Acupuncture For Low Back Pain Research Articles

The Effectiveness of Acupuncture for Low Back Pain: An Umbrella Review and Meta-Analysis.

Recommendations on the use of acupuncture in managing low back pain (LBP) vary across different guidelines. The methodological quality of existing systematic reviews and meta-analyses on this topic also demonstrates considerable diversity, potentially leading to biased conclusions. Therefore, we comprehensively searched PubMed, EMBASE, Web of Science, Cochrane Database of Systematic Reviews, and Chinese National Knowledge Infrastructure (CNKI) databases and conducted an umbrella review. Scrutiny was performed to ascertain whether primary studies within the systematic reviews and meta-analyses adhered to our inclusion criteria, followed by a meticulous reanalysis of pertinent data. Participant numbers, heterogeneity, publication bias, and excessive significance were taken into account when assessing the credibility of the evidence. For robustness, sensitivity analysis was performed using the leave-one-out method. The results of the umbrella review yielded highly suggestive evidence in favor of the immediate and short-term analgesic effects of acupuncture, with suggestive evidence supporting intermediate-term analgesic effects. However, the effectiveness of acupuncture on disability improvement has demonstrated weak to suggestive evidence. Evidence supporting the enhancement of quality of life by acupuncture is limited. The leave-one-out analysis corroborated the robustness of the meta-analysis, further confirming the credibility of the findings. This umbrella review indicated that the most significant advantage of acupuncture for LBP is its capacity to reduce pain.

Efficacy of Integrated Yoga and Naturopathy With Physiotherapy or Acupuncture for Low Back Pain: A Parallel, Two-Arm, Randomized Trial.

Low back pain (LBP) is a musculoskeletal condition that affects many individuals. While physiotherapy and acupuncture are frequently used treatments, determining their specific contributions when used alongside integrated yoga and naturopathy (IYN) therapy for relieving chronic LBP symptoms and enhancing quality of life is important. In the present prospective randomized comparative trial, a total of 60 participants were divided into the following two groups: physiotherapy with IYN and acupuncture with IYN. The treatment duration was 10 days, and assessments were conducted both before (baseline) and after the intervention. Various assessment tools, such as the visual analogscale (VAS), Oswestry Disability Index (ODI), fingertip-to-floor test (FTF), State-Trait Anxiety Inventory (STAI), and Short Form 36 (SF-36), were utilized. The statistical analysis was performed using SPSS version 21.0 (Armonk, NY:IBM Corp). The results revealed significant differences in VAS score, ODI, FTF score, STAI score, and SF-36 score between the physiotherapy and acupuncture groups (p<0.001). A t-test for the equality of means and a Mann-Whitney U test were used to compare the two groups; these tests revealed a significant difference in disability levels, range of motion, and state of anxiety. The acupuncture group showed a significant difference in the ODI (15.9 {12.6, 19.3}; p <0.001) and state anxiety (23.0 {20.0, 26.0}; p<0.001) compared to the physiotherapy ODI (22.4 {18.5, 26.4}) and state anxiety (27.5 {25.0, 30.0}). The physiotherapy group showed a significant difference in range of motion (7.7 {5.7, 9.7}; p<0.001) compared to the acupuncture group (11.6 {9.8, 13.5}). The present study findings revealed that both physiotherapy and acupuncture, as interventions along with integrated yoga and naturopathy may be considered an effective treatment strategy for chronic LBP.

