Effects of Trigger Point Acupuncture on Chronic Low Back Pain in Elderly Patients – a Sham-Controlled Randomised Trial

Abstract

Introduction There is some evidence for the efficacy of acupuncture, but it remains unclear whether trigger point acupuncture is effective. Our objective was to evaluate the effects of trigger point acupuncture on pain and quality of life in chronic low back pain patients compared with sham acupuncture. Methods Twenty-six consecutive out-patients (17 women, 9 men; age range: 65-91 years) from the Department of Orthopaedic Surgery, Meiji University of Oriental Medicine, with non-radiating low back pain for at least six months and normal neurological examination, were randomised to two groups. Each group received one phase of trigger point acupuncture and one of sham acupuncture with a three week washout period between them, over 12 weeks. Group A (n=13) received trigger point acupuncture in the first phase and sham acupuncture in the second. Group B (n=13) received the same interventions in the reverse order. Outcome measures were pain intensity (visual analogue scale, VAS) and Roland Morris Questionnaire. Results Nineteen patients were included in the analysis. At the end of the first treatment phase, group A receiving trigger point acupuncture scored significantly lower VAS (P<0.001) and Roland Morris Questionnaire scores (P<0.01) than the sham control group. There were significant within-group reductions in pain in both groups during the trigger point acupuncture phase but not in the sham treatment phase. However, the beneficial effects were not sustained. Conclusion These results suggest that trigger point acupuncture may have greater short term effects on low back pain in elderly patients than sham acupuncture.

Imperfect placebos are common in low back pain trials: a systematic review of the literature

“…For simplicity, each comparison was treated as an individual trial. Trials reported on the following categories of interventions: acupuncture (10 trials) [25,42,73,74,85,95,99,104,106,128], back school (2 trials) [11,28], behavioural (7 trials) [10,21,62,111,130,132,133], electrotherapy (20 trials) [8, 15, 25, 27, 37, 49-51, 54, 57, 63, 69, 76, 77, 89, 94, 107, 122, 137, 143], exercise (10 trials) [29,37,43,48,50,59,67,116,131,136], heatwrap therapy (2 trials) [109,110], insoles (1 trial) [127], magnets (1 trial) [33], massage (1 trial) [116], neuroreflexotherapy (1 trial) [93] [16,117,129]. Trial characteristics are presented in Table 1.…”

Effects of acupuncture on quality of life and pain in patients with osteoporosis—a pilot randomized controlled trial: reply to comments by Moran et al.

“…Thanks for this very helpful note, the faulty citation is very unpleasant for us and we would like to correct this herewith. The correct citations in the section BStatistical analysis^are the ones mentioned above by Inoue [3] and Itou [4].…”

“…In our paper, we present the original sample size calculation as done for the study protocol. This calculation of the number of cases is based on the work of Inoue [3] and Itou [4]. However, according to the pilot character of the study after the end of the intervention phase, we revised our strategy for data analyses based on the large number of measurements over time and the additional 3-month follow-up.…”

Acupuncture in the Treatment of Chronic Low Back Pain

“…Further complicating matters, it is unclear what type of methodology should constitute sham acupuncture. Many RCTs have administered to their sham treatment groups a form of minimal acupuncture, involving superficial needle insertion, sometimes at extrameridian sites; as Itoh and colleagues noted, 34 some schools of acupuncture use such techniques in their "real" acupuncture therapy, bringing into question whether any sort of penetrative needling technique could reasonably be considered a "sham. " Itoh et al advocated the use of non-penetrative needling as a sham but, at this time, it is unclear whether variations in sham technique significantly differ in their outcomes.…”