Acupuncture treatment of chronic low-back pain – a randomized, blinded, placebo-controlled trial with 9-month follow-up

Objective: To compare the effectiveness of an integrated rehabilitation programme with an existing rehabilitation programme in patients with chronic low back pain. Design: A single-centre, pragmatic, two-arm parallel, randomized controlled trial (1:1 ratio). Setting: A rheumatology inpatient rehabilitation centre in Denmark. Subjects: A total of 165 adults (aged ⩾ 18 years) with chronic low back pain. Interventions: An integrated rehabilitation programme comprising an alternation of three weeks of inpatient stay and 12 weeks of home-based activities was compared with an existing rehabilitation programme of four weeks of inpatient stay. Main measures: Patient-reported outcomes were collected at baseline and at the 26-week follow-up. The primary outcome was back-specific disability (Oswestry Disability Index). Secondary outcomes included pain intensity (Numerical Rating Scale), pain self-efficacy (Pain Self-Efficacy Questionnaire), health-related quality of life (EuroQol-5 Domain 5-level (EQ-5D)), and depression (Major Depression Inventory). A complete case analysis was performed. Results: A total of 303 patients were assessed for eligibility of whom 165 (mean age: 50 years (SD 13) and mean Oswestry Disability Index score 42 (SD 11)) were randomized (83 to existing rehabilitation programme and 82 to integrated rehabilitation programme). Overall, 139 patients provided the 26-week follow-up data. Baseline demographic and clinical characteristics were comparable between programmes. The between-group difference in the Oswestry Disability Index score when adjusting for the corresponding baseline score was −0.28 (95% confidence interval (CI): −4.02, 3.45) which was neither statistically nor clinically significant. No significant differences were found in the secondary outcomes. Conclusion: An integrated rehabilitation programme was no more effective than an existing rehabilitation programme at the 26-week follow-up.

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Effect of trigger point acupuncture treatment in older patients with chronic low back pain: randomized controlled trial

Zen Nihon Shinkyu Gakkai zasshi (Journal of the Japan Society of Acupuncture and Moxibustion) ◽

10.3777/jjsam.59.13 ◽

2009 ◽

Vol 59 (1) ◽

pp. 13-21 ◽

Cited By ~ 1

Author(s):

Satoko ITOH ◽

Kazunori ITOH ◽

Yasukazu KATSUMI

Keyword(s):

Randomized Controlled Trial ◽

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Older Patients ◽

Acupuncture Treatment ◽

Trigger Point ◽

Controlled Trial ◽

Low Back ◽

Randomized Controlled

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Three-month follow-up results of a double-blind, randomized placebo-controlled trial of 8-week self-administered at-home behavioral skills-based virtual reality (VR) for chronic low back pain

Journal of Pain ◽

10.1016/j.jpain.2021.12.002 ◽

2021 ◽

Author(s):

Laura M. Garcia ◽

Brandon J. Birckhead ◽

Parthasarathy Krishnamurthy ◽

Ian Mackey ◽

Josh Sackman ◽

...

Keyword(s):

Virtual Reality ◽

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Controlled Trial ◽

Low Back ◽

Double Blind ◽

Behavioral Skills ◽

At Home

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Reducing sedentary behaviour to decrease chronic low back pain: the stand back randomised trial

Occupational and Environmental Medicine ◽

10.1136/oemed-2017-104732 ◽

2018 ◽

Vol 75 (5) ◽

pp. 321-327 ◽

Cited By ~ 16

Author(s):

Bethany Barone Gibbs ◽

Andrea L Hergenroeder ◽

Sophy J Perdomo ◽

Robert J Kowalsky ◽

Anthony Delitto ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Sedentary Behaviour ◽

Chronic Low Back Pain ◽

Controlled Trial ◽

Randomised Trial ◽

Sitting Time ◽

Self Management ◽

Low Back

ObjectiveThe Stand Back study evaluated the feasibility and effects of a multicomponent intervention targeting reduced prolonged sitting and pain self-management in desk workers with chronic low back pain (LBP).MethodsThis randomised controlled trial recruited 27 individuals with chronic LBP, Oswestry Disability Index (ODI) >10% and desk jobs (sitting ≥20 hours/week). Participants were randomised within strata of ODI (>10%–<20%, ≥20%) to receive bimonthly behavioural counselling (in-person and telephone), a sit-stand desk attachment, a wrist-worn activity-prompting device and cognitive behavioural therapy for LBP self-management or control. Self-reported work sitting time, visual analogue scales (VAS) for LBP and the ODI were assessed by monthly, online questionnaires and compared across intervention groups using linear mixed models.ResultsBaseline mean (SD) age was 52 (11) years, 78% were women, and ODI was 24.1 (10.5)%. Across the 6-month follow-up in models adjusted for baseline value, work sitting time was 1.5 hour/day (P<0.001) lower comparing intervention to controls. Also across follow-up, ODI was on average 8 points lower in intervention versus control (P=0.001). At 6 months, the relative decrease in ODI from baseline was 50% in intervention and 14% in control (P=0.042). LBP from VAS was not significantly reduced in intervention versus control, though small-to-moderate effect sizes favouring the intervention were observed (Cohen’s d ranged from 0.22 to 0.42).ConclusionAn intervention coupling behavioural counselling targeting reduced sedentary behaviour and pain self-management is a translatable treatment strategy that shows promise for treating chronic LBP in desk-bound employees.Trial registration numberNCT0224687; Pre-results.

