her. In the main it was her husband/
(p < 0.005) between all three measurement occasions. GH
partner or a close relative/friend who dealt with the
(p < 0.023) and SF (p < 0.017) improved significantly be-
everyday, practical chores at home. Some, such as vacu-
tween treatment sessions one and four, one and eight,
uming, were particularly wearing.
though not between sessions four and eight. VT improved
It emerged that eight women in group 1 and six in group
significantly (p < 0.028) between treatment sessions one
2 continued to suffer from joint laxity even after delivery,
and eight, four and eight, but not between sessions one
albeit less severely. They found it difficult to walk quickly
and four.
or for any great distance without experiencing pelvic pain.
Lying on a hard surface could be painful and getting in and
Results of telephone interviews out of a car could be difficult.

Limitations in daily life. It became apparent that most of the

women were limited to a greater or lesser extent by joint Discussion
laxity problems. Pain was experienced as frustrating when
The aim of this intervention study was to describe preg-
the restricted movement limited their possibilities of doing
nant women’s experience of acupuncture treatment of low
what they wanted. Social activities that involved going out
back and pelvic pain during pregnancy.
and moving around normally were now not an option.
Some women experienced joint laxity problems much
earlier in this pregnancy. The following citations are Method discussion and study limitations
numbered according to the number of women reporting so.
In this study the instrument POM-VAS with a 10 cm
…then you had to decide that certain days…now I’ll do
vertical line showing pain intensity (19) was used together
that today and not do anything tomorrow (9)
with SF-MPQ, which describes pain experience. The
went about on crutches…in agony all the time…but it got
questionnaire was found to reflect the result of therapeutic
better obviously after the acupuncture session… (16)
measures (27), as does this study. Validation showed a
… it began as early as the third month, joint laxity, so it was
significant similarity between SF-MPQ and other instru-
hard work and very painful (22)
ments e.g. VAS-pain (21). SF-36 is a short form ques-
... felt it with the joints early on…in the seventh week or so
tionnaire, which is used world-wide. The intention was to
(29)
develop an instrument to measure subjective health,
Under the heading psychological well-being, several women
which was reliable and with wide application (22) and this
in both groups were positive about their pregnancies in
particular questionnaire was therefore chosen for this
spite of the problem of joint laxity, which influenced their
study.
mood, inducing irritation and fatigue. However, the posi-
There were some difficulties with the data collection in
tive side to pregnancy outweighed the difficulties.
the quantitative part of the study. A contributory factor
It was fine, except for that… (10)
could be that the onset of pain ideally should be prior
Yes, it was wonderful except for the joints… (26)
to gestational week 20 before randomisation could be
Very good…all was fine…my goal was to be able to work until
performed. Neither was it possible to conduct the study
the end of term and I did it, thanks to the acupuncture (31)
with a control group–obtaining evidence about relation-
One woman in group 1 and three in group 2 were able ships requires making at least one comparison (23). Pre-
to work through the whole of their pregnancies despite vious studies have however shown that acupuncture
back and pelvic pain. Three women in group 1 said that treatment resulted in greater pain relief compared with
they could not have worked at all had it not been for controls (12, 24, 25).
acupuncture treatment.

