Comparison of the Effectiveness of Acupuncture Treatment and Local Anaesthetic Injection for Low Back Pain: A Randomised Controlled Clinical Trial

Abstract

Objective: To compare the effectiveness of repeated acupuncture stimulation and local anaesthetic injection at the most painful points in patients with low back pain.

The Immediate Analgesic Effect of Acupuncture for Pain: A Systematic Review and Meta‐Analysis

“…For all of the eligible RCTs, the participants were required to have been diagnosed with disease-related pain for eligibility. Of the 13 RCTs, 4 investigated LBP [ 31 , 32 , 38 , 40 ], and the remaining 9 investigated neck pain [ 35 ], neck and shoulder pain [ 37 ], carpal tunnel syndrome (CTS) [ 36 ], knee osteoarthritis [ 34 ], fibromyalgia [ 39 ], dysmenorrhea [ 33 ], sore throat [ 41 ], renal colic [ 30 ], and migraine [ 42 ]. The RCTs included in this review used either the VAS or NRS to measure pain outcomes.…”

“…While 8 RCTs [ 30 , 33 , 36 , 38 – 42 ] used acupoints based on the traditional Chinese medicine theory of meridians and collaterals, 4 [ 31 , 32 , 35 , 37 ] used tender points near the most painful areas, and 1 [ 40 ] used points based on another acupuncture theory (i.e., the wrist-ankle acupuncture method). Electroacupuncture was administered in 5 RCTs [ 30 , 33 , 34 , 36 , 42 ] and manual acupuncture in 8 RCTs [ 31 , 32 , 35 , 37 – 41 ]. Of the 9 RCTs that had used sham acupuncture as a control, 4 had used nonpenetrating sham [ 31 , 36 , 37 , 40 ] and 5 had used penetrating sham [ 33 , 34 , 39 , 41 , 42 ].…”

“…Of the 9 RCTs that had used sham acupuncture as a control, 4 had used nonpenetrating sham [ 31 , 36 , 37 , 40 ] and 5 had used penetrating sham [ 33 , 34 , 39 , 41 , 42 ]. Of the 3 RCTs that had used analgesic injection as a control, 2 [ 30 , 38 ] had administered intramuscular analgesic injections and 1 [ 32 ] had administered a local anesthetic injection. One of the included RCTs [ 36 ] compared the effects of acupuncture at distal and local points and sham acupuncture; we, therefore, combined the results of the two real acupuncture groups to create a single pairwise comparison.…”

“…Neither of the trials had reported the exact treatment durations, while the rest of the trials included in this review had. While the acupuncturists in 10 of the trials [ 32 – 38 , 40 – 42 ] were judged as having adequate experience, we were unclear about the experience of the acupuncturists in the remaining 3 trials [ 30 , 31 , 39 ] owing to that fact that there is no description of the experience of acupuncturists in these studies. The assessors of acupuncture adequacy in this review were successfully blinded to all included publications and were unable to distinguish the origins of the results included.…”

“…The RCTs by Lu et al and Maeda et al claimed to have randomly assigned the participants but did not describe their methods in detail [ 34 , 36 ]. Nearly half (6/13) of the included trials did not mention allocation concealment [ 30 , 32 , 34 , 36 , 37 , 41 ] and were, therefore, assessed as having unclear risk of bias in this dimension. The remaining 7 trials were assessed as having a low risk of bias on allocation concealment.…”