Effect of Combined Electrowarm Dry Needling on Postpartum Pelvic Girdle Pain: A Randomized Controlled Study

Summary

This protocol describes a randomized controlled trial evaluating the efficacy of combined electrowarm dry needling in reducing pelvic girdle pain and improving functional status in postpartum women.

Abstract

Postpartum pelvic girdle pain (PGP) is a common complication after childbirth, with limited safe and effective treatment options due to the risks of pharmacological interventions in postpartum women. This study aimed to evaluate the efficacy and safety of combined electrowarm dry needling therapy targeting myofascial pain trigger points (MTrPs) for alleviating PGP in postpartum women. A total of 92 postpartum women with PGP were randomly assigned to a treatment group (n = 46) receiving electrowarm dry needling on MTrPs 5x per week for 4 weeks plus standard postpartum care; a control group (n = 46) received only standard postpartum care. The intervention was conducted 5x a week for 4 weeks, with pain assessed by the Visual Analog Scale (VAS) at 1/3/7 days post intervention, disability by the Oswestry Low Back Disability Questionnaire (OLBPQ), and quality of life by the Nottingham Health Profile (NHP) at 1 month and 3–5 months post intervention. Pubic symphysis distance was measured by B-mode ultrasound at follow-up. Baseline characteristics showed no significant differences between groups (all P > 0.05). The treatment group demonstrated significantly reduced VAS scores at 3 and 7 days post intervention (P = 0.029 and P < 0.001, respectively), and marked improvements in OLBPQ scores at 1 week and 4 weeks (P < 0.001). NHP scores indicated enhanced quality of life in the treatment group, particularly at 3–5 months follow-up (P < 0.001), and the pubic symphysis distance was significantly decreased (P. < 0.01). No serious adverse events were observed in the treatment group, with only two cases of mild local soreness. Combined electrowarm dry needling therapy targeting MTrPs is a safe and effective non-pharmacological intervention for reducing pain and disability and improving quality of life in postpartum women with acute PGP in this single-center study.

Introduction

In postpartum, pelvic girdle pain (PGP) is deemed a public health concern, considering its significant impact on the quality of life of pregnant women and their infants^1,2. PGP is typically marked by continuous discomfort in the bones and muscles surrounding the pelvic ring, and this can manifest either during pregnancy or after childbirth^3,4. Epidemiological evidence indicates that PGP affects 20% to 70% of pregnant women globally, with 8.5% to 37% continuing to experience persistent symptoms into the postpartum period⁵. It is ....

Protocol

Study design
This study was a single-center, randomized controlled trial (RCT) conducted at Boai Hospital of Zhongshan, China. The Ethics Committee of Bo'ai Hospital in Zhongshan (Zhongshan Maternal and Child Health Hospital) reviewed and approved this clinical protocol (KY-2023-005-03). The study was registered in the Chinese Clinical Trial Registry (ChiCTR2400081932) on March 15, 2024. In this study, the treatment process, therapeutic principles, potential adverse reactions, and two intervention options were explained in detail to the patients, and treatment was administered only after obtaining their signed informed consent. The Departmen....

Results

Study participants.
The execution of this study was conducted in accordance with a randomized controlled procedure (Figure 1). A total of 100 pregnant women participated in the screening. Then, six women were excluded from the study since they failed to meet the predetermined inclusion criteria, while an additional two women opted not to participate in the study. In the current investigation, 92 participants were randomly assigned to one of two experimental grou.......

Discussion

Study limitations
This study has certain limitations that need to be acknowledged. First, although the researchers who followed the patients and collected the data were unaware of the grouping (assessor blinding), it was impossible to completely blind the therapists who conducted the electrowarm dry needling intervention due to the nature of the clinical operation, which may have introduced a certain degree of performance bias. Second, this study is a single-center trial with a moderate sample size.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Disposable Sterile Acupuncture Needles	0.25 mm x 40 mm, 0.3 mm x75 mm	Suxiezhuzhun: 20162270588	Suzhou Acupuncture Products Co., Ltd.
GraphPad software	GraphPad Prism 9.0		Graphpad Software Inc, California,USA
Portable color doppler ultrasound system	Anesus TE9	Yuexiezhuzhun 20212060876	Shenzhen Mindray Biomedical Electronics Co., Ltd
SPSS software	SPSS 27.0		IBM Corporation, New York, USA
Warm Needle Electroacupuncture Therapy Device	HT-2	Suxiezhuzhun 20212201551	Jiangsu Yunlian Intelligent Medical Equipment Co., Ltd