Placebo Response among Different Types of Sham Acupuncture for Low Back Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Low back pain (LBP) is a prevalent and debilitating condition that poses a significant burden on healthcare systems. Acupuncture has been proposed as a promising intervention for LBP, but the evidence supporting its specific effect is insufficient, and the use of sham acupuncture as a control in clinical trials presents challenges due to variations in sham acupuncture techniques and the magnitude of the placebo effect. To investigate the magnitude of the placebo response of sham acupuncture in trials of acupuncture for nonspecific LBP, and to assess whether different types of sham acupuncture are associated with different responses. Four databases including PubMed, EMBASE, MEDLINE, and the Cochrane Library were searched through April 15, 2023, and randomized controlled trials (RCTs) were included if they randomized patients with LBP to receive acupuncture or sham acupuncture intervention. The main outcomes included the placebo response in pain intensity, back-specific function and quality of life. Placebo response was defined as the change in these outcome measures from baseline to the end of treatment. Random-effects models were used to synthesize the results, standardized mean differences (SMDs, Hedges'g) were applied to estimate the effect size. A total of 18 RCTs with 3,321 patients were included. Sham acupuncture showed a noteworthy pooled placebo response in pain intensity in patients with LBP [SMD -1.43, 95% confidence interval (CI) -1.95 to -0.91, I2=89%]. A significant placebo response was also shown in back-specific functional status (SMD -0.49, 95% CI -0.70 to -0.29, I2=73%), but not in quality of life (SMD 0.34, 95% CI -0.20 to 0.88, I2=84%). Trials in which the sham acupuncture penetrated the skin or performed with regular needles had a significantly higher placebo response in pain intensity reduction, but other factors such as the location of sham acupuncture did not have a significant impact on the placebo response. Sham acupuncture is associated with a large placebo response in pain intensity among patients with LBP. Researchers should also be aware that the types of sham acupuncture applied may potentially impact the evaluation of the efficacy of acupuncture. Nonetheless, considering the nature of placebo response, the effect of other contextual factors cannot be ruled out in this study. (PROSPERO registration No. CRD42022304416).

Acupuncture for Low Back Pain: Reevaluation of Systematic Reviews and Meta-analyses.

This overview aims to reevaluate the methodological quality, report quality, and evidence quality of systematic reviews (SRs)/meta-analyses (MAs) of acupuncture for low back pain to determine whether acupuncture effectively treats low back pain (LBP). Twenty-three SRs/MAs were deemed eligible for the present overview. The AMSTAR 2 score showed that the methodological quality of one SR/MA was of medium quality, one was of low quality, and 21 were of critically low quality. Based on the results of the PRISMA evaluation, there are certain areas for improvement in the quality of reporting of SRs/MAs. There were some reporting flaws in the topic of search strategy (8/23, 34.78%), certainty assessment (4/23, 17.39%), the certainty of evidence (4/23, 17.39%), registration and protocol (3/23, 13.04%), and availability of data, code, and other material (1/23, 4.35%). Results from the GRADE evaluation indicated that 13 of 255 outcomes were rated as moderate, 88 were low, and 154 were very low. Acupuncture effectively treated LBP in the SRs/MAs included in the reevaluation. However, the methodological, report, and evidence-based quality of the SRs/MAs on acupuncture for LBP was low. Therefore, further rigorous and comprehensive studies are warranted to improve the quality of SRs/MAs in this field.

When Patients' Assessments of Treatment for Subjective Symptoms are At Odds with Authoritative Assessments in the Biomedical Literature: The Case of Patients Treated with Acupuncture for Low Back Pain in a Traditional Chinese Medicine Clinic in China (and Story of a Bewildered Chicken).

