Factors associated with return to meaningful activities following physiotherapy for pelvic girdle pain during pregnancy: 3-year follow-up of a randomised controlled trial.

Pelvic girdle pain (PGP) affects many women during pregnancy, causing discomfort in the pelvis and lower back that can make daily activities challenging. Researchers in Sweden followed 113 pregnant women with PGP who received either acupuncture or transcutaneous electrical nerve stimulation (TENS) treatment, checking in with them at 4 months and 3 years after giving birth to see how well they recovered.

The study found encouraging news: most women were able to return to their normal activities within 4 months after delivery, and this improvement lasted for at least 3 years. Nearly half of the women reported complete return to all their baseline activities by the 3-year mark. Both acupuncture and TENS treatments showed similar positive results, with no significant difference between the two approaches.

Researchers identified some factors that predicted longer-lasting problems. Women who had more concern about their pain and those with higher disability scores during pregnancy tended to have more difficulty returning to activities. Importantly, the study found that having multiple positive pelvic provocation tests (physical exam maneuvers that reproduce pain) at 4 months postpartum was a strong predictor of continued pain problems at 3 years. This finding could help healthcare providers identify which women might need additional follow-up care after delivery.

For pregnant women experiencing PGP, this research suggests that physiotherapy interventions including acupuncture can be part of an effective treatment approach, with good prospects for long-term recovery. If you're considering acupuncture for pregnancy-related pelvic pain, seek care from a licensed acupuncturist with experience treating pregnant women.

This 3-year follow-up of an RCT examined long-term functional outcomes in 113 pregnant women with clinically verified pelvic girdle pain who received acupuncture or TENS therapy. Of the original cohort, 57 completed the 3-year follow-up. The primary outcome was the Patient-Specific Functional Scale (PSFS), with mean scores improving from baseline to 8.64 at 3 years (p<0.001), and 45.6% achieving full functional recovery (PSFS=10). No significant differences were observed between treatment modalities. Repeated linear regression demonstrated approximately 3-point improvement in PSFS scores from baseline to 3-year follow-up. Higher pain-related concern and Pelvic Girdle Questionnaire scores were associated with persistent activity limitations. Notably, logistic regression revealed that positive pelvic provocation tests at 4 months postpartum significantly predicted self-reported PGP at 3 years (OR 2.98, 95% CI 1.26-7.05, p=0.013). Clinical implication: The number of positive provocation tests at 4 months may serve as a prognostic indicator for identifying patients requiring extended postpartum management.