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

BACKGROUND. Low back pain is common during labor. Our randomized controlled trial compared the effectiveness of 3 nonpharmacologic approaches for reli ef 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 (T ENS); and (3) standard care, including back massage, whirlpool bath, and li beral mobilization. Women self-evaluated both intensity and affective dimen sions of pain using visual analog scales. Their evaluations of control and satisfaction were assessed using adapted versions of the Labour Agentry Sca le and the Labor and Delivery Satisfaction Index. RESULTS. Women in the ISW group rated the intensity and unpleasantness of p ain during the experimental period significantly lower than women in the st andard 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 significan tly 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 satisfa ction with labor and delivery, but less women in the ISW group indicated th at they would like to receive the same treatment for back pain during anoth er delivery. CONCLUSIONS. Intracutaneous sterile water injections are more effective tha n standard care (back massage, bath, and mobilization) or transcutaneous el ectrical nerve stimulation for relieving low back pain during labor.