Assessments of treatments for 'subjective symptoms' are problematic and potentially contentious. These are symptoms without ascertainable pathophysiology, also referred to as 'medically unexplained.' Treatments of them may be assessed from different perspectives, and an assessment as seen from one perspective may be discrepant with an assessment as seen from another perspective. The observational study described in the paper represents one perspective. Patients in the study were treated with acupuncture for the subjective symptom of low back pain in a Traditional Chinese Medicine Clinic in China; acupuncture is a form of TCM, which is indigenous to China. Shortly after treatment began and six months afterward, patients reported 'clinically important improvements' on a variety of standard, cross-culturally validated outcome measures, including pain intensity, physical functioning, and emotional functioning; this assessment is consistent with numerous assessments of acupuncture in China and other Southeastern Asian countries. On the other hand, clinical trials represent another perspective from which to assess acupuncture. Although assessments based on trials are not uniform, several assessments based on them, including those published in journals such as Lancet and New England Journal of Medicine, conclude that acupuncture is not effective. These trials, however, were mainly situated in the U.S., western European countries, and other WEIRD (Western, Educated, Industrialized, Rich, Democratic) countries. This is notable, because the population of China, the indigenous context of acupuncture, is greater than populations of WEIRD countries combined. Patients' expectations of a treatment such as acupuncture and their prior familiarity with it vary among contexts, and patients' experiences of treatment outcomes may vary accordingly. In short, although clinical trials constitute a test of truth in biomedicine and inform authoritative assessments in WEIRD countries, they do not necessarily represent the truth from the perspective of those experiencing outcomes of especially indigenous treatments for subjective symptoms in non-WEIRD contexts.

A brief discussion of Manual Therapy in the clinical Acupuncture for low back pain

A brief discussion of Manual Therapy in the clinical Acupuncture for low back pain

Clinical Studies of Bee Venom Acupuncture for Lower Back Pain in the Korean Literature.

This study aimed to identify all of the characteristics of bee venom acupuncture (BVA) for the treatment of lower back pain (LBP) that are described in the Korean literature, and to provide English-speaking researchers with bibliometrics. Six Korean electronic databases and sixteen Korean journals on BVA treatment for back pain were searched up to February 2022. This report included and analyzed 64 clinical studies on BVA interventions for back pain and 1297 patients with LBP. The most common disease in patients with back pain was lumbar herniated intervertebral discs (HIVD) of the lumbar spine (L-spine). All studies used bee venom (BV) diluted with distilled water. The concentration of BVA for HIVD of L-spine patients with LBP ranged from 0.01 to 5.0 mg/mL; the dosage per treatment was 0.02–2.0 mL, and for a total session was 0.3–40.0 mL. The most used outcome measure was the visual analogue scale for back pain (n = 45, 70.3%), and most of the papers reported that each outcome measure had a positive effect. Korean clinical studies were typically omitted from the review research, resulting in potential language bias. This study provides clinical cases in Korea for future development and standardization of BVA treatment for back pain.

Synopses of Cochrane Reviews from Cochrane Library Issue 12 2020 Through Issue 3 2021.

Synopses of Cochrane Reviews from Cochrane Library Issue 12 2020 Through Issue 3 2021.

Evaluating the Quality of Reports About Randomized Controlled Trials of Acupuncture for Low Back Pain.

ObjectiveThis study aims to improve the reporting quality of randomized controlled trials (RCTs) by evaluating RCTs of acupuncture for low back pain (LBP) based on the CONSORT and STRICTA statements.MethodsLiterature from the Cochrane Library, Medline, Embase, Ovid, China National Knowledge Infrastructure (CNKI), WanFang database, and Chongqing Weipu (VIP) was systematically searched from 2010 to 2020. The general characteristics and the overall quality score (OQS) of the literature were evaluated by two investigators. The agreement between investigators was calculated using Cohen’s kappa statistics.ResultsA total of 31 RCTs were extracted in the final analysis. Based on the CONSORT statement, the items “title and abstract”, “background and objectives”, “intervention”, “outcomes”, “statistical methods”, “baseline data”, “outcomes and estimation” and “interpretation” have a positive rate of greater than 80%. The items “implementation”, “generalizability” and “protocol” have a positive rate of less than 30%. Based on the STRICTA statement, the items “style of acupuncture”, “needle retention time”, “number of treatment sessions”, “frequency and duration of treatment” and “precise description of the control or comparator” have a positive rate of greater than 80%. The item “extent to which the treatment was varied” has a positive rate of less than 30%. The agreements among most items are determined to be moderate or good.ConclusionThe reporting quality of RCTs of acupuncture for LBP is moderate. Researchers should rigidly follow the CONSORT and STRICTA statements to enhance the quality of their studies.

