Systematic review and meta-analysis of effects of acupuncture on pain and function in non-specific low back pain

Abstract

Objective: To assess the effectiveness of acupuncture for non-specific low back pain (NSLBP) through systematic review of published randomised controlled trials (RCTs). Methods: Studies were identified in electronic databases from their inception to February 2018, and were grouped according to the control interventions. The outcomes of interest were pain intensity and disability. Methodological quality was evaluated using the Cochrane risk-of-bias criteria and the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) checklist. The review was reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results: 25 trials (n=7587 participants) were identified and included in a meta-analysis. The results showed that acupuncture was more effective at inducing pain relief than: no treatment (standardised mean difference (SMD) −0.69, 95% CI −0.99 to −0.38); sham acupuncture in the immediate term (SMD −0.33, 95% CI −0.49 to −0.18), short term (SMD −0.47, 95% CI −0.77 to −0.17), and intermediate term (SMD −0.17, 95% CI −0.28 to −0.05); and usual care in the short term (SMD −1.07, 95% CI −1.81 to −0.33) and intermediate term (SMD −0.43, 95% CI −0.77 to −0.10). Also, adjunctive acupuncture with usual care was more effective than usual care alone at all time points studied. With regard to functional improvement, the analysis showed a significant difference between acupuncture and no treatment (SMD −0.94, 95% CI −1.57 to −0.30), whereas the other control therapies could not be assessed. Conclusion: We draw a cautious conclusion that acupuncture appears to be effective for NSLBP and that acupuncture may be an important supplement to usual care in the management of NSLBP.

Acupuncture in chronic aspecific low back pain: a Bayesian network meta-analysis

“…These results are consistent with previous studies [ 10 , 11 ], which observed a superiority of acupuncture compared to sham treatment [ 57 , 58 ]. A meta-analysis by Amaral et al observed only moderate-quality evidence in favor of acupuncture treatment for LBP; however, this study focused only on trigger point acupuncture in the geriatric population, and the results are not directly comparable with those of the present cohort [ 9 ].…”

“…As the number of patients with chronic aspecific LBP increases, so does the demand for safe and effective therapies. Among these, acupuncture has been widely investigated in recent times as possible options, proving to be a safe and effective therapy for chronic aspecific LBP [ 9 – 11 ]. Many different acupuncture protocols have been proposed for the management of chronic aspecific LBP.…”

Acupuncture for Pain and Function in Patients with Nonspecific Low Back Pain: Study Protocol for an Up-to-Date Systematic Review and Meta-Analysis

“…In our previous study, 17 we assessed the effects of acupuncture for NSLBP on the outcomes of pain and function and found that, for pain relief, acupuncture comes out to be prior to no treatment, sham acupuncture, and usual care in the short-term and intermediate-term, but for functional improvement, we found it difficult to draw a credible conclusion due to limited data. After this first systematic review in 2018, several studies of acupuncture for NSLBP have been published, and these will maybe provide new evidence for the effect of acupuncture on NSLBP.…”

Effects of acupuncture and pelvic floor muscle training on bladder dysfunction after spinal cord injury: A meta-analysis

“…[1] Complications such as urinary tract infection, urinary calculi, hydronephrosis, and even renal failure are the main causes of death in patients with SCI in the middle and late stages. [2] This seriously endangers the health and quality of life of patients. Acupuncture, as a traditional Chinese medicine technique that can stimulate healthy qi and regulate oneself, plays a bidirectional, benign and holistic regulating effect of excitation and inhibition on central and peripheral nerve injury, so as to promote organ function recovery.…”