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META ANALYSIS: ACUPUNCTURE FOR LOW BACK PAIN
Background: Health professionals frequently use acupuncture in the treatment for low back pain but research to document its efficacy requires analysis.
Research question/s: Does acupuncture decrease pain in patients suffering from low back pain?
Methodology:Experimental procedure: 33 randomised, controlled trials that met inclusion criteria (comparing needle acupuncture with sham acupuncture, other sham treatments, no additional treatment, or another active treatment for patients with low back pain) were identified. Trials were sub-grouped according to acute or chronic pain, style of acupuncture, and type of control group used.
Measures of outcome: Pain, functional status, overall improvement, return to work, and analgesic consumption.
Chronic low back pain: pain relief in the acupuncture groups was significantly more effective than sham treatment (standardised mean difference, 0.54 (95% CI 0.35 to 0.73); 7 trials) and no additional treatment (standardised mean difference, 0.69 (CI 0.40 to 0.98); 8 trials).
Acute low back pain: there are insufficient data and findings are therefore inconclusive.
Conclusion/s: In a meta analysis of 33 randomised clinical trials, acupuncture has been shown to effectively relieve chronic low back pain, but there is no evidence that acupuncture is more effective than other active therapies (medication and TENS).
Evidence based rating: 9/10
Clinical interest rating: 8/10
Type of study: Meta analysis
Methodological considerations: Well conducted study, no longer-term follow up studies available …
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