Review: Acupuncture is effective in the treatment of acute low back pain
Su, X., Qian, H., Chen, B., Fan, W., Xu, D., Tang, C., & Lu, L. (2021). Acupuncture for acute low back pain: a systematic review and meta-analysis. Annals of palliative medicine, 10(4), 3924–3936.
https://doi.org/10.21037/apm-20-1998
QUESTION
Is acupuncture effective in the treatment of acute low back pain?
DATA SOURCES
Studies were identified by searching the Allied and Complementary Medicine Database (AMED), the Cochrane Central Register of Controlled Trials, Embase, Medline, the China National Knowledge Infrastructure database (CNKI), the Wanfang database, and the Chinese Science and Technology Periodicals database (VIP) (up to May, 2020).
STUDY SELECTION
Randomized controlled trials (RCTs) concerning acupuncture for treating acute (≤12 weeks) low back pain of participants aged ≥18 years were included, while conference papers, systematic reviews, case reports, research protocols, and experimental animal studies, studies with incomplete data were excluded (Fig 1).
DATA EXTRACTION
Two authors independently screened the studies and extracted data. Risk of bias was independently assessed using the Cochrane tool and the consistency evaluation of risk of bias assessment was examined using the kappa coefficient. Statistical analysis was performed using Review Manager version 5.3.
MAIN RESULTS
Meta-analysis showed moderate-quality evidence that acupuncture has a statistically significant association with improvements in VAS, ODI, and NOP, but not RMDQ.
CONCLUSION
Acupuncture is effective in the treatment of acute low back pain.
COMMENTARY
Authors identified 13 RCTs that address the question (Table 1). Sample size ranged from 20 to 71. Interventions in the treatment group included manual acupuncture, electroacupuncture, beryllium acupuncture, wrist-ankle acupuncture, Fu’s acupuncture, and Yamamoto’s acupuncture. The interventions in the control group were sham acupuncture and pharmacotherapy. The primary outcome included the visual analogue scale (VAS) and the secondary outcomes included the Roland-Morris Disability Questionnaire (RMDQ), the Oswestry Disability Index (ODI), and numbers of pills (NOP). Among the 13 studies, 5 were rated as high quality and 8 as low quality.
The result of 11 studies showed that the acupuncture group had a greater improvement in VAS than the control group (Fig 4).
