Acupuncture in patients with acute low back pain: A... : PAIN (original) (raw)

Article

Acupuncture in patients with acute low back pain: A multicentre randomised controlled clinical trial

Vas, Jorgea,*; Aranda, José Manuelb; Modesto, Manuelaa; Benítez-Parejo, Nicolásc,d; Herrera, Antoniae; Martínez-Barquín, Dulce Maríaf; Aguilar, Inmaculadaa; Sánchez-Araujo, Maxg,h; Rivas-Ruiz, Franciscoc,d

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

a_Public Health System, Servicio Andaluz de Salud, Pain Treatment Unit, Doña Mercedes Primary Health Care Centre, Dos Hermanas, Spain_

b_Public Health System, Servicio Andaluz de Salud, San Andres Torcal Primary Health Care Centre, Málaga, Spain_

c_Support Research Unit, Costa del Sol Hospital, Marbella, Spain_

d_CIBER de Epidemiología y Salud Pública (CIBERESP), Spain_

e_Public Health System, Servicio Andaluz de Salud, Unidad de Gestión Clinica de Rehabilitación, Hospital Regional Universitario Carlos Haya, Málaga, Spain_

f_Public Health System, Servicio Andaluz de Salud, Unidad de Tratamiento del Dolor con Técnicas Neuroestimulativas, Colonia Santa Inés-Teatinos Primary Health Care Centre, Málaga, Spain_

g_Research Unit of Complementary Therapy, Universidad “Francisco de Miranda” Coro, Caracas, Venezuela_

h_Instituto de Investigación de Salud y Terapéutica (INSYT), Caracas, Venezuela_

*Corresponding author. Address: Pain Treatment Unit, Doña Mercedes Primary Health Care Centre, Cl. Segovia s/n. 41700, Dos Hermanas, Spain. Tel.: +34 954994850; fax: +34 954721500.

E-mail address:[email protected]

Abstract

Summary

Each of the acupuncture modalities (true, sham, and placebo) associated with conventional treatment achieved a clinical improvement after 3 weeks that was greater than that achieved by conventional treatment alone in patients with acute low back pain, although there were no significant differences among the different forms of stimulus.

Reviews of the efficacy of acupuncture as a treatment for acute low back pain have concluded that there is insufficient evidence for its efficacy and that more research is needed to evaluate it. A multicentre randomized controlled trial was conducted at 4 primary-care centres in Spain to evaluate the effects of acupuncture in patients with acute nonspecific low back pain in the context of primary care. A total of 275 patients with nonspecific acute low back pain (diagnosed by their general practitioner) were recruited and assigned randomly to 4 different groups: conventional treatment either alone or complemented by 5 sessions over a 2-week period of true acupuncture, sham acupuncture, or placebo acupuncture per patient. Patients were treated from February 2006 to January 2008. The primary outcome was the reduction in Roland Morris Disability Questionnaire scores of 35% or more after 2 weeks’ treatment. The patients in the 3 types of acupuncture groups were blinded to the treatments, but those who received conventional treatment alone were not. In the analysis adjusted for the total sample (true acupuncture relative risk 5.04, 95% confidence interval 2.24–11.32; sham acupuncture relative risk 5.02, 95% confidence interval 2.26–11.16; placebo acupuncture relative risk 2.57 95% confidence interval 1.21–5.46), as well as for the subsample of occupationally active patients, all 3 modalities of acupuncture were better than conventional treatment alone, but there was no difference among the 3 acupuncture modalities, which implies that true acupuncture is not better than sham or placebo acupuncture.