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ACUPUNCTURE FOR CHRONIC LOW BACK PAIN IN OLDER PATIENTS: A RANDOMISED, CONTROLLED TRIAL

Background: Although acupuncture has been used in the treatment of low back pain (LBP) there is inconclusive data on the beneficial effects of acupuncture for back pain, particularly in elderly patients.

Research question/s: Is acupuncture an effective and safe adjunctive treatment to standard therapy for chronic LBP in older patients?

Methodology:Subjects: 55 subjects (LBP > 12 wks, age > 60 yrs) (no tumour, infection, fracture or neurological symptoms).

Experimental procedure: 47/55 subjects completing the trial were randomised to a control group (CON  =  23) receiving usual care (NSAIDs, muscle relaxants, paracetamol and back exercises) and an acupuncture group (ACU  =  24) receiving usual care (as CON group) and acupuncture with electrical stimulation 2/week for 5 weeks. The Roland Disability Questionnaire (RDQ) was administered at 0, 2, 6, and 9 weeks.

Measures of outcome: Mean RDQ score, pain (VAS), global transition score (GTS), side effects (frequency).

Main finding/s:


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RDQ score: There was a significant decrease in the RDQ score at week 6 in the ACU group (4.1 ± 3.9) compared with the CON group (0.7 ± 2.8) (p  =  0.001). After 4 weeks of stopping treatment, this effect was maintained (ACU score 3.5 ± 4.4 from baseline, CON  =  0.43 ± 2.7) (p  =  0.007).

Global transition score: The GTS was higher in the ACU group (3.7 ± 1.2) than the CON group (2.5 ± 0.9) (p < 0.001), indicating greater improvement in the ACU group.

Side effects: Fewer subjects in the ACU vs the CON group had medication related side effects.

Conclusion/s: Bi-weekly treatment with acupuncture for 5 weeks added to usual treatment is safe and effective (reduced pain and improved function) in elderly patients with LBP.

Evidence based rating: 7/10

Clinical interest rating: 6.5/10

Type of study: Randomised controlled clinical trial

Methodological considerations: Generally well conducted, no placebo …

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