Can Acupuncture Improve Chronic Spinal Pain? A Systematic Review and Meta-Analysis

Abstract

Study Design: Systematic review and meta-analysis. Objective: To investigate the effect and safety of acupuncture for the treatment of chronic spinal pain. Methods: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, the WHO Clinical Trial Registry, and the US National Library of Medicine clinical trial registry were searched from January 1, 2000, to November 1, 2019. Randomized controlled trials (RCTs) involving patients with chronic spinal pain treated by acupuncture versus sham acupuncture, no treatment, or another treatment were included. Results: Data was extracted from 22 RCTs including 2588 patients. Pooled analysis revealed that acupuncture can reduce chronic spinal pain compared to sham acupuncture (weighted mean difference [WMD] −12.05, 95% confidence interval [CI] −15.86 to −8.24), mediation control (WMD −18.27, 95% CI −28.18 to −8.37), usual care control (WMD −9.57, 95% CI −13.48 to −9.44), and no treatment control (WMD −17.10, 95% CI −24.83 to −9.37). In terms of functional disability, acupuncture can improve physical function at immediate-term follow-up (standardized mean difference [SMD] −1.74, 95% CI −2.04 to −1.44), short-term follow-up (SMD −0.89, 95% CI −1.15 to −0.62), and long-term follow-up (SMD −1.25, 95% CI −1.48 to −1.03). Conclusion: In summary, compared to no treatment, sham acupuncture, or conventional therapy such as medication, massage, and physical exercise, acupuncture has a significantly superior effect on the reduction in chronic spinal pain and function improvement. Acupuncture might be an effective treatment for patients with chronic spinal pain and it is a safe therapy.

Needling Interventions for Sciatica: Choosing Methods Based on Neuropathic Pain Mechanisms—A Scoping Review

“…Using our inclusion criteria, no studies on dry needling were identified cluded studies (n = 10) used acupuncture for treatment of sciatica and are out bles 3 and 4. The inclusion criteria for patients with sciatica varied across the s studies included participants with sciatica symptoms and clinical findings tha with MRI or CT confirmation of lumbar disc herniation [22,[38][39][40][41]. Three stud patients with a clinical diagnosis of sciatica based on nerve root pain and re [24,42,43].…”

“…According to the most updated review, Huang et al reported that for patients with sciatica, acupuncture showed favorable reduction in pain intensity at immediate weeks) follow up (weighted mean difference (WMD) −11.94, 95% confidence interval (CI) −13.22 to −10.67, I 2 0%). In addition, significant reduction in pain was demonstrated at short-term (<3 months) (WMD −8.90, CI −17.28 to −0.52, I 2 84.4%), med-term (3–6 months) (WMD −17.80, CI −19.51 to −16.60, I 2 93.0%), and long-term (>6 months) (WMD −17.60, CI −19.23 to −15.97, I 2 0%) follow ups (moderate quality evidence) [ 40 ]. Included studies for sciatica all favored acupuncture for pain compared to physical therapy, electrotherapy, and sham acupuncture.…”

“…Within the selected randomized controlled trials, three used acupuncture exclusively [ 22 , 39 , 41 ] while one reported manual manipulation followed by electric needle stimulation [ 38 ]. Most reported the elicitation of de qi (needle sensation) and needle manipulations varied across studies between lift-thrust, twirling or a combination of both [ 22 , 39 , 40 ]. Needle retention time ranged from 5–45 min between included studies in the reviews and between 15–30 min in the randomized controlled trials.…”

“…In addition, significant reduction in pain was demonstrated at short-term (<3 months) (WMD −8. 90 [40]. Included studies for sciatica all favored acupuncture for pain compared to physical therapy, electrotherapy, and sham acupuncture.…”

Understanding Traditional Chinese Medicine Therapeutics: An Overview of the Basics and Clinical Applications

“…Low back pain (LBP) is one of the most frequently reported complaints. Several studies point to acupuncture’s effectiveness in treating chronic spinal pain, which, besides low back pain, includes cervical and sciatic pain [ 95 , 123 , 124 ]. In this field, Molsberger et al (2002) performed a large, methodologically rigorous double-blinded trial to assess two questions: Can acupuncture contribute as an adjunctive therapy to the conservative management of LBP?…”