Is needle placement or skin penetration important in bringing out the benefits from acupuncture in patients with low back pain?

From: Archives of Internal Medicine

Journal rating:
rating: 99%
Study Quality:
rating: 85%
%

Overall Reliability

Article Quality:
rating: 80%
Partcipants
rating: 25%

Participants/situation

  • 638 adults with chronic mechanical low back pain

Study

  • Patients were randomised to individualised acupuncture, standardised acupuncture, simulated acupuncture, or usual care.
  • Ten treatments were provided over 7 weeks by experienced acupuncturists.  

Results

  • Participants receiving real or simulated acupuncture were more likely than those receiving usual care to experience clinically meaningful improvements on the dysfunction scale (60% vs 39%)
  • After 1 year, participants in the treatment groups were more likely than those receiving usual care to experience clinically meaningful improvements in dysfunction (59% to 65% vs 50%, respectively) but not in symptoms.
  • Although acupuncture was found effective for chronic low back pain, tailoring needling sites to each patient and penetration of the skin appear to be unimportant in providing therapeutic benefits. 

Answer

  • No (with confidence)

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Editors Notes

  • These findings raise questions about acupuncture’s purported mechanisms of action. It remains unclear whether acupuncture or our simulated method of acupuncture provide physiologically important stimulation or represent placebo or nonspecific effects.

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