Acupuncture in Patients With Chronic Low Back Pain

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JAMA Archives of Internal Medicine

Vol. 166 No. 4, February 27, 2006

 

Acupuncture in Patients With Chronic Low Back Pain

A Randomized Controlled Trial

<NOBR>Benno Brinkha; ; <NOBR>Claudia M. ; ; <NOBR>Susanne Jen; ; <NOBR>Klaus

L; ; <NOBR>Andrea Str; ; <NOBR>Stefan Wagen; ; <NOBR>Dominik Ir; ;

<NOBR>Heinz-Ulrich W; ; <NOBR>Dieter Melc; ; <NOBR>Stefan N. Willic

Arch Intern Med. 2006;166:450-457.

Background: Acupuncture is widely used by patients with low back pain,

although its effectiveness is unclear. We investigated the efficacy of

acupuncture compared with minimal acupuncture and with no acupuncture in

patients with

chronic low back pain.

Methods: Patients were randomized to treatment with acupuncture, minimal

acupuncture (superficial needling at nonacupuncture points), or a waiting list

control. Acupuncture and minimal acupuncture were administered by specialized

acupuncture physicians in 30 outpatient centers, and consisted of 12

sessions per patient over 8 weeks. Patients completed standardized

questionnaires

at baseline and at 8, 26, and 52 weeks after randomization. The primary

outcome variable was the change in low back pain intensity from baseline to the

end

of week 8, as determined on a visual analog scale (range, 0-100 mm).

Results: A total of 298 patients (67.8% female; mean ± SD age, 59 ± 9

years) were included. Between baseline and week 8, pain intensity decreased by

a

mean ± SD of 28.7 ± 30.3 mm in the acupuncture group, 23.6 ± 31.0 mm in the

minimal acupuncture group, and 6.9 ± 22.0 mm in the waiting list group. The

difference for the acupuncture vs minimal acupuncture group was 5.1 mm (95%

confidence interval, –3.7 to 13.9 mm; P = .26), and the difference for the

acupuncture vs waiting list group was 21.7 mm (95% confidence interval,

13.9-30.0 mm;

P<.001). Also, at 26 (P=.96) and 52 (P=.61) weeks, pain did not differ

significantly between the acupuncture and the minimal acupuncture groups.

Conclusion: Acupuncture was more effective in improving pain than no

acupuncture treatment in patients with chronic low back pain, whereas there

were no

significant differences between acupuncture and minimal acupuncture.

 

Author Affiliations: Institute of Social Medicine, Epidemiology, and Health

Economics (Drs Brinkhaus, Witt, Linde, and Willich and Ms Jena) and Center

for Musculo-skeletal Surgery (Dr Walther), Charité University Medical Center,

Berlin, Germany; Center for Complementary Medicine Research, Department of

Internal Medicine II (Drs Linde, Streng, and Melchart) and Institute of Medical

Statistics and Epidemiology (Dr Wagenpfeil), Technische Universität München,

Munich, Germany; Department of Anesthesiology, Ludwig Maximilians University,

Munich (Dr Irnich); and Division of Complementary Medicine, Department of

Internal Medicine, University Hospital Zurich, Zurich, Switzerland (Dr

Melchart).