Acupuncture and dry-needling for low back pain (Review)

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Coan 1980 Methods Participants Interventions Outcomes Notes -Randomization was carried out by having prepared in advance a small box with 50 identically-sized pieces of paper, folded so that they could not be read. 25 had A and 25 had B written on them. The box was shaken and one of the pieces of paper was removed from the box blindly. -Nobody was blinded -Funding: National Health and Medical Research Council of Australia -Setting: Acupuncture Center in Maryland, USA -Informed consent: ? -Ethics approval:? -All patients were followed -Analysis: Adherers (or “per protocol analysis”). 50 patients recruited via newspapers with low-back pain for at least 6 months Diagnoses: Abnormal X-ray (38/43), Sciatica (27/49), Muscle spasm (36/46) Inclusion criteria: no previous acupuncture treatments, no history of diabetes, infection or cancer, and not more than 2 back surgeries Mean age: 47 years old (range 18 to 67) 23 males and 27 females Working status:? Previous treatments: back surgery (4) 1) Acupuncture: Classical Oriental meridian theory. Electrical acupuncture in some patients. Selection of acupuncture loci varied. ’Acknowledged acupuncturists’. 10 or more sessions, approximately 10 weeks. Teh chi unclear. Randomized to this group: 25 2) Waiting list, no treatment for 15 weeks. Then they received the same acupuncture treatment as above. Randomized to this group: 25 1) Pain: Mean pain scores (0=no pain and 10=worst pain) 2) Function: Mean limitation of activity (0=none and 3=severe) 3) Mean pain pills per week 4) Global improvement (improved, same, worse) Results after 10 weeks in acupuncture and after 15 weeks in waiting list group Costs: not reported Complications: not reported The authors reported a per protocol analysis. However, because there is individual patient data reported in the article, we were able to recalculate using the intention-to-treat principle Language: English Publication: full paper Additional information from authors: no For results, see the comparisons: 4.1 4.2 4.4 4.5 Conclusions: “This study demonstrated that acupuncture was a superior form of treatment for these people with low-back pain, even though they had the condition for an average of 9 years” Acupuncture and dry-needling for low back pain (Review) Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 26
Ding 1998 Methods Participants Interventions Outcomes Notes - Randomized (method not described). No mention of concealment of allocation. -Patients blinded -Funding: not reported -Setting: University in GuangZhou, China -Informed consent: Not reported -Ethics approval: Not reported -All patients were followed -Analysis: chi-squares between groups 54 patients with chronic low-back pain, frequent recurrence, worse during work and relief with rest Diagnosis: chronic low-back pain. Excluded: specific pathological entities using lab tests and x-rays Mean age: 45 years old in the ancient needling technique and 42 in regular needling technique group (range 19-68) 40 males and 14 females Working status: ? Previous treatments: ? 1) Ancient needling technique “The turtle exploring the holes”. Major points: GV3, Ashi point(s). Supplement points: BL40. Needles 0.38 mm X 75 mm were used for deeper insertion and to different direction in 45 degree angle. Strong Teh chi sensation was obtained. The needles were retained for 40 to 50 minutes. Treatments were given daily up to 10 treatments. Randomized to this group: 35 2) Regular needling technique. Needles 0.38 mm X 75 mm were used for deeper perpendicular insertion with twirling or rotating technique was used until strong Teh Chi sensation was acquired. Needle retaining was 20 minutes with 3 to 4 times twirling or rotating stimulation in between. Treatments were given daily for up to 10 days. Randomized to this group: 19 1. Pain on a 4-point scale: “cure”: no pain for 2 months; “marked effective”: pain markedly improved; “improved”: pain is somewhat relieved; and “no change”. Measured immediately after and 2 months after the end of the sessions Costs: Not reported Complications: Not reported Language: Chinese Publication: full paper No additional information from authors For results, see the other data table: 7.3 Conclusions: “An ancient needling technique is better than the regular needling technique in treating chronic low back pain” Acupuncture and dry-needling for low back pain (Review) Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 27
Page 1 and 2: Acupuncture and dry-needling for lo
Page 3 and 4: Analysis 5.2. Comparison 5 acupunct
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5 physical examination 1 Mean Diffe
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Analysis 1.2. Comparison 1 acupunct
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Analysis 5.10. sick leave Compariso
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Analysis 5.14. Comparison 5 acupunc
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pain and function (adjusted for bas
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Review: Analysis 7.2. Comparison 7
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Analysis 10.3. Comparison 10 acupun
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improvement (Continued) Li 1997 Imp
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Table 2. Methodological quality ass
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Table 2. Methodological quality ass
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Table 3. Clinical relevance assessm
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Table 4. Improvement in pain Compar
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Table 5. Adequacy of acupuncture (C
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Table 5. Adequacy of acupuncture (C
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20 factorial$.ti,ab. (2463) 21 foll
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(Continued) 30 October 2004 New cit
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Acupuncture and dry-needling for low back pain (Review)

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