Clinical Practice Guidelines of Acupuncture for Low Back Pain : A Comparison of those of the UK and USA

Clinical Practice Guidelines of Acupuncture for Low Back Pain : A Comparison of those of the UK and USA

Evaluating the Characteristics, Reporting and Methodological Quality of Systematic Reviews of Acupuncture for Low Back Pain by Using the Veritas Plot.

ObjectiveTo evaluate systematic reviews (SRs) of acupuncture for low back pain (LBP) in terms of characteristics, reporting and methodological quality using a Veritas plot and to explore factors that may be associated with methodological quality and reporting quality.Study Design and SettingWe searched 8 electronic bibliographic databases to find all SRs, and we evaluated the SRs’ quality in 6 dimensions, including publication year, design type, homogeneity, risk of publication bias, methodological quality by Assessment of Multiple Systematic Reviews (AMSTAR) 2 and reporting quality by Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Excel 2010 and Adobe Illustrator CC were used to draw and optimize Veritas plots. Exploratory analysis was done using SPSS software version 23.0 to explore factors related to AMSTAR-2 and PRISMA scores. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) evidence quality evaluation tool was used to grade all the outcome indicators in the included literature.ResultsWe included 19 SRs in the analysis. Literature quality rank scores ranged from 9.67 to 17.00, with an average score of 13.18 ± 2.35. The average score of AMSTAR-2 was 7.47, and the average score of PRISMA was 18.47. Overall, the main issues were research strategies, inclusion and exclusion criteria, publication bias, and registration in PROSPERO. The results of exploratory analysis showed that duplication of literature selected and appropriate tools to assess the risk of bias were related to the AMSTAR-2 score, and the summary of evidence was related to the PRISMA score. The GRADE quality evaluation results showed mainly low quality.ConclusionThe quality of SRs on acupuncture for low back pain should be improved, mainly by strengthening the methodological quality and reporting quality. The Veritas plot is an effective graphical evaluation method that is worth popularizing.

Current status of application of acupuncture in low back pain guidelines

To systematically review the current status of application of acupuncture in low back pain guidelines. The computer retrieval was conducted in PubMed, Cochrane Library, EMbase, China Journal Full Text Database (CNKI), China Biomedical Literature Database (CBM), VIP, Wanfang, guidelines databases, and the official websites of WHO and academic organizations (American Pain Society, American College of Physicians, etc.). After screening, the basic information and acupuncture-related issues in the guidelines that met the inclusion criteria were extracted and compared by using Excel software. A total of 35 low back pain guidelines were included. ① One guideline was published before 2000, 16 guidelines were published from 2000 to 2010, and 18 guidelines were published from 2011 to 2017; 17 guidelines were published by the United States, 4 by Canada and China, 2 by New Zealand, the United Kingdom, and Europe, and 1 by Netherlands, Philippines, Denmark and Italy. ② Twenty-three guidelines were evidence-based guidelines, which was developed mainly by system review, meta-analysis and expert consultation, involving diagnosis, treatment, primary care of low back pain. ③ Acupuncture was mentioned in 23 guidelines, of them, 7 guidelines recommended acupuncture, 6 guidelines indicated that acupuncture might be considered under certain conditions such as combined with other therapies or patients were interested in acupuncture, however, 10 guidelines did not recommended acupuncture for low back pain. The guidelines of low back pain are mainly developed by Europe countries and the United States, and the majority is published in the last 20 years. Among them, 20% of the guidelines have recommend acupuncture for low back pain.

Scoping review of systematic reviews of complementary medicine for musculoskeletal and mental health conditions

ObjectiveTo identify potentially effective complementary approaches for musculoskeletal (MSK)–mental health (MH) comorbidity, by synthesising evidence on effectiveness, cost-effectiveness and safety from systematic reviews (SRs).DesignScoping review of SRs.MethodsWe searched literature databases,...

