Objectives: Although acupuncture has been frequently used for acute nonspecific low back pain (LBP), relevant systematic reviews indicate sparse and inconclusive evidence. This systematic review aimed at critically evaluating the evidence for/against acupuncture for acute LBP.
Methods: We searched Medline, Central, Embase, 2 Chinese databases, relevant journals, and trial registries for the randomized-controlled trials of acupuncture that involved needling for acute/subacute LBP. Risk of bias was assessed using the assessment tool from the Cochrane Back Review Group and the adequacy of acupuncture intervention was evaluated by 2 independent reviewers. The studies according to the control types were combined using a random-effects model.
Results: A total of 11 randomized-controlled trials (n=1139) were included. Compared with nonsteroidal anti-inflammatory drugs, acupuncture may more effectively improve symptoms of acute LBP (5 studies; risk ratio, 1.11; 95% confidence interval: 1.06, 1.16). For pain, there exists inconsistent evidence that acupuncture is more effective than medication. Compared with sham acupuncture, acupuncture may more effectively relieve pain (2 studies; mean difference, −9.38; 95% confidence interval: −17.00, −1.76) but not function/disability. Acupuncture appears to be associated with few side effects but the evidence is limited.
Discussion: The current evidence is encouraging in that acupuncture may be more effective than medication for symptom improvement or relieve pain better than sham acupuncture in acute LBP. The present findings should be confirmed by future studies that overcome the methodological limitations of the studies evaluated in our review.
*Department of Oriental Rehabilitation Medicine, College of Korean Medicine
‡Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul
†Division of Standard Research, Korea Institute of Oriental Medicine, Daejeon
§School of Korean Medicine, Pusan National University, Yangsan, Korea
Supported by Basic Science Research Program through the National Research Foundation of Korea, Daejeon, funded by the Korean Ministry of Education, Science and Technology, Seoul (No. 2005-0049404). The authors declare no conflict of interest.
Reprints: Hyangsook Lee, KMD, PhD, Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Hoegi-dong, Dongdaemun-gu, Seoul, 130-701, Korea (e-mail: firstname.lastname@example.org).
Received August 7, 2011
Accepted December 30, 2011