Acupuncture treatment of chronic back pain

Mendelson, George; Selwood, Thomas S.; Kranz, H; Loh, T; Kidson, M. A.; Scott, David

doi:10.1016/0002-9343(83)91117-8

Cited by 128 publications

(21 citation statements)

References 28 publications

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“…Acupuncture has been reported to be effective in numerous non-blinded [10,11] and sham-controlled trials [12][13][14], whereas others report no benefit [15][16][17][18][19][20][21]. Our recent study in anaesthetised volunteers constitutes the first fully double-blinded trial demonstrating acupuncture-induced analgesia [1].…”

Section: Discussionmentioning

confidence: 86%

The effect of auricular acupuncture on anaesthesia with desflurane

et al. 2002

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SummaryIn most acupuncture studies it is difficult or even impossible to conduct a truly double-blind trial. However, this is possible when treatments are carried out on anaesthetised patients. Because acupuncture provides analgesia, we tested the hypothesis that needle stimulation of a combination of four ear acupoints would significantly reduce anaesthetic requirement. Ten healthy volunteers were anaesthetised with desflurane and randomly assigned to no treatment or acupuncture; the alternative treatment was given on a subsequent study day. Auricular acupuncture was performed with needles placed at the Shen Men, Thalamus, Tranquiliser and Master Cerebral Points on the right ear. Anaesthetic requirement, determined by the Dixon up-and-down method, was defined by the average desflurane concentration that prevented purposeful movement of the extremities in response to noxious electrical stimulation. Volunteers required a greater desflurane concentration to prevent movement on the control than on the acupuncture day: 4.9 (0.7; SD) vs. 4.4 (0.8) -vol. %, p ¼ 0.003. Acupuncture thus reduced anaesthetic requirement by 8.5 (7)%.

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Section: Discussionmentioning

confidence: 86%

The effect of auricular acupuncture on anaesthesia with desflurane

et al. 2002

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“…For subjects with acute/subacute nonspecific LBP, acupuncture did not significantly differ from placebo on pain or disability outcomes [31, 53]. In a meta-analysis (Figure 4) of subjects with chronic nonspecific LBP, acupuncture compared to placebo led to statistically significantly lower pain intensity, but only for the immediate-posttreatment followup (10 trials; pooled VAS: −0.59, 95% CI: −0.93, −0.25) [51, 55, 56, 58, 59, 61–65, 67]. The mean pain intensity scores in the acupuncture and placebo groups were not significantly different at short- [51, 55, 56, 58] intermediate-[51, 54, 58], and long-term [51, 54, 63, 67] followups.…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of Efficacy, Cost-Effectiveness, and Safety of Selected Complementary and Alternative Medicine for Neck and Low-Back Pain

Furlan

Yazdi

Tsertsvadze

et al. 2012

Evidence-Based Complementary and Alternative Medicine

214

184

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Background. Back pain is a common problem and a major cause of disability and health care utilization. Purpose. To evaluate the efficacy, harms, and costs of the most common CAM treatments (acupuncture, massage, spinal manipulation, and mobilization) for neck/low-back pain. Data Sources. Records without language restriction from various databases up to February 2010. Data Extraction. The efficacy outcomes of interest were pain intensity and disability. Data Synthesis. Reports of 147 randomized trials and 5 nonrandomized studies were included. CAM treatments were more effective in reducing pain and disability compared to no treatment, physical therapy (exercise and/or electrotherapy) or usual care immediately or at short-term follow-up. Trials that applied sham-acupuncture tended towards statistically nonsignificant results. In several studies, acupuncture caused bleeding on the site of application, and manipulation and massage caused pain episodes of mild and transient nature. Conclusions. CAM treatments were significantly more efficacious than no treatment, placebo, physical therapy, or usual care in reducing pain immediately or at short-term after treatment. CAM therapies did not significantly reduce disability compared to sham. None of the CAM treatments was shown systematically as superior to one another. More efforts are needed to improve the conduct and reporting of studies of CAM treatments.

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“…After reviewing the full text of 26 articles, seven RCTs were found to fulfil the inclusion criteria [11, 40, 42, 43, 60, 64, 78], one of which is included with another intervention (SMT) and also represents the long-term follow-up of an earlier study included in the Cochrane review [60]. Of the 35 RCTs included in the Cochrane review [31], 15 publications representing 14 RCTs fulfilled the inclusion criteria [15, 22, 24, 33, 34, 36, 38, 46, 49, 50, 53, 57, 58, 67, 79]. Multiple publications were identified for Brinkhaus et al [9–11], Haake et al [39, 40], Mendelson et al [56, 57] and Muller and Giles [33, 34, 60] which represent protocols and preliminary or earlier findings.…”

Section: Resultsmentioning

confidence: 99%

“…In total, 35 RCTs (8 SMT [16, 26, 35, 37, 52, 59, 60, 77], 20 acupuncture [11, 15, 22, 24, 36, 38, 40, 42, 43, 46, 49, 50, 53, 57, 58, 60, 64, 67, 78, 79], 7 herbal medicine [17–21, 27, 45]) fulfilled the inclusion criteria.…”

Section: Resultsmentioning

confidence: 99%

A systematic review on the effectiveness of complementary and alternative medicine for chronic non-specific low-back pain

et al. 2010

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The purpose of this systematic review was to assess the effects of spinal manipulative therapy (SMT), acupuncture and herbal medicine for chronic non-specific LBP. A comprehensive search was conducted by an experienced librarian from the Cochrane Back Review Group (CBRG) in multiple databases up to December 22, 2008. Randomised controlled trials (RCTs) of adults with chronic non-specific LBP, which evaluated at least one clinically relevant, patient-centred outcome measure were included. Two authors working independently from one another assessed the risk of bias using the criteria recommended by the CBRG and extracted the data. The data were pooled when clinically homogeneous and statistically possible or were otherwise qualitatively described. GRADE was used to determine the quality of the evidence. In total, 35 RCTs (8 SMT, 20 acupuncture, 7 herbal medicine), which examined 8,298 patients, fulfilled the inclusion criteria. Approximately half of these (2 SMT, 8 acupuncture, 7 herbal medicine) were thought to have a low risk of bias. In general, the pooled effects for the studied interventions demonstrated short-term relief or improvement only. The lack of studies with a low-risk of bias, especially in regard to SMT precludes any strong conclusions; however, the principal findings, which are based upon low- to very-low-quality evidence, suggest that SMT does not provide a more clinically beneficial effect compared with sham, passive modalities or any other intervention for treatment of chronic low-back pain. There is evidence, however, that acupuncture provides a short-term clinically relevant effect when compared with a waiting list control or when acupuncture is added to another intervention. Although there are some good results for individual herbal medicines in short-term individual trials, the lack of homogeneity across studies did not allow for a pooled estimate of the effect. In general, these results are in agreement with other recent systematic reviews on SMT, but in contrast with others. These results are also in agreement with recent reviews on acupuncture and herbal medicine. Randomized trials with a low risk of bias and adequate sample sizes are direly needed.Electronic supplementary materialThe online version of this article (doi:10.1007/s00586-010-1356-3) contains supplementary material, which is available to authorized users.

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Acupuncture treatment of chronic back pain

Cited by 128 publications

References 28 publications

The effect of auricular acupuncture on anaesthesia with desflurane

The effect of auricular acupuncture on anaesthesia with desflurane

A Systematic Review and Meta-Analysis of Efficacy, Cost-Effectiveness, and Safety of Selected Complementary and Alternative Medicine for Neck and Low-Back Pain

A systematic review on the effectiveness of complementary and alternative medicine for chronic non-specific low-back pain

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