Acupuncture and Neural Mechanism in the Management of Low Back Pain-An Update.

Within the last 10 years, the percentage of low back pain (LBP) prevalence increased by 18%. The management and high cost of LBP put a tremendous burden on the healthcare system. Many risk factors have been identified, such as lifestyle, trauma, degeneration, postural impairment, and occupational related factors; however, as high as 95% of the cases of LBP are non-specific. Currently, LBP is treated pharmacologically. Approximately 25 to 30% of the patients develop serious side effects, such as drowsiness and drug addiction. Spinal surgery often does not result in a massive improvement of pain relief. Therefore, complementary approaches are being integrated into the rehabilitation programs. These include chiropractic therapy, physiotherapy, massage, exercise, herbal medicine and acupuncture. Acupuncture for LBP is one of the most commonly used non-pharmacological pain-relieving techniques. This is due to its low adverse effects and cost-effectiveness. Currently, many randomized controlled trials and clinical research studies have produced promising results. In this article, the causes and incidence of LBP on global health care are reviewed. The importance of treatment by acupuncture is considered. The efforts to reveal the link between acupuncture points and anatomical features and the neurological mechanisms that lead to acupuncture-induced analgesic effect are reviewed.

Acupuncture Treatment in Patients with Low Back Pain

Low back pain is the most common medical problem and very commonly treated condition with acupuncture today. The pain can arise from muscles, tendons, ligaments, bones or intervertebral discs. The pain is usually in the lower back region, gluteal region with or without radiation in the legs, with muscle tension and stiffness, limited movement or sometimes tingling and burning sensation. In the term of Traditional Chinese Medicine (TCM), pain appears if there is no good Blood and Qi flow in the body. Pain caused by Qi stagnation usually appears due to strong emotional and mental changes and stress. In this research, we included 60 patients, 28 males and 32 females, on age from 18 to 88, all treated with acupuncture for low back pain. All patients were cured with certain number of treatments. Most of the patients needed less than 5 treatments. Treatments were made with normal and fire needle and combined. The best results were achieved with fire needle acupuncture treatment. In the treatment, we used local Ashi i.e. trigger points and meridian points: BL24 (QiHaiSu), BL25 (DaChangShu), BL26 (GuanYanShu), BL27 (XioChangShu), BL28 (PangGuangShu), GB30 (HuanTiao), BL40 (WeiZhong), BL57 (ChengShen), GB37 (GuanMing) and BL60 (KunKun). Acupuncture as a treatment for low back pain is a very effective treatment giving very satisfying and positive results in a short time of period. The percentage of cured patients (relieved of the symptoms) is 100% which is a clear indicator of the success of acupuncture in the treatment of low back pain.

Acupuncture and pregnancy: oriental medicine as an ally in the treatment of low back pain

Objective: to identify scientific evidence in the literature on the effect of acupuncture for the relief of low back pain during pregnancy. Methods: this is an integrative literature review. The bibliographic survey included articles indexed in the portal of six databases, using controlled keywords. Results: seven articles published in English were included. The studies using acupuncture for low back pain have been successful in reducing pain, as well as increased mobility, improved sleep, a sense of well-being, increased capacity for some physical activities and improved emotional reactions of pregnant women. Conclusion: acupuncture contributed to the reduction of low back pain in the pregnant women, among other benefits, contributing to the promotion of health in a pleasurable, simple, practical, risk-free, cheap and cost-effective way.