 2010 The Authors. Journal compilation  2010 Nordic College of Caring Science
180 L. Ekdahl et al.

The qualitative method consisting of data collection from pain experienced a relief of pain during the study period,
telephone interviews was analysed with the help of con- compared with the control group (24). Guerreiro da Silva
tent analysis (23). Telephone interviews were conducted et al. (2004) concluded that acupuncture alleviated low
by appointment with the women to avoid or minimise back and pelvic pain during pregnancy. Furthermore the
disruptions. The interview guide was used as an aid during requirement for drugs (paracetamol) diminished and the
the telephone interviews. As the woman could get follow capacity for certain physical activities increased compared
up questions like ‘what do you mean?’ and ‘how did you with the control group undergoing conventional treatment
feel?’ during the interview, the significance of the answers (paracetamol and hyoscine) (25). In a study by Lund,
was deepened and thus raised the credibility of the mate- Lundeberg, Lönnberg and Svensson (2006), were pregnant
rial (23). All interviews were taped and this allowed the women with low back and/or pelvic pain randomised to
interviewer to concentrate fully in the knowledge that the one of two alternative modes of acupuncture stimulation,
conversation was being documented, in the interests of superficial or deep in late pregnancy (gestational age: 22–
credibility and confirmation (23, 28). 36 weeks). Reported significant changes in pain intensity,
In using telephone interviews, several advantages are but the study did not provide enough evidence to conclude
present: (i) data collection is relatively easy from the any difference in effects between the two modes of acu-
appropriate informants, (ii) the interviews can be organ- puncture stimulation (26).
ised to suit both parties, (iii) the relative anonymity with In telephone interviews it was established that there
the interviews are comfortable for many informants, and was no great difference in the experience of acupuncture
(iv) it is an economic method of data collection (28). treatment between the two groups in terms of limitations
Citations in the text were chosen to support the results in daily life due to low back and pelvic pain. During the
from this study. analysis three independent experts in the field and the
This study has limitations; the number of participants study mentor reviewed the material and coding before a
was small. However, the women were chosen randomly final decision was made about the categories, which
and telephone interviews were carried out 2–3 months supports the validity and reliability of the study (23).
after delivery. There is no medical tradition, and few Four of the 22 women interviewed were able to work
studies are published nationally or internationally, of throughout their pregnancies in spite of low back and
acupuncture treatment of pregnant women with low back pelvic pain. The results showed that, to be able to feel
and pelvic pain. the joy of pregnancy and at the same time experience
pain such that day-to-day life is disrupted, is a complex
phenomenon. By ensuring that all pregnant women re-
Result discussion
ceive information at an early stage from the maternity
The study showed that the patients in both groups expe- health care centre a proportion of back-ache problems
rienced pain relief after acupuncture treatment, both pain can be prevented. At registration the midwife can point
intensity (POM-VAS) and pain experience score (SF-MPQ) out that a proportion of women will suffer from back-
showed a reduction, more in group 2 than in group 1. The ache during their pregnancies. This early information for
study also showed that SF-MPQ was able to measure the which the physiotherapist can be responsible ought to be
result of therapeutic interventions and can beneficially be given prior to the ultrasound examination as many
used in investigations, which require more information women experience back-ache before week 16–17. The
than that provided by VAS-pain 0–10 and PPI-scale most important part of treatment is a regime that teaches
(Present Pain Intensity) 1–5 (19, 20). Results from SF-36 the women to avoid all asymmetrical movements. Many
indicated a marked amelioration of pain in both groups women in our study were awoken at night by pain
and this affected results of other quality-of-life dimensions, when turning in bed. With simple measures such as
particularly within group 2. Here, significant improvement reducing pelvic strain by placing a pillow between the
in general health, VT and social function were recorded in knees to support the upper leg when lying on her side,
spite of increased physical limitations. The study showed or placing an extra pillow under her stomach (9). For
that the women did not experience any improvement women with recurring or excessive periods of pain,
concerning physical function and function limitation due acupuncture can be helpful. Acupuncture can further-
to physical problems, but this was perhaps to be expected. more alleviate pain psychologically – the so-called pla-
As there was no control group, the results may be viewed cebo effect (18).
as descriptive with individual comparisons highlighted.
However, Wedenberg et al. (2000) showed that acupunc-
Conclusion
ture produced a better effect on function impairment than
physiotherapy when measured by Disability Rating Index The result suggests that acupuncture treatment of women
(12). In a study by Kvorning et al. (2004), the majority of in group 2 produced greater pain relief than it did for
women receiving acupuncture for low back and pelvic women in group 1. Mean pain intensity and mean pain

 2010 The Authors. Journal compilation  2010 Nordic College of Caring Science
 Acupuncture treatment of pregnant women 181

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