Acupuncture therapy for chronic low back pain: protocol of a prospective, multi-center, registry study (2025)

Efficacy of Acupuncture in Chronic Low Back Pain Treatment: A Literature Review

Journal of complementary and alternative medical research, 2024

Aims: To evaluate the effects of the use of acupuncture as a treatment of chronic low back pain. Methodology: This study follows the integrative methodology of literature review, seeking articles published on PubMed, using keywords from Medical Subject Headings (MeSH) to form the search Formula: Acupuncture AND "low back pain". Inclusion criteria were randomized controlled trials published between 2018 and 2023, with free full text available in english or portuguese. The exclusion criteria was not answering this review's orienting question. Results: Several studies analyzed the efficacy of different acupuncture and electroacupuncture approaches in the treatment of chronic low back pain. One study highlighted invasive laser acupuncture with different wavelengths, revealing improvements in pain and disability scales after 4 weeks. Another research compared electroacupuncture at various frequencies, observing similar reductions in pain between the groups. Combined acupuncture (hands and ear) was more effective than usual medical treatment, showing greater reduction in pain and cure rate. Both electroacupuncture and manual acupuncture also demonstrated efficacy in reducing pain intensity and quality. Acupuncture with embedded wires stood out, showing positive and rapid results in chronic low back pain. Another study revealed that both electroacupuncture and a placebo had positive impacts on pain intensity. Conclusion: Even though there are multiple forms of acupuncture used throughout the studies, and even those that appear on multiple studies are done differently on those appearances, all are used as a way to reduce CLBP. In that sense, the positive effects from using traditional acupuncture or some different form of acupuncture as a treatment for CLBP is highlighted by the results from the studies that were a part of this review.

An international expert survey on acupuncture in randomized controlled trials for low back pain and a validation of the low back pain acupuncture score

European Journal of Medical Research, 2011

Background: Acupuncture is a promising treatment approach in patients with chronic low back pain (clBP) but little is known about the quality of acupuncture in randomized controlled trials (Rct) of acupuncture clBP. Objective: to determine how international experts (IES) rate the quality of acupuncture in Rcts of clBP; independent international validation of the low Back Pain Acupuncture Score (lBPAS). Methodology: fifteen experts from 9 different countries outside china were surveyed (IES). they were asked to read anonymized excerpts of 24 Rcts of clBP and answer a three-item questionnaire on how the method of acupuncture conformed to 1) chinese textbook standards, 2) the expert's personally preferred style, and 3) how acupuncture is performed in the expert's country. likert scale rating, calculation of the mode for each answer, and Spearman's rank correlation coefficient between all three answers and the lBPAS were calculated. Results: on comparison with chinese textbook standards (question 1), 6 Rcts received a good rating, 8 trials a fair and 10 trials a poor or very poor rating. 5 of the 6 trials rated good, received at least a good rating also in question 2 or 3. we found a high correlation of 0.85 (p<0.0001) between the IES and lBPAS ratings for question 1 and question 2, and a correlation of 0.66 (p<0.0001) for question 3. Conclusion: the international expert survey (IES) revealed that only 6 out of 24 (25%) Rcts of acupuncture for clBP were rated "good" in respect to chinese textbook acupuncture standards. there were only small differences in how the acupuncture quality was rated in comparison to chinese textbook acupuncture, personally preferred and local styles of acupuncture. the rating showed a high correlation with the low Back Pain Acupuncture Score lBPAS.

Different frequencies of acupuncture treatment for chronic low back pain: An assessor-blinded pilot randomised controlled trial

Complementary Therapies in Medicine, 2009

To examine the feasibility of a main RCT to compare the effectiveness of two frequencies (2 versus 5 times/week) of acupuncture treatment for chronic low back pain (LBP). Participants (n=30) with chronic LBP were randomised into two groups to receive 10 acupuncture treatments: Low Frequency Group, 2 times/week for five weeks (n=15); High Frequency Group, 5 times/week for two weeks (n=15). The following outcomes were measured blindly at baseline, 2 weeks, 5 weeks, 3 months and 1 year: pain on a VAS, functional disability using the RMDQ, quality of life using the Measure Yourself Medical Outcome Profile (MYMOP-2), psychological impact with the Coping Strategies Questionnaire (CSQ) and Pain Locus of Control (PLC) questionnaire. Two objective outcomes, the Shuttle Walk Test (SWT) and Lateral Trunk Flexibility (LTF), were also measured. The compliance rate was 100% for each group. Some of the measurements were shown to be sensitive (VAS, RMDQ, MYMOP-2 Wellbeing). 66-330 participants would be required for a fully powered non-inferiority trial. The groups were balanced at baseline for LBP and demographic characteristics. There were no significant differences between the groups in terms of any of the outcomes, at each follow-up time point. It was notable however that the clinically important improvement in terms of pain, functional disability, quality of life, and SWT in both groups was achieved within the first two weeks, which was maintained at one year follow-up. It is feasible to conduct a main RCT, to compare different frequencies of acupuncture for LBP, using sensitive measurements. Also the trend for early clinically important improvement within a minimum of four measurements is worthy of further study.

