Article

Acupuncture for acute non-specific low back pain: a pilot randomised non-penetrating sham controlled trial.

Health and Rehabilitation Sciences Research Institute, School of Health Sciences, University of Ulster, Northern Ireland, United Kingdom.
Complementary Therapies in Medicine (Impact Factor: 2.22). 07/2008; 16(3):139-46. DOI: 10.1016/j.ctim.2007.03.001
Source: PubMed

ABSTRACT A pilot study to assess the feasibility of a trial to investigate the efficacy of acupuncture compared to placebo needling for the treatment of acute low back pain (LBP). As part of this, the study was designed to establish the credibility of the placebo control, and to provide data to inform a power analysis to determine numbers for a future trial.
A pilot patient and assessor blinded randomized controlled trial.
Primary care health centre facility, South and East Belfast Trust, Northern Ireland.
Patients from the physiotherapy waiting list (n=48) with LBP of less than 12 weeks duration.
Roland and Morris Disability Questionnaire (RMDQ), Visual Analogue Scale (VAS), medication use and an exit questionnaire were completed at baseline, end of treatment, and at 3 months follow up.
Ninety-four percent (45/48) of patients completed assigned treatment, 83% (40/48) completed 3 months follow-up. The sham needle used here proved to be credible: 91.7% in the placebo group believed they had received acupuncture, compared to 95.8% in the verum acupuncture group. Differences in baseline characteristics were accounted for using ANCOVA. There was no significant difference between groups on the RMDQ over time. For pain, the only statistically significant difference was at the 3 months follow up (worst VAS, point estimate, 18.7, 95% CI 1.5-36.0, p=0.034). The majority of patients were taking some form of analgesic medication for LBP at the start of treatment (n=44; 92%), and at the end of treatment the verum acupuncture group were taking significantly fewer tablets of pain control medication (mean (S.D.): 1.0+/-0.3) than the placebo group (mean (S.D.): 4.2+/-0.6, p<0.05). Based upon these data, power analysis (power=90%, alpha=0.05, minimal clinically important difference (MCID) for RMDQ=2.5 points) indicated that 120 participants (60 per group) would be needed to complete an adequately powered randomized controlled trial.
This study has demonstrated the feasibility of a randomized controlled trial of penetrating needle acupuncture compared to a non-penetrating sham for the treatment of acute LBP in primary care; 120 participants would be required in a fully powered trial. The placebo needle used in this study proved to be a credible form of control.

Full-text

Available from: G D Baxter, Jun 12, 2015
1 Follower
 · 
184 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: The mechanism of acupuncture, whilst not known with certainty, has previously been considered to be stimulatory. A novel hypothesis is presented here in which C fiber tactile afferent axons bifurcate at acupuncture points and then diverge, running along acupuncture meridians, to subsequently communicate with Merkel cells. It is proposed that acupuncture disrupts the bifurcation of these axons, preventing neural transmission between Merkel cells as well as central communication with the spinal cord. Making use of the known phenomenon that acupuncture points have lower electrical resistance than adjacent skin, this hypothesis was tested using an electrical circuit model and successfully predicted the observed 103 reduction in skin resistance at acupuncture points. In addition to explaining acupuncture and the roles of both Merkel cells and C fiber tactile afferents, the model has greater implications for neuroscience, through the postulation of a new division of the autonomic nervous system.
    Journal of Theoretical Biology 12/2009; DOI:10.1016/j.jtbi.2009.09.008 · 2.30 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Low back pain and chronic fatigue syndrome are major work-related disablers affecting millions around the globe today. This article assesses the clinical reliability of complementary and alternative therapies in the treatment of low back pain and chronic fatigue syndrome using the existing accessible literature. Multiple bibliographic databases that include medical, general health care, and natural medicine literature were searched for relevant terms and conclusions. The authors examined all abstracts obtained through the search and reviewed the full text of the relevant articles along with the additional supporting articles that resulted from the search. It is observed from the literature that most of the complementary and alternative treatments available today are clinically reliable for the treatment of low back pain, as significantly evidenced. However, not many studies support the clinical reliability of the use of complementary and alternative therapies in the treatment of chronic fatigue syndrome.
    07/2013; 18(3):216-224. DOI:10.1177/2156587213485436
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Neck pain (NP) and low back pain (LBP) are common symptoms bothering people in daily life. Traditional Chinese medicine (TCM) has been used to treat various symptoms and diseases in China and has been demonstrated to be effective. The objective of the present study was to review and analyze the existing data about pain and disability in TCM treatments for NP and LBP. Studies were identified by a comprehensive search of databases, such as MEDLINE, EMBASE, and Cochrane Library, up to September 1, 2013. A meta-analysis was performed to evaluate the efficacy and safety of TCM in managing NP and LBP. Seventy five randomized controlled trials (n = 11077) were included. Almost all of the studies investigated individuals experiencing chronic NP (CNP) or chronic LBP (CLBP). We found moderate evidence that acupuncture was more effective than sham-acupuncture in reducing pain immediately post-treatment for CNP (visual analogue scale (VAS) 10 cm, mean difference (MD) = -0.58 (-0.94, -0.22), 95% confidence interval, p = 0.01), CLBP (standardized mean difference = -0.47 (-0.77, -0.17), p = 0.003), and acute LBP (VAS 10 cm, MD = -0.99 (-1.24, -0.73), p< 0.001). Cupping could be more effective than waitlist in VAS (100 mm) (MD = -19.10 (-27.61, -10.58), p < 0. 001) for CNP or medications (e.g. NSAID) for CLBP (MD = -5.4 (-8.9, -0.19), p = 0.003). No serious or life-threatening adverse effects were found. Acupuncture, acupressure, and cupping could be efficacious in treating the pain and disability associated with CNP or CLBP in the immediate term. Gua sha, tai chi, qigong, and Chinese manipulation showed fair effects, but we were unable to draw any definite conclusions, and further research is still needed. The efficacy of tuina and moxibustion is unknown because no direct evidence was obtained. These TCM modalities are relatively safe.
    PLoS ONE 02/2015; 10(2):e0117146. DOI:10.1371/journal.pone.0117146 · 3.53 Impact Factor