Effectiveness of Acupuncture for Nonspecific Chronic Low Back Pain: A Systematic Review and Meta-analysis

@article{Lam2013EffectivenessOA,
  title={Effectiveness of Acupuncture for Nonspecific Chronic Low Back Pain: A Systematic Review and Meta-analysis},
  author={Megan Lam and Rose Galvin and Philip Curry},
  journal={Spine},
  year={2013},
  volume={38},
  pages={2124–2138}
}
Study Design. A systematic review and meta-analysis of randomized controlled trials (RCTs). Objective. To evaluate the totality of evidence in relation to the effectiveness of acupuncture for nonspecific chronic low back pain (NSCLBP). Summary of Background Data. Acupuncture has become a popular alternative for treating clinical symptoms of NSCLBP. A number of RCTs have examined the effectiveness of acupuncture in the treatment of NSCLBP. Methods. A systematic literature search was completed… 
Effectiveness of Acupuncture for Nonspecific Chronic Low Back Pain: A Systematic Review and Meta-Analysis.
TLDR
Both the systematic review and meta-analysis demonstrate that acupuncture as an adjunct to standard therapy is a safe and effective method in reducing pain and disability among adults with NScLBP.
Acupuncture for Low Back Pain: An Overview of Systematic Reviews
TLDR
Systematic reviews of variable quality showed that acupuncture, either used in isolation or as an adjunct to conventional therapy, provides short-term improvements in pain and function for chronic LBP.
Can Acupuncture Improve Chronic Spinal Pain? A Systematic Review and Meta-Analysis
TLDR
Compared to no treatment, sham acupuncture, or conventional therapy such as medication, massage, and physical exercise, acupuncture has a significantly superior effect on the reduction in chronic spinal pain and function improvement.
Evidence of efficacy of acupuncture in the management of low back pain: a systematic review and meta-analysis of randomised placebo- or sham-controlled trials
TLDR
There is moderate evidence of efficacy for acupuncture in terms of pain reduction immediately after treatment for NSLBP ((sub)acute and chronic) when compared to sham or placebo acupuncture.
Acupuncture for the Relief of Chronic Pain: A Synthesis of Systematic Reviews
TLDR
It is suggested that an enriched enrolment with randomised withdrawal design may overcome some of these methodological shortcomings of RCTs and improve the quality of evidence so that healthcare providers and commissioners can make informed choices on the interventions which can legitimately be provided to patients living with chronic pain.
The persistence of the effects of acupuncture after a course of treatment: a meta-analysis of patients with chronic pain
TLDR
The effects of a course of acupuncture treatment for patients with chronic pain do not seem to decrease importantly over 12 months and studies of the cost-effectiveness of acupuncture should take these findings into account when considering the time horizon of acupuncture effects.
Acupuncture for chronic nonspecific low back pain.
TLDR
Moderate-certainty evidence was found that acupuncture may relieve pain in the immediate term (up to seven days) compared to sham intervention, and low- Certainty evidence that acupuncture seemed not to be more effective clinically in the short term for quality of life.
The role of acupuncture in managing overactive bladder; a review of the literature
TLDR
Existing studies serve as a promising foundation for suggesting a role for acupuncture as an alternative therapy for OAB, although further well-designed studies are required to investigate optimal technique and their outcomes.
...
...

References

SHOWING 1-10 OF 10 REFERENCES
The effectiveness of acupuncture in treating chronic non-specific low back pain: a systematic review of the literature
TLDR
Some evidence is provided to support acupuncture as more effective than no treatment, but no conclusions can be drawn about its effectiveness over other treatment modalities as the evidence is conflicting.
A randomised controlled trial of acupuncture care for persistent low back pain: cost effectiveness analysis
TLDR
A short course of traditional acupuncture for persistent non-specific low back pain in primary care confers a modest health benefit for minor extra cost to the NHS compared with usual care.
How might acupuncture work? A systematic review of physiologic rationales from clinical trials
  • H. Moffet
  • Medicine
    BMC complementary and alternative medicine
  • 2006
TLDR
Many acupuncture trials fail to offer a meaningful rationale, but proposing a rationale can help investigators to develop and test a causal hypothesis, choose an appropriate control and rule out placebo effects.
Sham acupuncture may be as efficacious as true acupuncture: a systematic review of clinical trials.
  • H. Moffet
  • Medicine, Biology
    Journal of alternative and complementary medicine
  • 2009
TLDR
The findings cast doubt on the validity of traditional acupuncture theories about point locations and indications, and the theoretical basis for traditional acupuncture practice needs to be re-evaluated.
The use of electro-acupuncture in conjunction with exercise for the treatment of chronic low-back pain.
TLDR
This study indicates that the combination of electro-acupuncture and back exercise might be an effective option in the treatment of pain and disability associated with chronic LBP.
Randomised controlled trial of a short course of traditional acupuncture compared with usual care for persistent non-specific low back pain
TLDR
Weak evidence was found of an effect of acupuncture on persistent non-specific low back pain at 12 months, but stronger evidence of a small benefit at 24 months, and Referral to a qualified traditional acupuncturist for a short course of treatment seems safe and acceptable to patients with low backPain.
Outcome Measures for Low Back Pain Research: A Proposal for Standardized Use
TLDR
An international group of back pain researchers considered recommendations for standardized measures in clinical outcomes research in patients with back pain and recommended a short, 6‐item questionnaire and a somewhat expanded, more precise battery of questionnaires, which would facilitate scientific advances in clinical care.
Superficial acupuncture in the relief of chronic low back pain.
TLDR
A single-blind, randomised, placebo-controlled trial of superficial acupuncture in the treatment of low back pain showed significant superiority of acupuncture over placebo.
Outcome of low back pain in general practice: a prospective study
TLDR
A large population based study examined the outcome of episodes of low back pain in general practice with respect to both consultation behaviour and self reported pain and disability and results are consistent with the interpretation that 90% of patients with low backPain in primary care will have stopped consulting with symptoms within three months.
The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials
TLDR
The Cochrane Collaboration’s tool for assessing risk of bias aims to make the process clearer and more accurate.