Six months of acupuncture treatment may be more effective than conventional therapy in treating low back pain, according to a study in a recent issue of Archives of Internal Medicine. The study also suggested that both sham acupuncture and traditional Chinese verum acupuncture appear to be effective in treating low back pain.
Michael Haake, PhD, MD, of the University of Regensburg, Bad Abbach, Germany, and colleagues conducted a randomized clinical trial involving 1,162 patients (average age 50) who had experienced chronic low back pain for an average of 8 years. Patients underwent ten 30-minute sessions (approximately two sessions per week) of verum acupuncture (387 patients), sham acupuncture (387 patients) or conventional therapy (388 patients). Verum acupuncture consisted of needling fixed points and additional points to a depth of 5 mm to 40 mm based on traditional Chinese medicine, while sham acupuncture consisted of inserting needles superficially (1 millimeter to 3 millimeters) into the lower back avoiding all known verum points or meridians. Conventional therapy consisted of a combination of medication, physical therapy and exercise. Five additional sessions were offered to those who had a partial response to treatment (10% to 50% pain reduction).
According to the authors, a total of 13,475 treatment sessions were conducted — verum acupuncture, 4,821; sham acupuncture, 4,590; and conventional therapy, 4,064. Patients receiving the additional five sessions were 232 (59.9%) in the verum group, 209 (54.3%) in the sham group and 192 (52.5%) in the conventional group.
Response rate was defined as a 33% improvement in pain or a 12% improvement in functional ability. The trial results at 6 months indicated a response rate of 47.6% in the verum acupuncture group, 44.2% in the sham acupuncture group and 27.4% in the conventional therapy group. The authors further noted that differences among groups were as follows: verum vs. sham, 3.4%; verum vs. conventional therapy, 20.2%; and sham vs. conventional therapy, 16.8%.
“The superiority of both forms of acupuncture suggests a common underlying mechanism that may act on pain generation, transmission of pain signals or processing of pain signals by the central nervous system and that is stronger than the action mechanism of conventional therapy,” the authors concluded. “Acupuncture gives physicians a promising and effective treatment option for chronic low back pain, with few adverse effects or contraindications. The improvements in all primary and secondary outcome measures were significant and lasted long after completion of treatment.”