Acupuncture in Patients With Chronic Low Back Pain

Abstract

Background: Acupuncture is widely used by patients with low back pain, although its effectiveness is unclear. We investigated the efficacy of acupuncture compared with minimal acupuncture and with no acupuncture in patients with chronic low back pain. Methods: Patients were randomized to treatment with acupuncture, minimal acupuncture (superficial needling at nonacupuncture points), or a waiting list control. Acupuncture and minimal acupuncture were administered by specialized acupuncture physicians in 30 outpatient centers, and consisted of 12 sessions per patient over 8 weeks. Patients completed standardized questionnaires at baseline and at 8, 26, and 52 weeks after randomization. The primary outcome variable was the change in low back pain intensity from baseline to the end of week 8, as determined on a visual analog scale (range, 0-100 mm). Results: A total of 298 patients (67.8% female; mean±SD age, 59±9 years) were included. Between baseline and

Is Complementary and Alternative Medicine Effective in Job Satisfaction Among Dentists With Musculoskeletal Disorders? A Cross Sectional Study

“…In the previous studies, CAM therapies have shown significant results in reducing the risk of musculoskeletal and other problems in general population (20)(21)(22)(23)(24). In our study, individuals who used CAM therapies alone were less likely to report temporarily quitting work for longer than 2 months.…”

Acupuncture for chronic pain and depression in primary care: a programme of research

“…Of particular note was the funding by insurance companies of a series of trials in Germany, some of which had patient numbers in the thousands. These included the cluster of German Acupuncture Randomized Trials published in 2005 and early 2006, [66][67][68][69] which recruited around 300 patients in each of four separate trials on osteoarthritis, 69 chronic lower back pain, 66 migraine 68 and chronic tension headache. 67 Conducted at the same time were the GERman ACupuncture (GERAC) trials, including around 1000 patients with osteoarthritis, 70 chronic lower back pain 71 and migraine, 72 and 400 patients with chronic tension headache.…”

“…For sham RCTs, the type of sham control varied, including acupuncture needles inserted superficially, 72 sham acupuncture devices with needles that retract into the handle rather than penetrate the skin, 137 and non-needle approaches such as deactivated electrical stimulation 132 or a detuned laser. 118 The cointerventions also varied, with no additional treatment other than analgesics in some RCTs 66 and both acupuncture and sham groups receiving a course of additional treatment, such as exercise led by physical therapists, in other RCTs. 135 For the trials with non-acupuncture control groups, there was variation in usual care, for example control group patients being merely advised to 'avoid acupuncture'; 62 an attention control, such as group education sessions; 134 and guidelined care, in which, for example, patients were given advice on specific drugs and doses.…”

“…For the musculoskeletal analyses, heterogeneity was driven by two very large RCTs 74,75 (n = 2565 74 and n = 3118 75 ) for back and neck pain. If only back pain is considered, heterogeneity is dramatically reduced and is again driven by one RCT, that by Brinkhaus et al 66 with a waiting-list control. In the headache meta-analysis, the study by Diener et al 72 reported much smaller differences between groups.…”

“…In a meta-analysis of nine RCTs, [66][67][68][69][70][71][72]134,135 the effect size for sham control was 0.33 (95% CI 0.27 to 0.40) and 0.38 (95% CI 0.20 to 0.56) for fixed-and random-effects models, respectively (for tests of both effect and heterogeneity, p < 0.001). Results for substudy 1: influence of the control group on effect size…”