Complementary and alternative therapies for post-caesarean pain.

Area of Science:

• Obstetrics and Gynecology
• Pain Management
• Complementary and Alternative Medicine

Background:

• Post-caesarean section (CS) pain impacts maternal well-being and infant care.
• Conventional pain relief methods are sometimes limited by maternal and neonatal side effect concerns.
• Complementary alternative therapies (CAM) present potential alternatives for managing post-CS pain.

Purpose of the Study:

• To evaluate the effectiveness of complementary alternative therapies (CAM) for alleviating pain following caesarean sections (CS).

Main Methods:

• Systematic review of randomized controlled trials (RCTs), including quasi-RCTs and cluster-RCTs.
• Searched multiple databases (e.g., Cochrane, LILACS, PEDro) up to September 2019.
• Two independent reviewers assessed study selection, data extraction, risk of bias, and certainty of evidence using GRADE.

Main Results:

• 37 studies (3076 women) investigated eight CAM therapies; evidence certainty was often low due to small sample sizes and risk of bias.
• Acupuncture/acupressure, aromatherapy, electromagnetic therapy, music therapy, and transcutaneous electrical nerve stimulation (TENS) showed potential short-term pain reduction (up to 24 hours) when used with analgesia.
• Evidence regarding adverse effects and longer-term pain relief was uncertain or very low quality.

Conclusions:

• Certain CAM therapies may provide short-term pain relief post-CS, but safety and long-term efficacy remain unclear.
• Future research requires larger trials with standardized, dichotomous pain outcome measures to improve evidence certainty.
• Standardized measurement of pain relief (e.g., proportion of women with 30% or 50% relief) and other key outcomes is crucial for future studies.