<p>Therapeutic Efficacy and the Impact of the “Dose” Effect of Acupuncture to Treat Sciatica: A Randomized Controlled Pilot Study</p>

Abstract

Purpose: To investigate the required sample size for and feasibility of a full-scale randomized controlled trial examining the impact of the "dose" effect of acupuncture in treating sciatica. Patients and methods: Fifty-seven patients with sciatica, aged 35-70 years, were recruited and screened. Thirty-one participants were randomly assigned to receive "lowdose" manual acupuncture (MAL) (n= 15) or "high-dose" manual acupuncture (MAH) (n=16). The acupuncture treatment was administered twice weekly for 4 weeks. The primary outcome was the visual analog scale (VAS) score at baseline and after 4 weeks of acupuncture treatment. Secondary outcomes included the Roland Disability Questionnaire for Sciatica (RDQS), the Sciatica Bothersomeness Index (SBI), and the World Health Organization Quality of Life in the Brief Edition (WHOQOL-BREF) scores at baseline and after 4 weeks of acupuncture treatment. Results: Thirty patients completed the study. For all patients, acupuncture achieved significant improvement in the VAS (5.48±2.0, p<0.001), RDQS (3.18±2.83, p=0.004), and SBI (2.85±3.23, p=0.008) scores, but not in the WHOQOL-BREF scores. In the between-group analysis, the assessed scales showed no significant differences between the MAL and MAH groups. However, based on the level of chronicity, the MAH group demonstrated greater improvement in the outcomes and a significant benefit in the physical subscale of the WHOQOL-BREF (p<0.05). Conclusion: Results of this pilot study indicate that acupuncture is safe and may effectively relieve symptoms and disability in patients with non-acute sciatica. MAL was as effective as MAH in treating sciatica. A subsequent trial with a larger sample size (estimated at n=96) is required to confirm whether patients with a high level of chronicity would benefit from MAH treatment. Trial registration: NCT03489681.

The Management of Sciatica by Acupuncture: An Expert Consensus Using the Improved Delphi Survey

“…The “low-dose” manual acupuncture (MAL) treatment group, which involved six acupoints, was as effective as the “high-dose” manual acupuncture (MAH) treatment group, which involved 18 acupoints in treating sciatica. 29 However, the possible dose-related response has not been fully explored in sciatica. Therefore, we formulate consensus items on the parameters required for the effect of acupuncture intervention and finally reach recommendations on certain items, including the frequency of acupuncture treatment, needle holding time, and treatment time.…”

Tratamento da dor lombar com acupuntura: série de casos

“…Em aproximadamente 85% dos casos não é possível definir a etiologia de forma precisa. Muitas vezes a causa é multi-fatorial 1,2,4,5 .…”

“…Nos EUA, 30 bilhões de dólares são gastos anualmente com o tratamento da dor lombar 3,4,5 . Cerca de 600 milhões * Autor correspondente: yondersanjr@gmail.com de dólares são gastos com o tratamento cirúrgico 5 . Embora não se disponha de dados brasileiros, estima-se que anualmente 50 mil cirurgias sejam realizadas para tratamento da lombalgia.…”

“…O desequilíbrio entre os órgãos e vísceras (Zang-Fu) e o bloqueio da circulação energética (Qi) promove deficiências e estagnações, o que leva à dor. A acupuntura promove a livre circulação desta energia vital, restabelecendo o equilíbrio e permitindo a analgesia 1,5,6,7 .…”

“…A acupuntura promove a liberação de opioides endógenos, com ação central e periférica, atuando nas vias modulatórias da dor e no complexo sistema inflamatório local 1,5 . Diversos artigos comprovam a eficácia da acupuntura no controle da dor lombar 1,2,3,4,5,6,7,8,9,10,11 . A acupuntura atua sobre o controle da dor pela ativação de vias opioides, através da hiper-estimulação das terminações nervosas de fibras mielínicas Aδ, responsáveis pela condução do estímulo aos centros medulares, encefálicos e hipotálamo-hipofisários.…”