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 2weeks' 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.

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A TDE/VDE ratio of 3 : 1 implies that the clinical indications for the points of any dermatome on the torso are similar, regardless of their meridians, and suggests that most of the indications for trunk points involve a 'horizontal pattern' due to their neurobiological nature. These findings may help in understanding acupuncture's neurobiology and clarify some confusing results of clinical research, for example, excluding sham acupuncture as an inert intervention for future clinical trials.

Background Recurrent infections within a particular, well-localised body location are often seen in veterinary and medical practice. This condition could represent a localised or segmental immune defi ciency. Recurrent canine otitis seems to be one example of this problem. It has been reported that acupuncture increased the effi cacy of conventional treatment for canine otitis by >50%. Objective To assess whether the relapse rate of recurrent canine otitis over 1 year can be modifi ed by acupuncture in adult dogs. Methods One-year follow-up of a randomised controlled trial. 31 dogs with a history of recurring otitis were randomised into two groups. In addition to conventional treatment, each group received four sessions of either real acupuncture, group A (n=16), or sham acupuncture, group B (n=15). The main outcome for the follow-up was the rate of acute otitis episodes in each group over 1 year, with blinded evaluation. A χ 2 test was used for statistical analysis. Results There was one dropout in each group. Fourteen (93%) dogs in group A: were free of otitis relapses, compared with 7 (50%) in group B (p<0.01). Conclusion Acupuncture seems effective for preventing relapses in cases of recurrent canine otitis. This result suggests that acupuncture could be tested as a treatment of other recurrent localised infections. Given the ability of acupuncture to modulate neurotransmitters and opioid peptides, which can in turn modulate the immune system, the immune response to acupuncture also seems worth exploring.