A Critical Look into the 2016 NICE Guidelines: Acupuncture for Low-Back Pain and Sciatica

Abstract Background: In November of 2016, the National Institute for Health and Care Excellence (NICE) Guidelines for low-back pain (LBP) and sciatica were published. According to the NICE Guidelines Development Group (GDG), acupuncture is no longer a recommended treatment for LBP and sciatica, while other therapies including nonsteroidal anti-inflammatory drugs, exercise, epidurals, and manual therapy are recommended as treatments. Objective: The aim of this article is to discuss how the GDG decision-making process behind the recommendations against acupuncture—while supporting common conventional treatments for LBP and sciatica—is inconsistent and lacks sufficient evidence-based justification. Methods: The evidence used to develop the 2016 NICE Guidelines for LBP and sciatica were critically appraised using the Grading of Recommendations, Assessment, Development, and Evaluation framework, and examined for their limitations. Results: There is predominantly moderate-quality evidence favoring acupuncture o...

Efektivitas Pemberian Terapi Akupunktur Dengan Kombinasi Titik Akupunktur BL-23 (Shenshu), BL-40 (Weizhong) Dan BL-23 (Shenshu), KI 3 (Taixi) Terhadap Perbaikan Keluhan Nyeri Pada Kasus Nyeri Punggung Bawah Di Posyandu Lansia Klodran Dan Bendo Colomadu

Abstract: Lower Back Pain (NPB) or Low Back Pain (LBP), VAS, Acupuncture Therapy, Healing Effect. Previous studies of acupuncture for low back pain were conducted. In this study, the researcher used a combination of BL 23. BL 40 and BL 23, KI 3. This study is aimed to determine the effectiveness of the combination of BL 23. BL 40 and BL 23, KI 3 for recovery low back pain. This study is done during March until May 2015 at Posyandu Lansia Klodran and Bendo Colomadu Karanganyar. This is a quasy experiment research with pre-test and post-test. Thirty subject studies were divided into two groups were treated combination of BL 23. BL 40 in the first group and BL 23, KI 3 in the second group. This treatment was conducted for 10 times. VAS was done before and after 10th therapy. The data obtained thus were analyzed using the Mann-Whitney test. Twenty-nine out of thirty subjects experienced decrease their VAS only one subject did not show any alteration. The average value of VAS decrease is 3.03. Acupuncture therapy with a combination of BL 23. BL 40 and BL 23, KI 3 has been shown that there are no differences between two groups (p&gt;0.05)

Acupuncture for low back pain in a professional footballer. A Case Report

Acupuncture for low back pain in a professional footballer. A Case Report

Non-specific Mechanisms in Orthodox and CAM management of back pain (MOCAM)

Introduction: Non-specific effects can have substantial effects on pain and disability. We have designed a major mixed-methods cohort study to investigate and compare non-specific components in physiotherapy, osteopathy, and acupuncture for low back pain (LBP). This project will extend current evidence by identifying the most powerful non-specific components, providing a deeper understanding of the pathways through which they generate positive patient outcomes. Aims: • Identify the most powerful non-specific treatment components (largest effect on patient outcomes) • Compare the magnitude of non-specific effects across orthodox and CAM therapies • Test which theoretically-derived mechanistic pathways explain their effects • Compare patient-practitioner interactions across the three therapies Methods: We will recruit 1548 adults with LBP attending acupuncturists, physiotherapists, and osteopaths in private and NHS clinics. A quantitative longitudinal questionnaire-based study will use multi-level modelling to test hypothesized relationships between non-specific components, key theoretically derived mediators and patient outcomes. A randomised sample of 63 consultations (21 per treatment) will be audio-recorded and analysed using the quantitative Roter Interactional Analysis System and inductive qualitative analysis, to identify treatment-enhancing communication practices. Conclusions: Evidence suggests that non-specific components are important for patient outcomes across diverse conditions including LBP. The context of CAM therapies may contribute to their effectiveness and CAMs might be particularly good at enhancing non-specific components. To better understand the role of non-specifics in the management of LBP we will study multiple non-specific factors simultaneously, comparing them within different treatments and relating the findings to pain theories, to understand to how they contribute to the consultation.