Rapid Responses to:

PRIMARY CARE: Helen Elden, Lars Ladfors, Monika Fagevik Olsen, Hans-Christian Ostgaard, and Henrik Hagberg Effects of acupuncture and stabilising exercises as adjunct to standard treatment in pregnant women with pelvic girdle pain: randomised single blind controlled trial BMJ 2005; 330: 761 [Abstract] [Full text]

Rapid Responses: Submit a response to this article

Rapid Responses published:

Simple Measures

Amanda S Jones   (4 April 2005)

Good Show

Ned Hoke OMD, L.Ac.   (6 April 2005)

Acupuncture Trials Benefit From Patient Blinding and Proper Controls

Lloyd B Oppel   (6 April 2005)

Keep Researching Treatments

Julie D Pattison   (21 September 2007)

Simple Measures 4 April 2005
Amanda S Jones, Consultant Obstetrician and Gynaecologist North Manchester General Hospital, M8 6RB Send response to journal: Re: Simple Measures	My personal experience suggests that pelvic girdle pain is much commoner these days. The fibrous ligaments of the pelvis become much more flexible in pregnancy, and any action that stretches those ligaments can cause pain. My advice to all my pregnant ladies who are complaining of pain is to become very ladylike as they get in and out of a car. If they swivel on their bottom, keeping their knees together, they will not put a strain on their pelvic joints. Competing interests: None declared
Good Show 6 April 2005
Ned Hoke OMD, L.Ac., ecological medicine USA Send response to journal: Re: Good Show	This welcome report indicates a rational and properly designed study. Sensible care, such as represented, could become a reasonable standard when medical services lose more of their reflexive cultural hegemony as is so crippling here in the United States. Interestingly one finds with practice that similar service provided post-partum further advances postional restorations and residual complications in form and function. Competing interests: None declared
Acupuncture Trials Benefit From Patient Blinding and Proper Controls 6 April 2005
Lloyd B Oppel, Clinical Associate Professor University of British Columbia Send response to journal: Re: Acupuncture Trials Benefit From Patient Blinding and Proper Controls	The article by Elden et al (BMJ 2005;330:761 2 April) declares acupuncture superior to stabilising exercises in pelvic girdle pain in pregnancy. While patients were randomised to different wings of the study, provisions to sort out the specific effects of acupuncture were lacking. 'Preselected' patients were referred into the study and this population may have included a disproportionate number of patients with a prior belief in the efficacy of acupuncture. Because the patients were not blinded to treatment (no 'sham - acupuncture' control) we are not able to exclude the possibility that patients with a prior expectation of benefit simply responded in a positive (and predictable) way when offered acupuncture. In addition, even in the absence of prior belief in acupuncture, the placement of needles through the skin conveys significant psychological responses that may result in differential symptom perception and/or reporting. The use of a comparison group that received stablilsing exercises (rather than acupuncture) in addition to standard care does not provide reassurance that the nonspecific provider and placebo effects were equal between groups. The reader is left to look forward to a trial where patient blinding and sham- acupuncture controls are used in order to determine whether the benefits of acupuncture go beyond placebo effects. Competing interests: None declared
Keep Researching Treatments 21 September 2007
Julie D Pattison, Supporter And Advocate for Women with Pelvic Girdle Pain N/A Send response to journal: Re: Keep Researching Treatments	It's encouraging to see the increased interest in treatment options for woman with pelvic girdle pain. As a mother of 4 and still suffering 19 years later, it's important to remind the medical community that women who are severely disabled by this syndrome need help. Competing interests: None declared