A randomized controlled trial of nonpharmacologic approaches for relief of low back pain during labor

BACKGROUND. Low back pain is common during labor. Our randomized controlled trial compared the effectiveness of 3 nonpharmacologic approaches for relief of back pain. METHODS. A total of 34 women suffering from low back pain during labor were randomly assigned to receive 1 of 3 treatments: (1) intracutaneous sterile water injections (ISW); (2) transcutaneous electrical nerve stimulation (TENS); and (3) standard care, including back massage, whirlpool bath, and liberal mobilization. Women self-evaluated both intensity and affective dimensions of pain using visual analog scales. Their evaluations of control and satisfaction were assessed using adapted versions of the Labour Agentry Scale and the Labor and Delivery Satisfaction Index. RESULTS. Women in the ISW group rated the intensity and unpleasantness of pain during the experimental period significantly lower than women in the standard care group or the TENS group, (P = .001 and P = .003, respectively). Similar results were observed for intensity (P = .01) and unpleasantness (P = .03) of pain assessed just before delivery or request for an epidural. Mean pain intensity at 15 and 60 minutes after randomization was significantly reduced in the ISW group compared with the 2 other groups. There was no significant difference in the 3 groups in the level of control and satisfaction with labor and delivery, but less women in the ISW group indicated that they would like to receive the same treatment for back pain during another delivery. CONCLUSIONS. Intracutaneous sterile water injections are more effective than standard care (back massage, bath, and mobilization) or transcutaneous electrical nerve stimulation for relieving low back pain during labor.