The Effect of Acupressure Applied in the Postpartum Weeks 1 and 4 After Cesarean Delivery on Back Pain: A Randomized Controlled Trial.

BACKGROUND

In the early-subacute postpartum period, low-back pain is common due to frequent breastfeeding, suboptimal feeding postures, and increasing infant-carrying load, yet it often receives limited clinical attention.

OBJECTIVE

To examine whether acupressure at postpartum weeks 1 and 4 reduces low-back pain after cesarean delivery.

DESIGN

Prospective, parallel-group randomized controlled trial. Participant/provider blinding was not feasible for a manual intervention; data analysis was blinded.

PARTICIPANTS

Post-cesarean women (n=70) attending routine visits at a family health center in northwest Türkiye were randomized 1:1 to acupressure (n=35) or control (n=35).

INTERVENTION: A 10-minute standardized protocol per visit: LI4, HT2, LI11, and ST36 applied bilaterally in sequence (1 minute per side), and GB21 and UB43 applied bilaterally and simultaneously (1 minute per pair). Controls received usual care.

PRIMARY OUTCOME MEASURES: Visual analog scale (VAS) low-back pain at each visit (pre/post within the acupressure arm; a single, visit-matched assessment in controls). Nonparametric analyses were prespecified.

RESULTS

Immediately following the intervention, back pain in the acupressure group was less compared to the control group in the first and fourth weeks postpartum (P < .001). Across the postpartum window, the pattern was clear: in the control group, pre-session VAS increased from week 1 to week 4 (P < .001), reflecting the common trend of worsening back pain over time. In the acupressure group, VAS decreased immediately from pre- to post-session at both visits (P < .001 at week 1 and week 4), indicating consistent, session-linked relief.

CONCLUSION

A brief, standardized acupressure protocol delivered during routine postpartum care provides immediate relief to low-back pain after cesarean and appears feasible as a nonpharmacologic adjunct to usual care. Key limitations include the absence of a sham control, short follow-up without durability assessment, and no measurement of analgesic use; future trials should address these gaps.

KEYWORDS: acupressure, back pain, cesarean section, postpartum period, women.