Question To compare conservative care strategies on their efficacy and safety for women with pregnancy-related low back pain.
Design Systematic review with pairwise meta-analysis and network meta-analysis.
Participants People with pregnancy-related low back pain.
Intervention Any conservative approach for pregnancy-related low back pain.
Outcome measures The primary outcomes were pain intensity and physical function. The secondary outcomes were treatment withdrawal due to any reason and adverse events.
Results Twenty-three studies were included in the qualitative synthesis (18 randomised controlled trials were included in the network meta-analysis). For women with low back pain during pregnancy, mindfulness therapy (mean difference -3.96, 95% confidence interval -7.19 to -0.74, moderate-quality evidence) and Kinesio taping (-3.71, -6.55 to -0.87, low-quality evidence) reduced pain intensity (0-10-point Visual Analog Scale) compared with placebo. Moderate-quality evidence suggested that transcutaneous electrical nerve stimulation improved physical function (-6.33, -10.61 to -2.05; 0-24-point Roland Morris Disability Questionnaire) compared with placebo. For women with low back pain during the postpartum period, spinal manipulative therapy (moderate-quality evidence) and cupping therapy (very-low-quality evidence) reduced pain severity compared with usual care or no treatment. Spinal manipulative therapy (moderate-quality evidence) also improved physical function compared with usual care or no treatment. There was no difference for treatment withdrawal among these interventions.
Conclusions For patients experiencing low back pain during pregnancy, mindfulness therapy and Kinesio taping may help to decrease pain, and transcutaneous electrical nerve stimulation may improve physical function.
Trial registration PROSPERO CRD42018093542.