Manual therapy treatments in the management of pregnancy related pelvic girdle pain: a scoping review

OBJECTIVES: To synthesize evidence regarding manual therapy interventions for women experiencing pregnancy-related pelvic girdle pain (PGP) and to identify gaps in the existing literature. METHODS: Scoping review. Methodological frameworks by Arksey and O'Malley, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), and the Joanna Briggs Institute (JBI) guided data synthesis and reporting. Literature search was conducted across PubMed, Embase, CINAHL, and Scopus, and studies were selected based on the eligibility criteria. RESULTS: Of 407 potential studies, 16 were selected: eight randomized controlled trials (RCTs), three case studies, two observational studies, one crossover study, one quasi-experimental study, and one service evaluation. Manual therapy, delivered alone or in combination with exercise, education, or standard care, was generally associated with reduced pain intensity among pregnant individuals with pelvic girdle pain, although effects were often small or inconsistent. Many studies had small sample sizes, were pilot designs, and lacked blinding. Follow-up periods varied considerably, but no serious adverse events were reported. DISCUSSION & CONCLUSION: Overall, the findings indicate that manual therapy is associated with consistent short-term reduced pain intensity; however, the magnitude of these effects is generally small to moderate, suggesting a potential but not definitive clinical benefit. Considerable heterogeneity was observed across studies regarding diagnostic criteria, intervention protocols, and outcome measures. Confidence in the findings of is further constrained by methodological limitations of the studies, underscoring the need for methodologically rigorous studies with standardized diagnostic criteria, treatment protocols, and longer follow-up periods to determine the efficacy of manual therapy for pregnancy-related PGP.