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Acupuncture for Chronic Low Back Pain: A Randomized Placebo-Controlled Study With Long-Term Follow-Up

Carlsson, Christer P. O. M.D., Ph.D.; Sjölund, Bengt H. M.D., Ph.D.

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Objective The authors sought to determine whether a series of needle acupuncture treatments produced long-term relief of chronic low back pain.

Design A blinded placebo-controlled study with an independent observer. The patients were randomized to receive manual acupuncture, electroacupuncture, or active placebo (mock transcutaneous electrical nerve stimulation). Subjects were examined and monitored by an investigator who was blinded to the treatment given.

Setting A tertiary-level pain clinic at a Swedish university hospital.

Patients Fifty consecutive patients (33 women, 17 men; mean age, 49.8 years) with chronic low back pain (mean pain duration, 9.5 years) and without rhizopathy or history of acupuncture treatment were included in the study.

Interventions Treatments were given once per week for 8 weeks. Two further treatments were given during the follow-up assessment period of 6 months or longer.

Outcome Measures The independent observer made a global assessment of the patients 1, 3, and 6 months after treatment. The patients kept pain diaries to score pain intensity twice daily, analgesic intake, and quality of sleep daily, and activity level weekly.

Results At the 1-month independent assessment, 16 of 34 patients in the acupuncture groups and 2 of 16 patients in the placebo group showed improvement (p <0.05). At the 6-month follow-up assessment, 14 of 34 patients in the acupuncture groups and 2 of 16 patients in the placebo group showed improvement (p <0.05). A significant decrease in pain intensities occurred at 1 and 3 months in the acupuncture groups compared with the placebo group. There was a significant improvement in return to work, quality of sleep, and analgesic intake in subjects treated with acupuncture.

Conclusions The authors found a long-term pain-relieving effect of needle acupuncture compared with true placebo in some patients with chronic nociceptive low back pain.

Department of Rehabilitation, Lund University Hospital, Lund, Sweden

Received January 24, 2001;

revised August 29, 2001; accepted August 31, 2001.

Supported in part by grant No. 05658 from the Swedish Medical Research Council project (to B.S.).

Address correspondence and reprint requests to Dr. Christer P. O. Carlsson, Physical Medicine Unit, Department of Rehabilitation, Lund University Hospital, S-221 85 Lund, Sweden; e-mail: akusyd@swipnet.se

© 2001 Lippincott Williams & Wilkins, Inc.