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Acupuncture Eases Low Back Pain


YORK, England -- Acupuncture is no panacea for the ravages of unspecified low back pain, but the needles can help a little over the long haul, according to researchers here.

YORK, England, Sept. 18 -- Acupuncture is no panacea for the ravages of unspecified low back pain, but the needles can help a little over the long haul, according to researchers here.

Patients with unspecified low back pain may get a little relief a year after completing a short course of acupuncture treatments, and still more from two years after being needled, Hugh MacPherson, Ph.D., of the University of York, and colleagues, reported in the online edition of BMJ.

Their two-year study was designed to help fill in the gaps on long-term data on the benefits of the ancient Chinese remedy. "For chronic low back pain there is evidence of short term pain relief and functional improvement using acupuncture compared with no treatment or sham therapy, but evidence for long term effectiveness is sparse," they wrote.

Their study was designed to see whether 10 acupuncture treatments spread over a three-month course could control low back over the ensuing years compared with standard treatment.

Practitioners in three private acupuncture clinics and 18 general medical practices in York took part. The investigators enrolled 241 patients ages 18 to 65 years with non-specific low-back pain lasting from one month to one year.

The patients were randomly assigned 10 sessions of acupuncture over three months (160 patients) or usual care (81 patients). Usual care consisted of one or more of the following: drugs, physiotherapy, manipulation, massage, transcutaneous electrical nerve stimulation, and back exercises.

The primary outcome was the score for bodily pain on SF-36, a validated health status questionnaire in which scores range from 0 to 100, with 100 representing no pain. Secondary outcomes were reported use of analgesics, scores on the Owestry pain disability index, safety, and patient satisfaction.

They found that at 12 months, the average SF-36 pain scores (on a scale of 0 to 100, 0 being the worst) increased by 33.2 points to 64.0 in the acupuncture group, and by 27.9 points to 58.3 in the control (standard treatment) group.

When the results were adjusted for baseline score and for clustering by acupuncturist, they estimated that the intervention effect of acupuncture was 5.6 points (95% confidence interval, ? 0.2 to 11.4 points) at 12 months, and 8.0 points (95% CI, 2.8 to 13.2 points) at 24 months.

"The magnitude of the difference between the groups was about 10% to 15% of the final pain score in the control group," the authors wrote. "Functional disability was not improved. No serious or life threatening events were reported."

They concluded that at 12 months the evidence for an effect of acupuncture on persistent nonspecific low back pain was weak, and that there was stronger evidence for a small benefit at 24 months.

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