Short Term Effect of Acupuncture in Chronic Low Back Pain: A Case Study

Journal of Yoga and Physiotherapy, 2018

Various evidence suggest better outcome measures after classifying the patient in one or more of the five dominant movement-based classifications, but these classifications are less frequently used in the clinical practice [7]. Witt et al. [8] identified some characteristics that indicate better responses to acupuncture i.e. young age, education of more than 10 years, and worse back baseline function, whereas patients with gradual onset may respond favourably [9]. In a recent comparative study by Oakes & Bassett [10], it was found that individualized targeted acupuncture and physiotherapy showed better outcomes than group acupuncture and physiotherapy in 51 patients with low back pain. The author did recommend using the Four Gates treatment, if it helps in easing the pain at later stages [10]. There are various clinical prediction rules that indicate the efficacy of spinal manipulation, lumbar stabilization exercises, and facet joint block as treatments for LBP, but there is a scarcity of good evidence indicating the efficacy of acupuncture as a treatment for LBP [11-13]. Previous research, focusing on the use of acupuncture in the treatment of LBP, is conflicting and many trials have poor methodology. Due to the conflict regarding the efficacy of acupuncture for the treatment of LBP, acupuncture is not used as a treatment for LBP in many clinical settings. The other reason may also be that patients have found conventional medical treatment to be unsatisfactory [14]. But since the National institute of clinical Excellence (NICE) guidelines of 2009, acupuncture has been popular among clinicians and patients of chronic LBP. According to Manheimer et al. [15], the current data indicates that acupuncture is more beneficial than sham acupuncture and no additional treatment for short-term relief for chronic LBP. However, in spite of these positive results, due

Efficacy of acupuncture for chronic low back pain: protocol for a randomized controlled trial

Trials, 2008

Chronic back pain is a major public health problem and the primary reason patients seek acupuncture treatment. Therefore, an objective assessment of acupuncture efficacy is critical for making informed decisions about its appropriate role for patients with this common condition. This study addresses methodological shortcomings that have plagued previous studies evaluating acupuncture for chronic low back pain.

Acupuncture in patients with acute low back pain: A multicentre randomised controlled clinical trial

2012

Acupuncture Acute low back pain Placebo Randomised controlled trial a b s t r a c t Reviews of the efficacy of acupuncture as a treatment for acute low back pain have concluded that there is insufficient evidence for its efficacy and that more research is needed to evaluate it. A multicentre randomized controlled trial was conducted at 4 primary-care centres in Spain to evaluate the effects of acupuncture in patients with acute nonspecific low back pain in the context of primary care. A total of 275 patients with nonspecific acute low back pain (diagnosed by their general practitioner) were recruited and assigned randomly to 4 different groups: conventional treatment either alone or complemented by 5 sessions over a 2-week period of true acupuncture, sham acupuncture, or placebo acupuncture per patient. Patients were treated from February 2006 to January 2008. The primary outcome was the reduction in Roland Morris Disability Questionnaire scores of 35% or more after 2 weeks' treatment. The patients in the 3 types of acupuncture groups were blinded to the treatments, but those who received conventional treatment alone were not. In the analysis adjusted for the total sample (true acupuncture relative risk 5.04, 95% confidence interval 2.24-11.32; sham acupuncture relative risk 5.02, 95% confidence interval 2.26-11.16; placebo acupuncture relative risk 2.57 95% confidence interval 1.21-5.46), as well as for the subsample of occupationally active patients, all 3 modalities of acupuncture were better than conventional treatment alone, but there was no difference among the 3 acupuncture modalities, which implies that true acupuncture is not better than sham or placebo acupuncture. Ó

Acupuncture for acute non-specific low back pain: a protocol for a randomised, controlled multicentre intervention study in general practice--the Acuback Study

