OBJECTIVE: To evaluate the efficacy of acupuncture and moxibustion combined with core stabilization exercises (CSE) in enhancing the function of the transverse abdominal muscle (TAM) and pelvic floor muscle in postpartum women with pelvic pain.

METHODS: This retrospective cohort study included 205 postpartum women with moderate to severe pelvic pain [visual analog scale (VAS) score ≥ 4] between January 2020 and January 2022. Participants were allocated to either a control group receiving CSE (n= 93) or a joint treatment group receiving CSE with acupuncture and moxibustion (n =112). Outcomes assessed included pain relief (VAS), TAM thickness (ultrasound measurement), pelvic floor muscle recovery (manual assessment), urinary incontinence pad test, international consultation on incontinence questionnaire-short form, incontinence quality of life questionnaire, sexual satisfaction (validated questionnaire), quality of life world health organization quality of life questionnaire-abbreviated version, and depression (Self-Rating Depression Scale).

RESULTS: Both groups experienced significant reductions in pelvic pain, with superior outcomes noted in the joint treatment group (P =0.008). Pelvic floor muscle recovery and sexual satisfaction rates were comparable between groups. The SE group demonstrated better post-treatment scores for urinary symptoms and quality of life related to urinary incontinence. TAM thickness remained unchanged in both groups. Quality of life and depression scores improved similarly across both groups post-treatment.

CONCLUSION: While acupuncture paired with CSE did not greatly surpass CSE alone in all outcomes, it provided enhanced pain relief and similar psychological benefit. These findings suggest a potential role for integrative approaches in managing postpartum pelvic pain, though longer-term studies with more objective measures are needed.