373: Early Pregnancy Low Back Pain Managed Without Analgesics: A Case Report of Scalp Acupuncture

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Acute musculoskeletal pain, Non-pharmacological treatments, Treatment/management , Pain in special populations (e.g. neonates, children, teens, elderly, neurodegenerative diseases)

Background and Aims: During pregnancy, women commonly experience discomfort related to physiological and hormonal changes, including low back pain (LBP). LBP affects up to half of pregnant women and significantly impairs daily functioning and quality of life, with some cases persisting after delivery. Pharmacological management is limited due to potential fetal risks, particularly during the first trimester, making non-pharmacological approaches preferable. Acupuncture has been widely used as a safe complementary therapy for musculoskeletal pain. This case report aims to describe the clinical outcome of acupuncture treatment in a pregnant woman with LBP and its potential role as a safe therapeutic option.

Methods: A 31-year-old primigravida at 9 weeks of gestation presented with acute low back pain for 10 days, with baseline pain intensity of 6/10 on the Numeric Rating Scale (NRS). Clinical assessment included history and physical examination, with no neurological deficits and a negative Straight Leg Raising (SLR) test. Red flags were excluded. The patient received Zhu's scalp acupuncture targeting lumbar and sacral areas for six sessions over three weeks, performed two to three times weekly with 30-minute needle retention and no manual stimulation. Pain intensity was assessed at each visit, and adverse events were monitored. Written informed consent was obtained.

Results: There was a significant improvement in low back pain, indicated by a reduction in NRS score from 6 at baseline to 0 after the sixth treatment session. Pain relief was reported progressively after each session, with complete resolution by the end of treatment. The patient did not receive any analgesic medications or other therapeutic interventions during the treatment period. During follow-up until delivery, the patient reported only minimal recurrent discomfort (NRS 1–2), described as mild stiffness without significant pain, despite a total gestational weight gain of 10 kg. No adverse events, maternal complications, or pregnancy-related complaints were observed.

Conclusions: Scalp acupuncture may serve as a safe and effective non-pharmacological option for managing low back pain during early pregnancy. This case highlights its potential benefit as a standalone complementary therapy, particularly when pharmacological treatment is avoided due to fetal safety concerns.

References: 1. Katonis P, Kampouroglou A, Aggelopoulos A, et al. Pregnancy-related low back pain. Hippokratia. 2011;15(3):205–210.
2. Tingting L, Tongou L, Mingfu L. Effectiveness and safety of acupuncture in pregnancy-related symptoms: a systematic review and meta-analysis. J Tradit Chin Med. 2024;44(1):16–26.
3. Li R, Chen L, Ren Y, et al. Efficacy and safety of acupuncture for pregnancy-related low back pain: a systematic review and meta-analysis. Heliyon. 2023;9(8):e18439.
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Presenting Author: Atalya Vetta Widarto
Submitting Author: Atalya Vetta Widarto

Senior Author: Wahyuningsih Djaali

IASP 2026 Global Year theme of Neuropathic Pain: No

• Atalya Vetta Widarto: MD - Universitas Indonesia
• Miranda Hartini Marpaung: MD - Universitas Indonesia
• Wahyuningsih Djaali: MD, PhD - Universitas Indonesia