Effect of Electroacupuncture vs Sham Treatment on Change in Pain Severity Among Adults With Chronic Low Back Pain

Abstract

Key Points Question What is the effect of electroacupuncture vs sham treatment on pain severity in adults with chronic low back pain? Findings In this randomized clinical trial including 121 adults with chronic low back pain, there was no significant difference between real and sham electroacupuncture conditions in reduction in pain scores 2 weeks after treatment; however, real electroacupuncture resulted in statistically and clinically greater reduction in back pain–specific disability compared with the sham control. Having coping strategies and not being White race were associated with treatment response to real electroacupuncture. Meaning This randomized clinical trial found no difference in pain reduction between real and sham electroacupuncture, but there was greater reduction in back pain–specific disability compared with sham control.

Electroacupuncture for Treating Chronic Low-Back Pain: Preliminary Research Results

“…The researchers found statistically and clinically greater reduction of RMDQ in the verum, compared to the sham arm, in the prediction study. 9 However, this difference was not statistically significant in the mechanism study. 8 The contrasting results between the 2 studies could have been due to differences in the enrollment criteria, the lapses between enrollment and first treatment in the studies, treatment durations, or provider oversights.…”

“…The second study (N = 102) developed and validated a prediction algorithm using reduction techniques from machine learning on a large number of baseline characteristics. 9 Inclusion criteria were people ages 21-65 with CLBP lasting >6 months, and no acupuncture within the past 3 years. Both studies 8,9 used the Roland Morris Disability Questionnaire (RMDQ) as the primary functional outcome measure.…”

“…9 Inclusion criteria were people ages 21-65 with CLBP lasting >6 months, and no acupuncture within the past 3 years. Both studies 8,9 used the Roland Morris Disability Questionnaire (RMDQ) as the primary functional outcome measure. 10,11 The neural mechanism study 8 used a numeric rating scale (0-100) for pain intensity, and the other study 9 used the PROMIS Ò [Patient-Reported Outcomes Measurement Information System] pain-intensity instrument.…”

“…12 Kong and colleagues used this method to predict patient responses to verum and sham EA. 8 Even with differences between the studies, preliminary LASSO regression identified a predictive algorithm from the neural mechanisms study 8 that was validated in the second study 9 and predicted 40% of the variance in the RMDQ from the responder group. Ultimately, this study will help refine an individually adaptable, effective treatment protocol for CLBP, with the ability to identify responders to acupuncture and perform cost-effective triaging.…”

Rapid Progression to Complete Paraplegia After Electroacupuncture in a Patient With Spinal Dural Arteriovenous Fistula: A Case Report

“…Therefore, it has been reported that the symptoms worsened in patients with SDAVF in the prone position for a long time during spinal surgery (16,17), or after singing or standing for a long time (18,19). Electroacupuncture is a method of applying electrical stimulation with about 20 needles inserted in the prone position for about 20-30 min (20), and it is highly likely that the increase in intrathecal pressure caused by the prone position for a long time made the condition worse. In particular, since the patient was slightly overweight, this may have contributed to the worsening of his condition.…”