A 2015 Cochrane Systematic Review (1) looked at 7 RCT’s investigating acupuncture for treatment of lower back pain (LBP) and/or pelvic pain (PP) during pregnancy. One study looked at auricular only (ear) acupuncture treatment while the remaining 6 looked at acupuncture performed locally at the site of pain as well as distally at acupuncture points thought to help with pain relief. The studies varied in risk of bias, what type of intervention was used as a comparator group and location of pain reported by participants (LBP only, PGP only, or a combination). For this reason, the results of the individual studies could not be pooled due to heterogenity. While the overall quality of evidence of the studies was rated as low or moderate, the authors concluded that acupuncture improved lower back pain more than usual prenatal care. In all studies where they were reported, adverse events were infrequent and short-lived.

In a study determined to have low risk of bias (Elden 2008), patients with pelvic pain received either acupuncture or non-penetrating sham acupuncture. Although both groups experienced a statistically significant reduction in pain, no difference was found between these two groups.*

Low-Quality evidence showed acupuncture resulted in less PP in the evening compared to stabilizing exercises or usual care (Elden 2005). In a well-designed study with low risk of bias, ear acupuncture significantly reduced LBP and PP compared to both penetrating sham points and the control group (Wang 2009). Additionally, women at both 20 and 26 weeks reported significantly less pain and improved quality of life, but the group at 26 weeks had a greater reduction in pain after having acupuncture treatment (Ekdahl 2010).

*It is notable that the NIH has stated there is limited value in trials which compare true and sham acupuncture, because these types of trials consistently show there is a smaller treatment effect compared with trials comparing true acupuncture and usual care. This tells us that sham acupuncture is not an inert control, and some degree of physiological and/or placebo effect must exist. The NIH now prioritizes pragmatic trials that compare acupuncture to a group receiving usual care or acupuncture to groups receiving other therapies (7). Both the NIH and the Society for Acupuncture Research have stated the need for more research into acupuncture mechanisms (8).