Acupuncture and dry-needling for low back pain

Acupuncture in the Treatment of Chronic Low Back Pain

“…Furlan and colleagues' Cochrane systematic review of acupuncture in the treatment of chronic low back pain assessed thirty-five randomized controlled trials published between 1976 and 2003, of which two were excluded from analysis for major flaws. 21 Their pooled analysis examined the efficacy of acupuncture compared to: First, the comparison with no treatment found that acupuncture is more effective at short-(up to 3 month) and intermediate-term (3 to 12 months) follow-ups for pain outcomes, and produced short-term functional improvement. Compared to sham therapy (e.g., non-penetrative needle insertion, or needling outside of traditionally-defined points), acupuncture resulted in more effective pain relief immediately after the end of sessions and at short-term follow-up, but this benefit was not observed at longer-term follow-ups.…”

“…In terms of functional outcomes, there was no benefit of acupuncture over sham therapy. 21 The Cochrane systematic review also reported comparisons between acupuncture and other interventions for chronic low back pain, specifically spinal manipulation, massage, NSAIDs, and transcutaneous electrical nerve stimulation. In these comparisons, there was no advantage of acupuncture in either pain or functional outcomes.…”

“…However, as an adjunct to other interventions (e.g., exercises, NSAIDs), acupuncture was found to improve both pain and function outcomes immediately after sessions, and after short-and intermediate-term follow-up. 21 Based on this, Furlan and colleagues concluded that there was some evidence for the effectiveness of acupuncture as a therapy for chronic low back pain, but this conclusion was tentative. 21 Based on characteristics such as sample size, attrition, and description of methodology, they had ranked most of the studies discussed in their systematic review as being of relatively low methodological quality.…”

“…21 Based on this, Furlan and colleagues concluded that there was some evidence for the effectiveness of acupuncture as a therapy for chronic low back pain, but this conclusion was tentative. 21 Based on characteristics such as sample size, attrition, and description of methodology, they had ranked most of the studies discussed in their systematic review as being of relatively low methodological quality. Overall, they cited a need for higher-quality randomized controlled trials (RCTs) to be conducted before clear recommendations could be made.…”

“…Since the last Cochrane systematic review update in 2005, 21 a number of RCTs and systematic reviews have been published. The present review aims to synthesize these new research findings, and assess whether it is now possible for stronger conclusions to be reached.…”