What is the evidence on the use of pregnancy belts for back pain in pregnancy?

Evidence on Pregnancy Belts for Back Pain in Pregnancy

Pregnancy belts may help reduce low back pain and pelvic girdle pain during pregnancy by providing support and stability, though the scientific evidence supporting their effectiveness as a sole intervention remains limited. 1

Prevalence and Impact of Back Pain in Pregnancy

• Low back pain (LBP) occurs in up to two-thirds of pregnancies, with peak prevalence in months 6 and 7 of gestation 2
• Pelvic girdle pain (PGP) affects nearly 20% of pregnant women 2
• Severe LBP/PGP symptoms affect 15-20% of pregnant women, potentially leading to:
  • Sleep disturbances 2
  • Impaired daily activities 2
  • Elevated depression risk 2
  • Postpartum weight retention due to activity limitations 2

Mechanisms of Back Pain in Pregnancy

• Joint laxity: Pregnancy hormones reduce ligament rigidity, weakening joint stability and increasing demand on stabilizing muscles 3, 2
• Biomechanical changes: Increased abdominal mass and shifts in center of gravity create additional load on the musculoskeletal system 3, 2
• Postural adaptations: Changes to accommodate the growing fetus place stress on the spine and supporting structures 2

Evidence on Pregnancy Support Belts

Types and Mechanisms

• Maternity support belts are one of four main types of commercially available maternity support garments 4
• These belts may provide stabilization effects for the pelvis and lower back during pregnancy 4, 1

Effectiveness for Pain Relief

• A 2019 systematic review found that maternity support garments could have beneficial effects for LBP and PGP alleviation 1
• A randomized trial using the BellyBra showed significant reduction in:
  • Impact of back pain on sleeping 5
  • Getting up from sitting position 5
  • Walking 5
  • Use of analgesic medication 5
• A pilot study found significant reduction in mean pain scores and effect of pain on daily activities when using a maternity support binder for two weeks 6

Limitations of Evidence

• Insufficient scientific evidence exists to conclusively determine that maternity support belts reduce pregnancy-related LBP and/or PGP 4
• Most studies use the garments as a conjunct intervention with other therapies 1
• The mechanisms of action and duration of effectiveness are not well elucidated 1

Potential Adverse Effects

• Increased pain 4
• Fetal heart rate changes 4
• Skin irritation 4
• Discomfort 4

Alternative Interventions

• Stability ball exercise programs have shown significant reduction in LBP and daily life interference at 36 weeks gestation compared to control groups 7
• Regular quadriceps strengthening and mobility exercises are recommended by the American College of Rheumatology for pain reduction during pregnancy 8
• Weight control is essential as increased weight correlates with pain severity 8

Clinical Recommendations

• Consider recommending maternity support belts as part of a comprehensive approach to managing pregnancy-related back pain 1, 6
• Advise pregnant women that while support belts may provide relief, evidence for their effectiveness as a sole intervention is limited 4
• Monitor for adverse effects such as skin irritation or discomfort when using support belts 4
• Encourage complementary approaches such as appropriate exercise programs that have demonstrated effectiveness in reducing pregnancy-related back pain 7