Effect and neurophysiological mechanism of acupuncture in patients with chronic sciatica: protocol for a randomized, patient-assessor blind, sham-controlled clinical trial

Abstract

BackgroundSciatica is a relatively frequent illness that easily becomes a chronic and relapsing condition. Although numerous systematic reviews have analyzed various therapies for sciatica, the validity of their included studies is limited. Considering the limitations of conventional treatment options for sciatica, acupuncture is a possible option; however, evidence supporting its efficacy and mechanism in patients with sciatica is lacking. The aim of this proposed protocol is to investigate the effect and neurophysiological mechanism of acupuncture in patients with chronic sciatica.Methods/designThis study is a randomized, patient-assessor blind, two-arm, parallel, non-penetrating, sham-controlled clinical trial. Eligible participants will include adults (aged 19–70 years old) with a clinical diagnosis of chronic sciatica (40 mm or more of a 100-mm visual analog scale (VAS) for bothersomeness) blinded to the treatment received. Patients will be randomly allocated into the acupuncture treatment group (manual acupuncture plus electroacupuncture (EA), n = 34) or the sham acupuncture control group (sham acupuncture plus placebo EA without electrical stimulation, n = 34). Groups will receive treatment twice a week for a total of eight sessions over 4 weeks. Functional magnetic resonance imaging will be implemented at baseline and endpoint to investigate the mechanism of acupuncture. The primary outcome measure is the VAS for bothersomeness and secondary outcomes include the VAS for pain intensity, Oswestry Disability Index, EuroQol 5-Dimension, Coping Strategy Questionnaire, Beck’s Depression Inventory, and State-Trait Anxiety Inventory. Adverse events will be assessed at every visit.DiscussionThe results of this trial (which will be available in 2020) should provide important clinical evidence for the effect of acupuncture and demonstrate how acupuncture can be helpful for the treatment of chronic sciatica.Trial registrationClinicalTrials.gov, ID: NCT03350789. Registered on 15 November 2017.Electronic supplementary materialThe online version of this article (10.1186/s13063-018-3164-8) contains supplementary material, which is available to authorized users.

Acupuncture alleviates chronic pain and comorbid conditions in a mouse model of neuropathic pain: the involvement of DNA methylation in the prefrontal cortex

“… 17 , 57 These acupoints were selected by a process of consensus with doctors of Korea medicine who all specialized in Rehabilitation Medicine of Korean Medicine on the basis of a literature review regarding acupuncture for low back pain and sciatica. 31 For the acupuncture treatments, mice were mildly immobilized, and a sterilized acupuncture needle (8 mm in length and 0.18 mm in diameter; Haenglim-seoweon Acuneedle Co, Gyeonggi-Do, South Korea) was inserted bilaterally to a depth of 3 mm and turned bidirectionally for 30 seconds (twice per second; one 180° clockwise rotation and one 180° counterclockwise rotation) using the fingers. Using hematoxylin and eosin staining, we observed that there were needle tracts around the acupunctured sites regardless of acupoint but no tissue damage and/or inflammatory response (data not shown).…”

Trends of Acupuncture Therapy on Depression From 2011 to 2020: A Bibliometric Analysis

“…These subclasses have both common and divergent acupoints (Kim et al, 2020). A randomized controlled trial, a coping strategy, a questionnaire, Beck's depression inventory, and the State-Trait Anxiety Inventory were used to evaluate the therapeutic effects of acupuncture on chronic sciatica (Kim et al, 2019). In another randomized controlled trial, the feasibility and efficacy of acupuncture for atopic dermatitis (including pruritus) were evaluated using instruments including the Center for Epidemiologic Studies Depression Scale (Kang et al, 2018).…”

Using acupuncture and electroacupuncture in the treatment of laminitis in racing horses: a comparative study

“…The neurophysiological mechanisms of acupuncture analgesia have been recorded and included: opiate and nonopiate pain modulation, hippocampal nitric oxide synthase activity, and the expression of various mediators of neurologic inflammation have been documented as well. (10).…”