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Motor Control Exercises, Sling Exercises, and General Exercises for Patients With Chronic Low Back Pain: A Randomized Controlled Trial With 1-Year Follow-up

Physical Therapy ◽

10.2522/ptj.20090421 ◽

2010 ◽

Vol 90 (10) ◽

pp. 1426-1440 ◽

Cited By ~ 82

Author(s):

Monica Unsgaard-Tøndel ◽

Anne Margrethe Fladmark ◽

Øyvind Salvesen ◽

Ottar Vasseljen

Keyword(s):

Randomized Controlled Trial ◽

Low Back Pain ◽

Motor Control ◽

Back Pain ◽

Outcome Measures ◽

Chronic Low Back Pain ◽

Controlled Trial ◽

Low Back ◽

Randomized Controlled

BackgroundExercise benefits patients with chronic nonspecific low back pain; however, the most effective type of exercise remains unknown.ObjectiveThis study compared outcomes after motor control exercises, sling exercises, and general exercises for low back pain.DesignThis was a randomized controlled trial with a 1-year follow-up.SettingThe study was conducted in a primary care setting in Norway.PatientsThe participants were patients with chronic nonspecific low back pain (n=109).InterventionsThe interventions in this study were low-load motor control exercises, high-load sling exercises, or general exercises, all delivered by experienced physical therapists, once a week for 8 weeks.MeasurementsThe primary outcome measure was pain reported on the Numeric Pain Rating Scale after treatment and at a 1-year follow-up. Secondary outcome measures were self-reported activity limitation (assessed with the Oswestry Disability Index), clinically examined function (assessed with the Fingertip-to-Floor Test), and fear-avoidance beliefs after intervention.ResultsThe postintervention assessment showed no significant differences among groups with respect to pain (overall group difference) or any of the outcome measures. Mean (95% confidence interval) group differences for pain reduction after treatment and after 1 year were 0.3 (−0.7 to 1.3) and 0.4 (−0.7 to 1.4) for motor control exercises versus sling exercises, 0.7 (−0.6 to 2.0) and 0.3 (−0.8 to 1.4) for sling exercises versus general exercises, and 1.0 (−0.1 to 2.0) and 0.7 (−0.3 to 1.7) for motor control exercises versus general exercises.LimitationsThe nature of the interventions made blinding impossible.ConclusionsThis study gave no evidence that 8 treatments with individually instructed motor control exercises or sling exercises were superior to general exercises for chronic low back pain.

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Standardized versus Individualized Acupuncture for Chronic Low Back Pain: A Randomized Controlled Trial

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2013/125937 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 13

Author(s):

Daniel Pach ◽

Xiaoli Yang-Strobel ◽

Rainer Lüdtke ◽

Stephanie Roll ◽

Katja Icke ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Acupuncture Treatment ◽

Controlled Trial ◽

Area Under The Curve ◽

Medical Doctor ◽

Low Back ◽

Single Center ◽

Randomized Controlled

We aimed to compare the effectiveness of standardized and individualized acupuncture treatment in patients with chronic low back pain. A single-center randomized controlled single-blind trial was performed in a general medical practice in Germany run by a Chinese-born medical doctor trained in western and Chinese medicine. One hundred and fifty outpatients with chronic low back pain were randomly allocated to two groups (78 standardized and 72 individualized acupuncture). Patients received either standardized acupuncture or individualized acupuncture. Treatment encompassed between 10 and 15 treatments based on individual symptoms with two treatments per week. The main outcome measure was the area under the curve (AUC) summarizing eight weeks of daily rated pain severity measured with a visual analogue scale (0 mm = no pain, 100 mm = worst imaginable pain). No significant differences between groups were observed for the AUC (individualized acupuncture mean: 1768.7 (95% CI, 1460.4; 2077.1); standardized acupuncture 1482.9 (1177.2; 1788.7); group difference, 285.8 (−33.9; 605.5)P=0.080). In this single-center trial, individualized acupuncture was not superior to standardized acupuncture for patients suffering from chronic pain. As a next step, a multicenter noninferiority study should be performed to investigate whether standardised acupuncture treatment for chronic low back pain might be applicable in a broader usual care setting. This trial is registered with ClinicalTrials.govNCT00758017.

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