BMJ Open, 2012

Treatment regimens of acupuncture for low back pain—A systematic review

Complementary Therapies in Medicine, 2008

Objectives: To investigate the difference in acupuncture treatment regimens for low back pain (LBP) among textbooks, clinical studies and clinical practice, and explore reasons for such differences. Methods: A systematic review of textbooks, surveys, clinical studies (randomised controlled trials (RCTs) and case studies) published in English or Chinese, was conducted, plus Chinese expert opinions. Data on detailed acupuncture treatment regimens were extracted. Results: 12 textbooks in English, 31 textbooks in Chinese, 3 surveys in English, no surveys in Chinese, 9 Chinese expert opinions, 25 RCTs in English, 29 RCTs in Chinese, and 38 case studies in English were included. For chronic non-specific LBP, the outstanding differences in regimens found were (irrespective of the approach of acupuncture): (i) clinical studies and surveys (9-11 points) reported the use of many more points per session than Chinese experts (5 points); (ii) two extreme frequencies of treatments were used across all sources (1-2 times/week vs. 5-6 times/week). For acute LBP, the notable differences between RCTs and case studies were: (i) a variety of special points were investigated; (ii) case studies reported the use of many more points per session (10 points) than RCTs in Chinese (2 points); (iii) RCTs in Chinese administrated more treatments (6.5 sessions) than RCTs in English (3.5 sessions) and case studies (3 sessions). Conclusion: For non-specific LBP, treatment regimens of acupuncture differ by the types of reference sources, in terms of treatment frequency, the points chosen, number of points needled per session, duration and sessions, and co-interventions.

Acupuncture for low back pain: results of a pilot study for a randomized controlled trial

Complementary Therapies in Medicine, 1999

Objectives:To pilot procedures to be used in a randomized controlled trial of acupuncture for low back pain. Design: Uncontrolled clinical trial. Setting: Primary care and acupuncture clinics in York, England. Subjects: 20 patients with low back pain lasting I month or more. Interventions: I 0 sessions of individualized acupuncture from a traditional acupuncturist. Main outcome measures: Change in Oswestry low back pain disability questionnaire; present pain intensity scale; effect on daily living scale, and SF-36 general health questionnaire at post-treatment and 6 months after the end of treatment. Results: 14 patients completed follow-up. Patients had similar severity scores at baseline to those referred to an NHS outpatient clinic. Post-treatment, there were statistically significant improvements in Oswestry, present pain intensity, effect on daily living and the physical functioning, social functioning, bodily pain, vitality and mental health sub-scales of the SF36. Similar results were found at the six month follow-up. Oswestry scores showed reduced levels of pain at 6 months compared to than at post-treatment, falling approximately 40% from baseline. Conclusions:Though the improvements in pain and quality in life may be due to the natural course of back pain, the promising responses justify further research.The procedures used in the study are appropriate for a randomized controlled trial. Drop-out could be reduced by more careful patient monitoring. Foundation for Tradittonal Chinese Medione, 122A Acomb Road,York.YO2 4EY, UK Complementary Therapies in Medicine (I 999). 7, 83-90

Acupuncture for acute non-specific low back pain: a pilot randomised sham controlled trial

Focus on Alternative and Complementary Therapies, 2010

Objective To assess the efficacy of Yamamoto's acupuncture method on pain, drug intake, functional capacity and quality of life for the treatment of acute non-specific low back pain (ANLBP). Methods A prospective, randomised, parallelgroup, double-blind, placebo-controlled trial was performed in 80 men and women with ANLBP who were randomly assigned to five acupuncture sessions (intervention group (IG), n=40) and to five non-penetrating acupuncture sessions (sham group (SG), n=40). Patients were evaluated at baseline and at 3, 7, 14, 21 and 28 days. The measurements used were: visual analogue scale (VAS) for cumulative pain (before intervention, VAS1) and immediate pain (after intervention, VAS2); function (Roland-Morris Disability Questionnaire (RM)); quality of life (SF-36); improvement rating; and number of antiinflammatory tablets taken. The primary endpoint was a decrease of at least 2 cm in VAS1. Results Pain VAS improved significantly in the IG from day 14 onwards compared with the SG, but the difference did not reach the prespecified clinically relevant value of 2 cm. The IG was significantly superior to the SG in the following outcomes: cumulative pain, function, pain (SF-36) and vitality (SF-36) at days 14, 21 and 28 (p<0.05); limitation in physical aspects (SF-36) at all times (p=0.007 and p=0.02); and functional capacity (SF-36) at days 21 and 28 (p<0.05). The IG also took significantly fewer anti-inflammatory tablets than the SG (p=0.004) at all evaluation times and the improvement rating was better than the SG (p<0.001). Conclusions Yamamoto's new scalp acupuncture was more effective than sham treatment with regard to decrease in pain and anti-inflammatory intake as well as improving functional status and quality of life for patients with ANLBP. ClinicalTrials.gov NCT 01124955.