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Acupuncture for low back pain relief

Is acupuncture effective for long-term relief of low back pain?

Is acupuncture effective for long-term relief of low back pain?

Synopsis

Acupuncture has been shown to be effective for some patients for short-term relief of low back pain.

The researchers of this study evaluated the long-term effect following a short course of acupuncture. They enrolled 241 patients with non-specific low back pain of four to 52 weeks' duration.

Patients with identified causes of pain or red flag symptoms (spinal disease, prolapsed central disc, progressive motor weakness, and so forth) were excluded.

The patients were randomised, using concealed allocation, to receive 10 weekly treatments with acupuncture or to receive usual care, including physical therapy, manipulation, exercises, and drugs at the discretion of the patients' usual physicians.

Patients were aware of the treatment they received, since no sham acupuncture was used. The primary outcome was the bodily pain dimension of the SF-36, the widely used scale to evaluate back pain that ranges from 0 to a best score of 100 (no pain).

At 12 months after treatment, scores improved from a baseline average of 30 to an average of 64 in the acupuncture care group and an average of 58 in the usual care group.

At two years after treatment, acupuncture scores were statistically better than usual care: 68 versus 60, though this difference might not be clinically noticeable.

Patient satisfaction was higher with acupuncture. Patient expectation of benefit of acupuncture was weakly associated with greater improvement.

Acupuncture treatment was more expensive than usual care, but was cost-effective based on the health gain associated with the treatment

Level of evidence

1b (see www.infopoems.com/concept/ebm_ loe.cfm)

Reference

Thomas KJ, MacPherson H, Thorpe L, et al. Randomised controlled trial of a short course of traditional acupuncture compared with usual care for persistent non-specific low back pain. BMJ 2006;333:623.

Bottom line: Over the long term (one to two years), treatment of non-specific low back pain with a short course of acupuncture is as effective as a range of usual care provided by physicians.

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